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	<title>Symptom Advice .com &#187; treatment protocol</title>
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		<title>FDA Advisory Committee Supports Proposed Clinical Trial Design to Evaluate Repeat Treatment Cycles of XIFAXAN® for Irritable Bowel Syndrome with Diarrhea</title>
		<link>http://symptomadvice.com/fda-advisory-committee-supports-proposed-clinical-trial-design-to-evaluate-repeat-treatment-cycles-of-xifaxan%c2%ae-for-irritable-bowel-syndrome-with-diarrhea/</link>
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		<pubDate>Sat, 10 Dec 2011 04:00:31 +0000</pubDate>
		<dc:creator>Symptom Advice</dc:creator>
				<category><![CDATA[colitis symptoms]]></category>
		<category><![CDATA[rifaximin]]></category>
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		<category><![CDATA[treatment protocol]]></category>

		<guid isPermaLink="false">http://symptomadvice.com/fda-advisory-committee-supports-proposed-clinical-trial-design-to-evaluate-repeat-treatment-cycles-of-xifaxan%c2%ae-for-irritable-bowel-syndrome-with-diarrhea/</guid>
		<description><![CDATA[RALEIGH, N.C.&#8211;(BUSINESS WIRE)&#8211;Salix Pharmaceuticals, &#108;&#116;&#100;. (NASDAQ:SLXP) today announced &#116;&#104;&#097;&#116; &#116;&#104;&#101; Gastrointestinal Drugs Advisory Committee of &#116;&#104;&#101; FDA supports &#116;&#104;&#101; Salix/FDA developed proposed design of &#097; clinical trial to evaluate &#116;&#104;&#101; safety, efficacy &#097;&#110;&#100; durability of response with repeat treatment cycles of XIFAXAN® (rifaximin) &#102;&#111;&#114; irritable bowel syndrome with diarrhea (IBS). “We &#097;&#114;&#101; extremely pleased with [...]]]></description>
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<p>RALEIGH, N.C.&#8211;(BUSINESS WIRE)&#8211;Salix Pharmaceuticals, &#108;&#116;&#100;. (NASDAQ:SLXP) today announced &#116;&#104;&#097;&#116; &#116;&#104;&#101; Gastrointestinal Drugs Advisory Committee of &#116;&#104;&#101; FDA supports &#116;&#104;&#101; Salix/FDA developed proposed design of &#097; clinical trial to evaluate &#116;&#104;&#101; safety, efficacy &#097;&#110;&#100; durability of response with repeat treatment cycles of XIFAXAN® (rifaximin) &#102;&#111;&#114; irritable bowel syndrome with diarrhea (IBS). </p>
<p> “We &#097;&#114;&#101; extremely pleased with &#116;&#104;&#101; Advisory Committee’s support of &#116;&#104;&#101; proposed study design elements &#102;&#111;&#114; &#097; repeat treatment protocol proposal,” commented &#098;&#105;&#108;&#108; Forbes, Executive Vice President, Medical, Research &#097;&#110;&#100; Development, Salix. “Over &#116;&#104;&#101; past several months Salix &#097;&#110;&#100; &#116;&#104;&#101; FDA have worked collaboratively to develop &#097; study proposal intended to collect prospective controlled data to support &#116;&#104;&#101; repeat &#117;&#115;&#101; of rifaximin &#105;&#110; IBS with diarrhea following &#116;&#104;&#101; recrudescence of symptoms. Following &#116;&#104;&#101; outcome of today’s meeting, &#119;&#101; &#108;&#111;&#111;&#107; forward to continuing our collaboration with &#116;&#104;&#101; FDA &#105;&#110; order to expeditiously finalize &#116;&#104;&#101; protocol &#102;&#111;&#114; &#097; multi-center, randomized, double-blind, placebo-controlled trial with IBS patients to demonstrate &#116;&#104;&#101; efficacy &#097;&#110;&#100; safety of rifaximin on repeat treatment. At this time, &#119;&#101; &#097;&#114;&#101; targeting to initiate patient enrollment &#100;&#117;&#114;&#105;&#110;&#103; &#116;&#104;&#101; first quarter of 2012, &#097;&#110;&#100; anticipate approximately 24 months &#099;&#111;&#117;&#108;&#100; be required to complete &#116;&#104;&#101; trial, file &#097; resubmission to &#116;&#104;&#101; Complete Response Letter &#097;&#110;&#100; secure an FDA &#100;&#101;&#099;&#105;&#115;&#105;&#111;&#110; regarding approval.” </p>
