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Sunday, December 6, 2015
Alnylam Reports that ALN-CC5 Achieves Up to 99 Percent Knockdown of Serum C5 and Up to 98 Percent Inhibition of Serum Hemolytic Activity with Durability Supportive of Once Monthly and Possibly Once Quarterly Subcutaneous Dose Regimen
CAMBRIDGE, Mass.--(BUSINESS WIRE)--Alnylam
Pharmaceuticals, Inc. Keppra (Levetiracetam) with free prescription (Nasdaq:ALNY), the leading RNAi therapeutics
company, announced today positive interim results from its ongoing Phase
1/2 clinical study with ALN-CC5, an investigational RNAi therapeutic
targeting complement C5 for the treatment of complement mediated
diseases. Buy Motrin (Ibuprofen) with free prescription These new
clinical data were presented at the American Society of Hematology
(ASH) 2015 Annual Meeting, held December 5 – 8 in Orlando, Florida. Buy Plavix (Clopidogrel) with free prescription New
results show that ALN-CC5 achieved up to 99 percent knockdown of serum
C5 and up to 98 percent inhibition of serum hemolytic activity, an assay
for complement activity. About Intal with no Rx In addition, ALN-CC5 administration resulted in
low levels of residual C5, which – based on comparisons from separate
studies – were at or below the estimated levels of free C5 observed at
therapeutic doses of eculizumab, an approved anti-C5 monoclonal
antibody. Cardizem (Diltiazem) without Rx The effects of ALN-CC5 were also found to be highly durable,
with C5 knockdown and complement inhibition results supporting a once
monthly and possibly a once quarterly subcutaneous dose regimen. Buy Horse Chestnut online
Importantly, ALN-CC5 was shown to be generally well tolerated, with no
clinically significant, drug-related adverse events to date. http://doctor-answers.blogspot.com/ Consistent
with previous guidance, the company remains on track to initiate dosing
by year’s end in Part C of the Phase 1/2 study, which is being conducted
in patients with paroxysmal nocturnal hemoglobinuria (PNH), and expects
to present initial results from this part of the study in mid-2016.
“We believe that these new ALN-CC5 results meet our goal of achieving
both inhibition of serum hemolytic activity at the 80% target level and
highly robust knockdown of serum C5 to residual levels at or below those
estimated – in separate studies –for free C5 at therapeutic doses of
eculizumab. We’re also very pleased with the consistency and durability
of ALN-CC5 clinical activity, which we believe supports at least a once
monthly, and possibly a once quarterly subcutaneous dose regimen,” said
Akshay Vaishnaw, M.D., Ph.D., Executive Vice President of R&D and Chief
Medical Officer of Alnylam. “With these data in hand, we’re now
transitioning our study to PNH patients, and plan to initiate dosing by
the end of this year. We look forward to presenting initial results from
this new stage of our Phase 1/2 study, including effects of ALN-CC5 on
levels of lactate dehydrogenase (LDH) – a disease marker of endogenous
red blood cell hemolysis – in mid-2016.”
“Significant progress has been made in the treatment of
complement-mediated diseases, including PNH, but we continually strive
for even further improvements for our patients. In this regard, I
believe that a new medicine providing both a consistent level of
inhibition of complement activity and infrequent subcutaneous dosing
would be a welcome addition to the treatment landscape,” said Peter
Hillmen, MB ChB, F.R.C.P., F.R.C.Path., Ph.D., Professor of Experimental
Haematology and Honorary Consultant Haematologist at Leeds Teaching
Hospitals NHS Trust, U.K. “I am encouraged by the data from this ongoing
Phase 1/2 trial, and, in particular, the results showing very low
residual levels of serum C5. If these results can be duplicated in
patients with PNH, I believe ALN-CC5 has the potential to offer a novel
therapeutic option for these patients.”
New
data were presented in a poster at ASH, and include updated data
(N=20) from the single ascending dose (SAD) cohorts, as well as initial
data (N=12) from multiple ascending dose (MAD) cohorts. Safety data are
as of a cutoff date of October 19, 2015, and clinical activity
data are as of a cutoff date of up to November 6, 2015.
