Amgen Receives Proposal for Amending EU Prescribing Information for Aranesp(R)



    Amgen (NASDAQ:AMGN) today announced that the European Medicines
    Agency's (EMEA) Committee for Medicinal Products for Human Use (CHMP)
    has communicated to Marketing Authorization Holders (MAHs) of epoetins
    a proposal for amending prescribing information for Erythropoiesis
    Stimulating Agents (ESAs) in the European Union, including Aranesp(R)
    (darbepoetin alfa).

    The CHMP's proposal includes:

    -- Amending the Summaries of Product Characteristics (SmPCs) for
    all approved ESAs to stipulate a uniform target hemoglobin
    range for all epoetins of 10 g/dL to 12 g/dL with guidance to
    avoid sustained hemoglobin levels above 12 g/dL.

    -- Providing guidance for dosage adjustments to maintain
    hemoglobin concentration between 10-12 g/dL.

    -- Amending the Special Warnings to explain that trials have
    shown an unexplained excess mortality in association with high
    target hemoglobin concentrations (greater than 12 g/dL).

    -- Amending the Special Warnings to say that epoetins have not
    been shown to improve overall survival or the risk of tumor
    progression in patients with anemia associated with cancer.

    -- Amending the therapeutic indication for chronic renal failure
    (CRF) from "treatment of anemia associated with CRF" to
    "treatment of symptomatic anemia associated with CRF" in adult
    and pediatric patients.

    The proposed amendments are not final and Amgen will continue
    discussions with EMEA to finalize the language and update product
    labeling accordingly. Over the coming weeks Amgen will also advise
    prescribing health care professionals of the appropriate changes in
    the form of a Dear Health Care Professional (DHCP) Letter. Final
    approved prescribing information is expected in early 2008.

    About Aranesp

    Aranesp was granted marketing authorization by the European
    Commission in 2001 for the treatment of anemia associated with chronic
    renal failure (CRF), in adults and pediatric subjects 11 years of age
    or older. In 2002, the European Commission approved Aranesp for the
    treatment of anemia in adult cancer patients receiving chemotherapy
    with solid tumors. This patient population was subsequently expanded
    in 2003 to include treatment of symptomatic anemia in adult cancer
    patients with non-myeloid malignancies receiving chemotherapy.
    Approval was granted in 2004 for extended dosing intervals of
    once-every-three-weeks in the treatment of anemia in adult cancer
    patients with non-myeloid malignancies who are receiving chemotherapy
    and up to once-per-month Aranesp administration in the treatment of
    anemia in chronic kidney disease (CKD) patients not on dialysis. In
    2006, the Aranesp label was updated to allow CKD patients on dialysis
    to switch from rHuEPO one to three times a week to Aranesp every two
    weeks. In 2007, the Aranesp label was updated to allow for treatment
    of anemia associated with CRF, in all European pediatric patients on
    dialysis or not on dialysis.

    Aranesp was approved by the U.S. Food and Drug Administration
    (FDA) in September 2001 for the treatment of anemia associated with
    CRF for patients on dialysis and patients not on dialysis. In July
    2002, the FDA approved weekly dosing of Aranesp for the treatment of
    anemia caused by concomitantly administered chemotherapy in patients
    with nonmyeloid malignancies and in March 2006, the FDA approved
    every-three-week dosing in these patients.

    Important EU Aranesp Safety Information

    Aranesp is contraindicated in patients with uncontrolled
    hypertension. Erythropoietic therapies may increase the risk of
    thrombotic and other serious events; regional guidelines should be
    referred to for target and maximum hemoglobin levels, and dose
    adjustment rules should be performed in line with regional prescribing
    information.

    The most commonly reported side effects in clinical trials were
    arthralgia, edema, injection site pain, and thromboembolic event
    reactions. Prescribers are recommended to consult regional prescribing
    information before prescribing Aranesp, including side-effects,
    precautions and contra-indications.

    Important U.S. Aranesp Safety Information

    Use the lowest dose of Aranesp(R) that will gradually increase the
    hemoglobin concentration to the lowest level sufficient to avoid the
    need for red blood cell transfusion.

    Aranesp(R) and other erythropoiesis-stimulating agents (ESAs)
    increased the risk for death and for serious cardiovascular events
    when administered to target a hemoglobin of greater than 12 g/dL

    Cancer Patients: Use of ESAs

    -- Shortened the time to tumor progression in patients with
    advanced head and neck cancer receiving radiation therapy when
    administered to target a hemoglobin of greater than 12 g/dL,

    -- Shortened overall survival and increased deaths attributed to
    disease progression at 4 months in patients with metastatic
    breast cancer receiving chemotherapy when administered to
    target a hemoglobin of greater than 12 g/dL,

    -- Increased the risk of death when administered to target a
    hemoglobin of 12 g/dL in patients with active malignant
    disease receiving neither chemotherapy or radiation therapy.
    ESAs are not indicated for this population.

    Patients receiving ESAs pre-operatively for reduction of
    allogeneic red blood cell transfusions: A higher incidence of deep
    venous thrombosis was documented in patients receiving Epoetin alfa
    who were not receiving prophylactic anticoagulation. Aranesp(R) is not
    approved for this indication.

    Aranesp is contraindicated in patients with uncontrolled
    hypertension.

    About Amgen

    Amgen discovers, develops and delivers innovative human
    therapeutics. A biotechnology pioneer since 1980, Amgen was one of the
    first companies to realize the new science's promise by bringing safe
    and effective medicines from lab, to manufacturing plant, to patient.
    Amgen therapeutics have changed the practice of medicine, helping
    millions of people around the world in the fight against cancer,
    kidney disease, rheumatoid arthritis and other serious illnesses. With
    a deep and broad pipeline of potential new medicines, Amgen remains
    committed to advancing science to dramatically improve people's lives.
    To learn more about our pioneering science and our vital medicines,
    visit www.amgen.com.

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