<p> <b>About IBS</b> </p>
<p> IBS affects approximately 15 percent<b> </b>or potentially over 40 million adults &#105;&#110; &#116;&#104;&#101; United States &#097;&#110;&#100; is &#097;&#109;&#111;&#110;&#103; &#111;&#110;&#101; of &#116;&#104;&#101; most common, chronic conditions. IBS includes altered bowel habits with bloating, abdominal pain &#097;&#110;&#100; discomfort. Irritable bowel syndrome without constipation (Non-C IBS) encompasses &#116;&#119;&#111; of &#116;&#104;&#101; most common IBS subtypes: patients with diarrhea-predominant symptoms (IBS-D) &#097;&#110;&#100; patients &#119;&#104;&#111; suffer &#102;&#114;&#111;&#109; intermittent periods of diarrhea &#097;&#110;&#100; constipation known as mixed IBS (IBS-M). &#097;&#109;&#111;&#110;&#103; &#111;&#116;&#104;&#101;&#114; contributors, &#114;&#101;&#099;&#101;&#110;&#116; science &#104;&#097;&#115; shown &#116;&#104;&#097;&#116; alterations &#105;&#110; gut flora/bacteria have been identified as &#097; potentially important contributor to &#116;&#104;&#101; pathophysiology of IBS. </p>
<p> <b>About XIFAXAN</b><b>®</b><b> (rifaximin</b>) </p>
<p> Rifaximin is &#097; gut-selective antibiotic with negligible systemic absorption &#097;&#110;&#100; broad-spectrum activity <i>in vitro</i> against both gram-positive &#097;&#110;&#100; gram-negative pathogens. Rifaximin &#104;&#097;&#115; &#097; similar tolerability profile to &#116;&#104;&#097;&#116; of placebo. </p>
<p> Rifaximin tablets 200 mg is approved &#105;&#110; over 30 countries worldwide. Alfa Wassermann S.p.&#097;. &#105;&#110; Bologna, Italy &#104;&#097;&#115; marketed rifaximin &#105;&#110; Italy &#117;&#110;&#100;&#101;&#114; &#116;&#104;&#101; trade name Normix® &#102;&#111;&#114; over 30 years. Salix acquired rights to market rifaximin &#105;&#110; North America &#102;&#114;&#111;&#109; Alfa Wassermann. </p>
<p> <b>About XIFAXAN</b><b>®</b><b> (rifaximin) 550 mg tablets</b> </p>
<p> <i><b>Important Safety Information</b></i> </p>
<p> XIFAXAN 550 mg is &#105;&#110;&#100;&#105;&#099;&#097;&#116;&#101;&#100; &#102;&#111;&#114; reduction &#105;&#110; risk of overt hepatic encephalopathy (HE) recurrence &#105;&#110; patients ? 18 years of age. &#105;&#110; &#116;&#104;&#101; trials of XIFAXAN &#102;&#111;&#114; HE, 91 percent of &#116;&#104;&#101; patients were &#117;&#115;&#105;&#110;&#103; lactulose concomitantly. XIFAXAN &#104;&#097;&#115; not been studied &#105;&#110; patients with MELD scores greater &#116;&#104;&#097;&#110; 25, &#097;&#110;&#100; only 8.6 percent of patients &#105;&#110; &#116;&#104;&#101; controlled trial had MELD scores over 19. There is increased systemic exposure &#105;&#110; patients with &#109;&#111;&#114;&#101; severe hepatic dysfunction. &#116;&#104;&#101;&#114;&#101;&#102;&#111;&#114;&#101;, caution &#115;&#104;&#111;&#117;&#108;&#100; be exercised when administering XIFAXAN to patients with severe hepatic impairment (Child-Pugh C). </p>
<p> XIFAXAN is contraindicated &#105;&#110; patients with &#097; hypersensitivity to rifaximin, &#097;&#110;&#121; of &#116;&#104;&#101; rifamycin antimicrobial agents, or &#097;&#110;&#121; of &#116;&#104;&#101; components &#105;&#110; XIFAXAN. Hypersensitivity reactions have included exfoliative dermatitis, angioneurotic edema &#097;&#110;&#100; anaphylaxis. </p>
<p> <i>Clostridium difficile</i>-associated diarrhea (CDAD) &#104;&#097;&#115; been reported with &#117;&#115;&#101; of nearly &#097;&#108;&#108; antibacterial agents, including XIFAXAN &#097;&#110;&#100; may range &#105;&#110; severity &#102;&#114;&#111;&#109; mild diarrhea to fatal colitis. Treatment with antibacterial agents alters &#116;&#104;&#101; normal flora of &#116;&#104;&#101; colon which may lead to overgrowth of <i>C. difficile</i>. &#105;&#102; CDAD is suspected or confirmed, ongoing antibiotic &#117;&#115;&#101; not directed against <i>C. difficile</i> may need to be discontinued. </p>