Alnylam and collaborators will discuss these new clinical results with
ALN-CC5 at the company’s upcoming R&D Day, to be held on Thursday,
December 10, 2015, at the Sofitel New York in New York City. This event
will be webcast live on the Investors section of the company’s website, .alnylam.com.
An audio replay of the event will be available on the Alnylam website
approximately 90 minutes after the event.
Preliminary Phase 1/2 Study Clinical Activity Results
In the SAD cohorts (N=20), ALN-CC5 achieved potent and dose-dependent
knockdown of serum C5 of up to 99 percent, with a mean maximum knockdown
of 98 ± 0.3 percent (p less than 0.01 compared with placebo) in the top
dose cohort. After a single dose, nadir levels of residual C5 as low as
1.1 microgram/milliliter (mcg/mL) were achieved. This level of residual
C5 in healthy volunteers is at or below the levels of free C5 estimated
for eculizumab at therapeutic drug concentrations in an earlier
published study in patients with atypical hemolytic uremic syndrome
(aHUS)1. Maximal effects on C5 knockdown were achieved
starting on day 20, and lasted for several months. For example, an up to
97.8 percent knockdown of serum C5 was still maintained at day 98 after
just a single dose of drug in the top dose cohort. The company believes
that the durable and clamped nature of C5 knockdown supports a once
monthly and possibly a once quarterly, fixed dose subcutaneous regimen.
In addition, single dose administration of ALN-CC5 was associated with
potent, dose-dependent, and durable inhibition of complement activity.
In particular, a single ALN-CC5 dose resulted in an up to 95 percent
inhibition of complement alternative pathway (CAP) activity, an up to 97
percent inhibition of complement classical pathway (CCP) activity, and
an up to 79 percent inhibition of serum hemolytic activity (mean maximum
74 ± 4.2 percent). In addition, as with C5 knockdown, the inhibitory
effects of ALN-CC5 toward complement activity were found to be highly
durable, lasting for several months after just a single dose.
In MAD cohorts (N=12) receiving five weekly doses of ALN-CC5, an up to
99 percent knockdown of serum C5 was achieved with a mean maximum
knockdown of 98 ± 0.2 percent (p less than 0.01 compared with placebo)
in the top dose cohort. Following ALN-CC5 administration, nadir levels
of residual C5 as low as 0.6 mcg/mL were observed. Regarding effects on
complement activity, multiple doses of ALN-CC5 resulted in an up to 97
percent inhibition of CAP activity, an up to 97 percent inhibition of
CCP activity, and an up to 98 percent inhibition of serum hemolytic
activity (mean maximum 84 ± 7.6 percent). These effects on complement
activity were statistically significant (p less than 0.05 compared with
placebo). The level of CAP inhibition achieved in these healthy
volunteers is comparable to results seen in people with homozygous C5
deficiency2,3, which highlights the highly robust knockdown
of serum C5 levels achieved with ALN-CC5. Furthermore, multiple dose
administration of ALN-CC5 achieved the 80 percent target level of serum
hemolytic activity inhibition previously correlated with LDH reductions
in PNH patients4. Finally, after the last dose of ALN-CC5, C5
knockdown and inhibition of complement activity were highly durable,
with effects lasting several months. For example, after five weekly
doses in the 200 mg cohort, an up to 98.3 percent knockdown of serum C5
was maintained at day 112.
Preliminary Phase 1/2 Safety Results
All safety results remain blinded as to treatment allocation. Single and
multiple weekly subcutaneous doses of ALN-CC5 or placebo were generally
well tolerated with no clinically significant, drug-related adverse
events (AEs) reported to date. There were no serious adverse events
(SAEs), study discontinuations, or clinically significant laboratory
findings. In Part A of the study, a total of 29 AEs were observed, all
of them mild or moderate in severity, of which 3 were deemed possibly
related to ALN-CC5 or placebo. Two patients experienced mild, transient
injection site reactions (ISRs). In Part B of the study, a total of 30
AEs were observed, all of them mild or moderate in severity, of which 12
AEs were deemed possibly related to ALN-CC5 or placebo. Four subjects
experienced mild, transient ISRs.
