New Data Demonstrate Benefits of Aranesp(R) Dosed Every Two Weeks in European Haemodialysis Patients With CKD-Related Anaemia



    Studies Show Patients Switched to Every-Two-Week Dosing With
    Aranesp Achieve Stable Haemoglobin Levels and
    Receive Fewer Injections

    Amgen (Nasdaq:AMGN), the world's largest biotechnology company,
    today announced new trial results from two studies,(1)(2) showing that
    Aranesp(R) (darbepoetin alfa) administered every two weeks (Q2W) is an
    effective treatment for chronic kidney disease (CKD) anaemia patients
    in European dialysis settings. The data were presented today at the
    2006 European Renal Association - European Dialysis and Transplant
    Association Congress (ERA-EDTA). One of these studies formed the basis
    for a European Medicines Agency (EMEA) Aranesp label update in Europe
    earlier this year. This label update offers the benefit of switching
    to Aranesp Q2W from any recombinant human erythropoietin (rHuEPO)
    dosing regimen without requiring a dose increase.
    "For patients with anaemia associated with chronic kidney disease,
    achieving stable haemoglobin levels within the target range as
    recommended by the European Best Practice Guidelines is an important
    goal," said Fernando Carrera, MD, Eurodial Dialysis Clinic, Leiria,
    Portugal. "The results presented today are good news for patients and
    physicians as the Aranesp every two week dosing regimen means this
    goal can be achieved with less frequent injections. This can help to
    improve operational efficiency in dialysis centres."
    The results showed the Aranesp Q2W was as effective as Aranesp
    once weekly (QW) or other rHuEPO QW in maintaining haemoglobin (Hb)
    stability in the normal range (Hb 10-13 g/dL), with no evidence of
    overshooting Hb target or increased risk of adverse events.(1)
    "Aranesp is the only erythropoietin stimulating agent available in
    Europe that offers the treatment option of every two week IV dosing
    for all haemodialysis patients," said William Sheridan, MD, vice
    president, medical affairs, Amgen International.
    "Amgen remains committed to improving the lives of chronic kidney
    disease patients and is delighted that the EMEA has recognised the
    importance of this new data and labelling to offer a new option to the
    Aranesp dosing regimen."
    With nearly two million patients treated with Aranesp worldwide,
    Amgen continues its commitment to improving the lives of patients with
    CKD through meaningful offerings, such as label updates and an
    extensive Phase 3 clinical trials programme to study the effect of
    treating anaemia or CKD complications in different patient
    populations. At ERA-EDTA today, Amgen also announced EVOLVE
    (EValuation Of Cinacalcet HCI Therapy to Lower CardioVascular
    Events)(TM), the first international, prospective clinical outcomes
    study designed to determine whether treating secondary
    hyperparathyroidism (HPT) with Mimpara (cinacalcet HCl) can
    effectively reduce the risk of mortality and cardiovascular morbidity
    in patients undergoing maintenance dialysis. Amgen recently announced
    the initiation of the large-scale Phase 3 RED-HF (Reduction of Events
    with Darbepoetin alfa in Heart Failure) Trial(TM) that will evaluate
    the effect of treatment of anaemia with Aranesp on morbidity and
    mortality in patients with symptomatic heart failure. Amgen continues
    its ongoing TREAT (Trial to Reduce cardiovascular Events and Aranesp
    Therapy) trial in diabetic patients with CKD and anaemia not requiring
    dialysis.

    About the Phase 3 Data Presented at ERA-EDTA

    This 30-week Phase 3 multicentre, double-blind study of 308
    haemodialysis patients compared the safety and efficacy of Aranesp Q2W
    and QW following a switch from rHuEPO. (2) Patients treated with
    rHuEPO were randomised to switch to either Aranesp Q2W or Aranesp QW
    for 24 weeks, and Hb and dose were reassessed during weeks 25-30.
    Results showed that Aranesp Q2W and QW were comparable in maintaining
    Hb with no dose increase after switching from rHuEPO. Additionally,
    Aranesp Q2W was not associated with an increased frequency of Hb
    greater than 14 g/dL, a level associated with vascular risk, nor was
    there a difference in the incidence of vascular disorders or
    cerebrovascular accidents between the two arms.
    The investigators concluded that Aranesp Q2W keeps haemodialysis
    patients within their target range, with no evidence of an increase of
    overshooting Hb target or increased risk of adverse vascular events.

    Additional Aranesp Data Presented at ERA-EDTA

    In another study, 105 haemodialysis patients (41 percent female,
    mean age 64.4 years) were followed for 12 months.(1) During the first
    six months, they received Aranesp QW, and were switched to receive
    Aranesp Q2W for the second six months. The investigators found that
    switching dose regimen resulted in no significant differences in mean
    haemoglobin levels (P = 0.8) or in mean weekly dose of Aranesp (P =
    0.3). They concluded that a switch from Aranesp QW or Q2W maintained
    efficacy in stabilising Hb levels without the need for increased
    dosing.