<p> &#116;&#104;&#101; most common adverse reactions occurring &#105;&#110; greater &#116;&#104;&#097;&#110; eight percent of patients &#105;&#110; &#116;&#104;&#101; clinical study were edema peripheral (15 percent), nausea (14 percent), dizziness (13 percent), fatigue (12 percent), ascites (11 percent), muscle spasms (nine percent), pruritus (nine percent) &#097;&#110;&#100; abdominal pain (nine percent). </p>
<p> <b>About XIFAXAN</b><b>®</b><b> (rifaximin</b>) <b>200 mg tablets</b> </p>
<p> Rifaximin is &#097; gut-selective antibiotic with negligible systemic absorption &#097;&#110;&#100; broad-spectrum activity <i>in vitro</i> against both Gram-positive &#097;&#110;&#100; Gram-negative pathogens. Rifaximin &#104;&#097;&#115; &#097; similar tolerability profile to &#116;&#104;&#097;&#116; of placebo. </p>
<p> Rifaximin tablets 200 mg, which Salix markets &#105;&#110; &#116;&#104;&#101; U.S. &#117;&#110;&#100;&#101;&#114; &#116;&#104;&#101; trade name XIFAXAN® (rifaximin) tablets 200 mg, &#099;&#117;&#114;&#114;&#101;&#110;&#116;&#108;&#121; is approved &#102;&#111;&#114; &#116;&#104;&#101; treatment of patients, 12 years of age or older, with travelers&#8217; diarrhea (TD) caused by non–invasive strains of <i>Escherichia coli</i>. XIFAXAN &#115;&#104;&#111;&#117;&#108;&#100; not be &#117;&#115;&#101;&#100; &#105;&#110; patients with diarrhea complicated by fever or blood &#105;&#110; &#116;&#104;&#101; stool or diarrhea due to pathogens &#111;&#116;&#104;&#101;&#114; &#116;&#104;&#097;&#110; <i>Escherichia coli</i>. XIFAXAN &#115;&#104;&#111;&#117;&#108;&#100; be discontinued &#105;&#102; diarrhea symptoms &#103;&#101;&#116; worse or persist &#109;&#111;&#114;&#101; &#116;&#104;&#097;&#110; 24–48 hours, &#097;&#110;&#100; alternative antibiotic therapy &#115;&#104;&#111;&#117;&#108;&#100; be considered. &#105;&#110; clinical trials, XIFAXAN was generally well-tolerated. &#116;&#104;&#101; most common &#115;&#105;&#100;&#101; effects (versus placebo) were flatulence 11.3 percent (versus 19.7 percent), headache 9.7 percent (versus 9.2 percent), abdominal pain 7.2 percent (versus 10.1 percent) &#097;&#110;&#100; rectal tenesmus 7.2 percent (versus 8.8 percent). </p>
<p> Rifaximin &#104;&#097;&#115; been &#117;&#115;&#101;&#100; &#105;&#110; Italy &#102;&#111;&#114; 24 years &#097;&#110;&#100; is approved &#105;&#110; 33 countries. Salix acquired rights to market rifaximin &#105;&#110; North America &#102;&#114;&#111;&#109; Alfa Wassermann S.p.&#097;. &#105;&#110; Bologna, Italy. Alfa Wassermann markets rifaximin &#105;&#110; Italy &#117;&#110;&#100;&#101;&#114; &#116;&#104;&#101; trade name Normix®. </p>
<p> <b>About Salix</b> </p>
<p> Salix Pharmaceuticals, &#108;&#116;&#100;., headquartered &#105;&#110; Raleigh, North Carolina, develops &#097;&#110;&#100; markets prescription pharmaceutical products &#102;&#111;&#114; &#116;&#104;&#101; prevention &#097;&#110;&#100; treatment of gastrointestinal diseases. Salix’s strategy is to in-license late-stage or marketed proprietary therapeutic drugs, complete &#097;&#110;&#121; required development &#097;&#110;&#100; regulatory submission of &#116;&#104;&#101;&#115;&#101; products, &#097;&#110;&#100; market &#116;&#104;&#101;&#109; &#116;&#104;&#114;&#111;&#117;&#103;&#104; &#116;&#104;&#101; Company’s gastroenterology specialty sales &#097;&#110;&#100; marketing team. </p>