ALN-CC5 Phase 1/2 Study Design
The ongoing Phase 1/2 trial of ALN-CC5 is being conducted in three
parts. Parts A and B are randomized (3:1, drug:placebo), double-blind,
placebo-controlled, SAD and MAD studies, respectively, which will enroll
up to a total of 60 healthy adult volunteers. These parts of the study
are designed to evaluate safety and tolerability of single and multiple
subcutaneous doses of ALN-CC5. Additional objectives include clinical
activity as measured by knockdown of serum C5 and levels of residual C5.
In addition, additional objectives include measurement of effects on
inhibition of serum complement activity, including measurements of CAP
and CCP activity, and serum hemolytic activity. A total of 5 SAD cohorts
were enrolled in the study, with fixed doses ranging from 50 to 900 mg.
A total of 3 MAD cohorts have been enrolled in the study with fixed
doses of 100, 200 or 400 mg, where subjects are receiving once weekly,
subcutaneous doses of ALN-CC5 or placebo for 5 weeks. Part C is an
open-label, multi-dose study in patients with PNH, to assess safety,
tolerability, and clinical activity of ALN-CC5, administered for up to
13 weeks. This part of the study will include an exploratory evaluation
of ALN-CC5 effects on levels of LDH, a measure of endogenous red blood
cell hemolysis.
About ALN-CC5
ALN-CC5 is an investigational RNAi therapeutic targeting the C5
component of the complement pathway, currently in early stage clinical
development for the treatment of complement-mediated diseases. The
safety and efficacy of ALN-CC5 have not been evaluated by the U.S. Food
and Drug Administration or any other health authority. The complement
system plays a central role in immunity as a protective mechanism for
host defense, but its dysregulation results in life-threatening
complications in a broad range of human diseases including paroxysmal
nocturnal hemoglobinuria (PNH), atypical hemolytic-uremic syndrome
(aHUS), myasthenia gravis, neuromyelitis optica, membranous nephropathy,
amongst others. Complement component C5, which is predominantly
expressed in liver cells, is a genetically and clinically validated
target; loss of function human mutations are associated with an
attenuated immune response against certain infections and intravenous
anti-C5 monoclonal antibody (mAb) therapy has demonstrated clinical
activity and tolerability in a number of complement-mediated diseases. A
subcutaneously administered RNAi therapeutic that silences C5 represents
a novel approach to the treatment of complement-mediated diseases.
ALN-CC5 utilizes Alnylam s ESC-GalNAc conjugate technology, which
enables subcutaneous dosing with increased potency and durability and a
wide therapeutic index.
Genzyme Alliance
In January 2014, Alnylam and Genzyme, a Sanofi company, formed an
alliance to accelerate and expand the development and commercialization
of RNAi therapeutics across the world. The alliance is structured as a
multi-product geographic alliance in the field of rare diseases. Alnylam
retains product rights in North America and Western Europe, while
Genzyme obtained the right to access certain programs in Alnylam s
current and future Genetic Medicines pipeline, including ALN-CC5, in the
rest of the world. In certain defined instances, Genzyme has
co-development/co-commercialization and/or global product rights.
Genzyme s rights are structured as an opt-in that is triggered upon
achievement of human proof-of-principle.
About RNAi
RNAi (RNA interference) is a revolution in biology, representing a
breakthrough in understanding how genes are turned on and off in cells,
and a completely new approach to drug discovery and development. Its
discovery has been heralded as “a major scientific breakthrough that
happens once every decade or so,” and represents one of the most
promising and rapidly advancing frontiers in biology and drug discovery
today which was awarded the 2006 Nobel Prize for Physiology or Medicine.
RNAi is a natural process of gene silencing that occurs in organisms
ranging from plants to mammals. By harnessing the natural biological
process of RNAi occurring in our cells, the creation of a major new
class of medicines, known as RNAi therapeutics, is on the horizon. Small
interfering RNA (siRNA), the molecules that mediate RNAind comprise
Alnylam s RNAi therapeutic platform, target the cause of diseases by
potently silencing specific mRNAs, thereby preventing disease-causing
proteins from being made. RNAi therapeutics have the potential to treat
disease and help patients in a fundamentally new way.
