About Actelion

Passion for discovery • Dedication to innovation • Focus on Patients

Over 10 years ago, Drs. Martine and Jean-Paul Clozel, along with their friend and colleague Walter Fischli, made an exciting discovery: a drug that might help those with pulmonary arterial hypertension (PAH)*.

Their employer at the time, a major pharmaceutical company, decided to abandon the project. Still, the researchers were determined. They firmly believed in the potential of the medicine. And so they risked everything—laying career and personal finances on the line—to start a new company and bring this promising product to market. Actelion and the first oral medication for PAH*, Tracleer^® (bosentan), were born.

"There is something magical about discovering and developing a compound that can change someone's life," said Dr. Jean-Paul Clozel, Actelion's CEO. "It's not about faceless diseases—there are people who suffer terribly because of these diseases. At Actelion, we want to make a difference."

Nine years later, Tracleer has made a difference in the lives of over 82,000 patients around the world.¹ And Actelion has firmly cemented its role as a leading innovator in the PAH* community.

Driven by innovation

Actelion's commitment to patients with PAH* began in the 1980s, when Dr. Martine Clozel and her colleagues were the first scientists to discover an important substance in blood vessels (later named “endothelin”). They believed that blocking this substance was likely to help patients with PAH*. Their passion, commitment, and dedication laid the groundwork for the discovery of Tracleer.

Since then, Actelion has continued to pave the way in the treatment of PAH* by targeting additional therapeutic pathways.

Actelion's achievements with Tracleer

Leaders now and in the future

As part of Actelion's leadership team, Drs. Martine and Jean-Paul Clozel are still committed to science and the well-being of PAH* patients. Innovation remains the driving force behind Actelion's dedication and commitment to the PAH* community:

	Extensive ongoing research in PAH*¹
	Expanding the PAH* knowledge base with REVEAL and QuERI patient registries
	Services and support every step of the way with PAH Pathways^®

—	Ongoing patient education and support with Sure Steps^™
—	Financial assistance for eligible patients
—	Support for physician offices

To learn more, visit www.ActelionUS.com.

*INDICATION
Tracleer is indicated for the treatment of pulmonary arterial hypertension (PAH) (WHO Group 1) to improve exercise ability and to decrease clinical worsening. Studies establishing effectiveness included predominantly patients with NYHA Functional Class II-IV symptoms and etiologies of idiopathic or heritable PAH (60%), PAH associated with connective tissue diseases (21%), and PAH associated with congenital systemic-to-pulmonary shunts (18%).

Considerations for use
Patients with WHO class II symptoms showed reduction in the rate of clinical deterioration and a trend for improvement in walk distance. Physicians should consider whether these benefits are sufficient to offset the risk of liver injury in WHO class II patients, which may preclude future use as their disease progresses.

IMPORTANT SAFETY INFORMATION

Because of the risks of liver injury and birth defects, Tracleer may be prescribed and dispensed only through the Tracleer Access Program (T.A.P.), a restricted distribution program, by calling 1-866-228-3546. Only prescribers and pharmacies registered with T.A.P. may prescribe and distribute Tracleer. Tracleer may be dispensed only to patients who are enrolled in and meet all conditions of T.A.P.

Liver injury
Elevations of liver aminotransferases (ALT, AST) and liver failure have been reported with Tracleer. In a setting of close monitoring, rare cases of liver failure and unexplained hepatic cirrhosis were observed after prolonged treatment. In general, avoid using Tracleer in patients with elevated aminotransferases
(>3 × ULN). Measure liver aminotransferases prior to initiation of treatment and then monthly. Discontinue Tracleer if aminotransferase elevations are accompanied by signs or symptoms of liver dysfunction or injury or increases in bilirubin ≥2 × ULN.

Teratogenicity
Based on animal data, Tracleer is likely to cause major birth defects if used during pregnancy. Exclude pregnancy before and during treatment. To prevent pregnancy, females of childbearing potential must use 2 reliable forms of contraception during treatment and for 1 month after stopping Tracleer unless the patient has a tubal sterilization or Copper T 380A IUD or LNg 20-IUS inserted, in which case no other contraception is needed. Monthly pregnancy tests should be obtained.

CONTRAINDICATIONS
Tracleer is contraindicated with cyclosporine A, glyburide, in females who are or may become pregnant, or in patients who are hypersensitive to bosentan or any component of Tracleer.

WARNINGS AND PRECAUTIONS
In clinical trials, Tracleer caused ALT/AST elevations (>3 × ULN) in 11% of patients accompanied by elevated bilirubin in a few cases. The combination of hepatocellular injury (increases in aminotransferases of >3 × ULN) and increases in total bilirubin (≥3 × ULN) is a marker for potential serious liver injury. Liver aminotransferase levels must be measured prior to initiation of treatment and then monthly. Avoid using Tracleer in patients with moderate or severe liver impairment or elevated ALT/AST >3 × ULN.

If clinically significant fluid retention develops, with or without associated weight gain, the cause, such as Tracleer or underlying heart failure, must be determined. Patients may require treatment or Tracleer therapy may need to be discontinued.

Preclinical data and an open-label safety study (N=25) showed a decline in sperm count of ≥50% in 25% of Tracleer-treated patients after 3 or 6 months. After 6 months, sperm count remained in normal range, with no changes in sperm morphology or motility, or hormone levels. Endothelin receptor antagonists such as Tracleer may adversely affect spermatogenesis.

Treatment with Tracleer can cause a dose-related decrease in hemoglobin (Hgb) and hematocrit. Hgb should be checked after 1 and 3 months, and then every 3 months. Upon marked decrease in Hgb, determine the cause and need for specific treatment.

If signs of pulmonary edema occur, the possibility of associated pulmonary veno-occlusive disease should be considered. Tracleer should be discontinued.

ADVERSE EVENTS
In Tracleer pivotal trials, the most common adverse events occurring more often in Tracleer-treated patients than in patients taking placebo (≥2%) were respiratory tract infection, edema, hypotension, sinusitis, arthralgia, liver function test abnormal, palpitations, and anemia.

Please see full Prescribing Information, including BOXED WARNING about liver injury and pregnancy.

Data on file, Actelion Pharmaceuticals. July 2010.