    About CKD and Anaemia

    According to recently published research, around ten percent of
    Europeans suffer from CKD,(3) an irreversible condition characterised
    by kidney damage and impaired function that often progresses over
    time. Patients with CKD often suffer from serious complications such
    as anaemia, which occurs when failing kidneys no longer produce
    sufficient erythropoietin, a hormone that stimulates the production of
    oxygen-carrying red blood cells (RBCs). RBCs contain Hb, a red,
    iron-rich protein that carries oxygen from the lungs to all of the
    body's tissues. Oxygen provides the energy the body needs for normal
    activities. Anaemia occurs when the number of RBCs (or the Hb in them)
    falls below normal. Anaemia is defined by the World Health
    Organisation (WHO) and European Best Practice Guidelines (EBPG) as
    Hb less than 12 g/dL in women and Hb less than 13 g/dL in men.

    About Aranesp(R) (darbepoetin alfa)

    Aranesp is a recombinant erythropoietic protein (a protein that
    stimulates production of red blood cells, which carry oxygen). Amgen
    revolutionised the treatment of anaemia with the development of
    recombinant erythropoietin, Epoetin alfa. Building on this heritage,
    Amgen developed Aranesp, a unique erythropoiesis stimulating protein,
    which contains two additional sialic acid-containing carbohydrate
    chains compared to the epoetin alfa molecule and remains in the
    bloodstream longer than epoetin alfa as demonstrated by its longer
    half-life.(4)
    Aranesp was granted marketing authorisation by the European
    Commission in 2001 for the treatment of anaemia associated with
    chronic renal failure in adults and paediatric subjects 11 years of
    age or older. Approval was granted in 2004 for an extended dosing of
    up to once monthly for the treatment of anaemia in 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.
    Aranesp is contraindicated in patients with uncontrolled
    hypertension. Erythropoietic therapies may increase the risk of
    thrombotic events and other serious events.(5) The target haemoglobin
    should not exceed 14 g/dL. If the Hb increase exceeds 2.5 g/dL in any
    four-week period, dose reductions are recommended.
    Pure red cell aplasia (PRCA) caused by neutralising
    anti-erythropoietin antibodies has been reported in association with
    erythropoietin therapy. These antibodies have been shown to
    cross-react with all erythropoietic proteins, and patients suspected
    or confirmed to have neutralising antibodies to erythropoietin should
    not be switched to Aranesp.
    The most commonly reported side effects in clinical trials were
    headache, hypertension, injection site pain and thrombosis of vascular
    access.(6)

    About Amgen

    Amgen discovers, develops and delivers innovative human
    therapeutics. A biotechnology pioneer since 1980, Amgen was one of the
    first companies to realise the new science's promise by bringing safe
    and effective medicines from lab, to manufacturing plant, to patient.
    Amgen therapeutics has 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 broad and deep pipeline of potential new medicines, Amgen
    remains committed to advancing science to dramatically improve
    people's lives.

    Forward-Looking Statement

    This news release contains forward-looking statements that involve
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    December 31, 2005, and in Amgen's periodic reports on Form 10-Q and
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    -0-
    *T
    (1)Carrera F, Oliveira L, Maia P, Mendes T, Ferreira C. Aranesp
    (darbepoetin alfa) administered once every two weeks (Q2W)
    maintains recommended haemoglobin (Hb) in chronic kidney disease
    (CKD) patients on haemodialysis switched from weekly (QW) dosing.
    Abstract presented at XLIII European Renal Association's European
    Dialysis and Transfusion Association Congress (ERA-EDTA). 15-18
    July 2006; Glasgow, UK.

    (2)Locatelli F, Backs W, Del Pino MD, et al. Control of anemia with
    Aranesp(R): Hb stability achieved with fewer patients requiring
    dose adjustments after switching to Aranesp(R) every two weeks.
    Abstract presented at XLIII European Renal Association's European
    Dialysis and Transfusion Association Congress (ERA-EDTA) congress.
    15-18 July 2006; Glasgow, UK.

    (3)De Zeeuw D, Hillege HL, de Jong PE. The kidney, a cardiovascular
    risk marker, and a new target for therapy. Kidney Int Suppl 2005;
    98: S25-S29.

    (4)Macdougall IC, Gray SJ, Elston O, et al. Pharmacokinetics of novel
    erythropoiesis stimulating protein compared with epoetin alfa in
    dialysis patients. J Am Soc Nephrol 1999; 10: 2392-2395.

    (5)Aranesp summary of product information

    (6)Aranesp Prescribing Information;
    http://www.aranesp.com/pdf/aranesp_PI.pdf.
    Last accessed: 27 June 2006.
    *T