Regulatory Approval

GlaxoSmithKline PLC 11 October 2002 Issued - Friday 11 October 2002, London, UK FDA Approves GlaxoSmithKline's AvandametTM for The Treatment Of Type 2 Diabetes GlaxoSmithKline, plc (GSK) announced today that the U.S. Food and Drug Administration (FDA) approved AvandametTM (rosiglitazone maleate and metformin HCI) for the treatment of type 2 diabetes. Avandamet is the first treatment to combine AvandiaTM (rosiglitazone), a medication that directly targets insulin resistance, a major underlying cause of type 2 diabetes, with a leading oral diabetes therapy, metformin, in one convenient pill. This combination offers the opportunity to help people manage their type 2 diabetes longer1. As an adjunct to diet and exercise, Avandamet is indicated to improve blood sugar control in people with type 2 diabetes who are already treated with rosiglitazone and metformin as separate tablets or who are not adequately controlled on metformin alone. Avandamet will be commercially available in the U.S. in approximately one month. "The approval of Avandamet represents a significant opportunity for our diabetes franchise, and we intend to realise the full potential of this exciting new combination product. One pill combining Avandia and metformin is designed to offer an effective, convenient treatment option for people suffering from uncontrolled type 2 diabetes," said J.P. Garnier, chief executive officer of GlaxoSmithKline. Type 2 diabetes affects an estimated 16 million Americans and 150 million people worldwide. The disease is characterised by high blood sugar levels that occur when the body cannot make enough insulin and/or respond normally to the natural insulin it makes (a condition called insulin resistance).2 In patients with type 2 diabetes, beta cells (the cells that make and release insulin in the pancreas) may become overworked and eventually fail, producing less insulin. This may lead to increased blood sugar levels and progressive worsening of the disease. When blood sugar levels are elevated over an extended period of time, serious complications can result, including cardiovascular disease, kidney damage and blindness.2 To reach blood sugar levels recommended by experts, many people with type 2 diabetes will need to take a combination of therapies that treat the disease in different ways.3 According to the UK Prospective Diabetes Study (UKPDS), approximately half of all patients on monotherapy will require multiple drugs to control the disease within three years.4 "The combination of rosiglitazone and metformin provides two different, yet complementary mechanisms of action to manage diabetes," said Barry Goldstein, M.D. Ph.D., Director, Division of Endocrinology, Diabetes and Metabolic Diseases, Jefferson Medical College of Thomas Jefferson University, Philadelphia. "Rosiglitazone targets insulin resistance, an underlying cause of type 2 diabetes, whereas metformin works to reduce the amount of blood sugar (or glucose) produced by the liver. The two medications, when used in combination, target core metabolic defects to help achieve better blood sugar control than metformin alone, making this an important option for patients with type 2 diabetes." Safety Information A small number of people who have taken metformin, one of the components of Avandamet, have developed a serious yet rare condition called lactic acidosis (a build up of lactic acid in the blood). Lactic acidosis occurs most often in people with kidney problems and can be fatal in up to half of the cases. In addition, rosiglitazone (another component of Avandamet) may cause fluid retention, especially if it is used with insulin. If left unchecked, fluid retention could lead to or worsen heart failure. Avandamet is not indicated for use with insulin. Avandamet should not be used in patients with renal disease or dysfunction or with congestive heart failure requiring medication. Before using Avandamet, patients over the age of 80 should have their renal function tested to assure that their kidney function is adequate. Avandamet is not recommended for people with liver disease. Patients should inform their doctor if they drink alcohol excessively. Tests should be conducted before and while taking Avandamet to check for liver problems. About GlaxoSmithKline GlaxoSmithKline is one of the world's leading research-based pharmaceutical and health care companies. GlaxoSmithKline is committed to improving the quality of human life by enabling people to do more, feel better and live longer. Notes to Non-US Editors Only For further information on Avandamet, Avandia and/or diabetes, please log onto www.diabetespressoffice.com Enquiries: UK Media enquiries: Martin Sutton (020) 8047 5502 Alan Chandler (020) 8047 5502 Siobhan Lavelle (020) 8047 5502 US Media enquiries: Nancy Pekarek (215) 751 7709 Mary Anne Rhyne (919) 483 2839 Patricia Seif (215) 751 7709 European Analyst/Investor enquiries: Duncan Learmouth (020) 8047 5540 Philip Thomson (020) 8047 5543 Joan Toohill (020) 8047 5542 US Analyst/ Investor enquiries: Frank Murdolo (215) 751 7002 Tom Curry (215) 751 5419 References 1. GlaxoSmithKline. Avandamet Prescribing Information. 2. Groop LC. Insulin resistance: the fundamental trigger of Type 2 diabetes. Diabetes, Obesity and Metabolism 1999;1(suppl 1): S1-7. 3. The International Diabetes Federation 2001: About Diabetes Factsheet. 4. Turner RC, Cull CA, Frighi V, Holman RR. Glycemic control with diet, sulfonylurea, metformin, or insulin in patients with type 2 diabetes mellitus. Progressive requirement for multiple therapies (UKPDS 49). JAMA 1999; 281: 2005-2012. This information is provided by RNS The company news service from the London Stock Exchange

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