<p> Salix also markets OSMOPREP® (sodium phosphate monobasic monohydrate, USP &#097;&#110;&#100; sodium phosphate dibasic anhydrous, USP) Tablets, VISICOL® (sodium phosphate monobasic monohydrate, USP, &#097;&#110;&#100; sodium phosphate dibasic anhydrous, USP) Tablets, APRISO™ (mesalamine) extended-release capsules 0.375 g, METOZOLV® ODT (metoclopramide HCl), RELISTOR® (methylnaltrexone bromide) Subcutaneous Injection, PEPCID® (famotidine) &#102;&#111;&#114; Oral Suspension, Oral Suspension DIURIL® (Chlorothiazide), AZASAN® (Azathioprine) Tablets, USP, 75/100 mg, ANUSOL-HC® 2.5% (Hydrocortisone Cream, USP), ANUSOL-HC® 25 mg Suppository (Hydrocortisone Acetate), PROCTOCORT® Cream (Hydrocortisone Cream, USP) 1% &#097;&#110;&#100; PROCTOCORT® Suppository (Hydrocortisone Acetate Rectal Suppositories) 30 mg. Crofelemer, budesonide foam, RELISTOR®, Lumacan® &#097;&#110;&#100; rifaximin &#102;&#111;&#114; additional indications &#097;&#114;&#101; &#117;&#110;&#100;&#101;&#114; development. </p>
<p> &#102;&#111;&#114; &#102;&#117;&#108;&#108; prescribing information &#097;&#110;&#100; important safety information on Salix products, including BOXED WARNINGS &#102;&#111;&#114; VISICOL, OSMOPREP &#097;&#110;&#100; METOZOLV, please visit salix.com where &#116;&#104;&#101; Company promptly posts press releases, SEC filings &#097;&#110;&#100; &#111;&#116;&#104;&#101;&#114; important information or contact &#116;&#104;&#101; Company at 919 862-1000. </p>
<p> Salix trades on &#116;&#104;&#101; NASDAQ Global Select Market &#117;&#110;&#100;&#101;&#114; &#116;&#104;&#101; ticker symbol “SLXP.” </p>
<p> &#102;&#111;&#114; &#109;&#111;&#114;&#101; information, please visit our Website at salix.com or contact &#116;&#104;&#101; Company at 919-862-1000. Follow &#117;&#115; on Twitter (@SalixPharma) &#097;&#110;&#100; Facebook (facebook.com/SalixPharma). Information on our web site is not incorporated &#105;&#110; our SEC filings. </p>
<p> <i>Please Note: &#116;&#104;&#101; materials &#112;&#114;&#111;&#118;&#105;&#100;&#101;&#100; &#104;&#101;&#114;&#101;&#105;&#110; &#099;&#111;&#110;&#116;&#097;&#105;&#110; projections &#097;&#110;&#100; &#111;&#116;&#104;&#101;&#114; forward–looking statements regarding future events. &#115;&#117;&#099;&#104; statements &#097;&#114;&#101; &#106;&#117;&#115;&#116; predictions &#097;&#110;&#100; &#097;&#114;&#101; subject to risks &#097;&#110;&#100; uncertainties &#116;&#104;&#097;&#116; &#099;&#111;&#117;&#108;&#100; &#099;&#097;&#117;&#115;&#101; &#116;&#104;&#101; actual events or results to differ materially. &#116;&#104;&#101;&#115;&#101; risks &#097;&#110;&#100; uncertainties include, &#097;&#109;&#111;&#110;&#103; others: &#116;&#104;&#101; cost, timing &#097;&#110;&#100; results of clinical trials &#097;&#110;&#100; &#111;&#116;&#104;&#101;&#114; development activities involving pharmaceutical products; generic &#097;&#110;&#100; &#111;&#116;&#104;&#101;&#114; competition &#105;&#110; an increasingly global industry; litigation &#097;&#110;&#100; &#116;&#104;&#101; possible impairment of, or inability to obtain, intellectual property rights &#097;&#110;&#100; &#116;&#104;&#101; costs of obtaining &#115;&#117;&#099;&#104; rights &#102;&#114;&#111;&#109; &#116;&#104;&#105;&#114;&#100; parties &#105;&#110; an increasingly global industry; &#116;&#104;&#101; unpredictability of &#116;&#104;&#101; duration &#097;&#110;&#100; results of regulatory review of &#110;&#101;&#119; Drug Applications &#097;&#110;&#100; Investigational NDAs; market acceptance &#102;&#111;&#114; approved products; revenue recognition &#097;&#110;&#100; &#111;&#116;&#104;&#101;&#114; critical accounting policies; &#097;&#110;&#100; &#116;&#104;&#101; need to acquire &#110;&#101;&#119; products. &#116;&#104;&#101; reader is referred to &#116;&#104;&#101; documents &#116;&#104;&#097;&#116; &#116;&#104;&#101; Company files &#102;&#114;&#111;&#109; time to time with &#116;&#104;&#101; Securities &#097;&#110;&#100; Exchange Commission.</i> </p></p>
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