About Alnylam Pharmaceuticals
Alnylam is a biopharmaceutical company developing novel therapeutics
based on RNA interference, or RNAi. The company is leading the
translation of RNAi as a new class of innovative medicines. Alnylam’s
pipeline of investigational RNAi therapeutics is focused in 3 Strategic
Therapeutic Areas (STArs): Genetic Medicines, with a broad pipeline of
RNAi therapeutics for the treatment of rare diseases; Cardio-Metabolic
Disease, with a pipeline of RNAi therapeutics toward genetically
validated, liver-expressed disease targets for unmet needs in
cardiovascular and metabolic diseases; and Hepatic Infectious Disease,
with a pipeline of RNAi therapeutics that address the major global
health challenges of hepatic infectious diseases. In early 2015, Alnylam
launched its “Alnylam 2020” guidance for the advancement and
commercialization of RNAi therapeutics as a whole new class of
innovative medicines. Specifically, by the end of 2020, Alnylam expects
to achieve a company profile with 3 marketed products, 10 RNAi
therapeutic clinical programs – including 4 in late stages of
development – across its 3 STArs. The company’s demonstrated commitment
to RNAi therapeutics has enabled it to form major alliances with leading
companies including Merck, Medtronic, Novartis, Biogen, Roche, Takeda,
Kyowa Hakko Kirin, Cubist, GlaxoSmithKline, Ascletis, Monsanto, The
Medicines Company, and Genzyme, a Sanofi company. In addition, Alnylam
holds an equity position in Regulus Therapeutics Inc., a company focused
on discovery, development, and commercialization of microRNA
therapeutics. Alnylam scientists and collaborators have published their
research on RNAi therapeutics in over 200 peer-reviewed papers,
including many in the world’s top scientific journals such as Nature,
Nature Medicine, Nature Biotechnology, Cell, New England Journal of
Medicine, and The Lancet. Founded in 2002, Alnylam maintains
headquarters in Cambridge, Massachusetts. For more information about
Alnylam’s pipeline of investigational RNAi therapeutics, please visit .alnylam.com.
Alnylam Forward Looking Statements
Various statements in this release concerning Alnylam s future
expectations, plans and prospects, including without limitation,
Alnylam s views with respect to the potential for RNAi therapeutics,
including ALN-CC5, expectations regarding the timing of clinical trials
with ALN-CC5 and the reporting of clinical data from these trials,
including the expected reporting of additional data from its ongoing
Phase 1/2 trial in mid-2016, its expectations regarding its STAr
pipeline growth strategy, and its plans regarding commercialization of
RNAi therapeutics, constitute forward-looking statements for the
purposes of the safe harbor provisions under The Private Securities
Litigation Reform Act of 1995. Actual results may differ materially from
those indicated by these forward-looking statements as a result of
various important factors, including, without limitation, Alnylam s
ability to discover and develop novel drug candidates and delivery
approaches, successfully demonstrate the efficacy and safety of its drug
candidates, the pre-clinical and clinical results for its product
candidates, which may not be replicated or continue to occur in other
subjects or in additional studies or otherwise support further
development of product candidates, actions of regulatory agencies, which
may affect the initiation, timing and progress of clinical trials,
obtaining, maintaining and protecting intellectual property, Alnylam s
ability to enforce its patents against infringers and defend its patent
portfolio against challenges from third parties, obtaining regulatory
approval for products, competition from others using technology similar
to Alnylam s and others developing products for similar uses, Alnylam s
ability to manage operating expenses, Alnylam s ability to obtain
additional funding to support its business activities and establish and
maintain strategic business alliances and new business initiatives,
Alnylam s dependence on third parties for development, manufacture,
marketing, sales and distribution of products, the outcome of
litigation, and unexpected expenditures, as well as those risks more
fully discussed in the "Risk Factors" filed with Alnylam s most recent
Quarterly Report on Form 10-Q filed with the Securities and Exchange
Commission (SEC) and in other filings that Alnylam makes with the SEC.
In addition, any forward-looking statements represent Alnylam s views
only as of today and should not be relied upon as representing its views
as of any subsequent date. Alnylam explicitly disclaims any obligation
to update any forward-looking statements.
1 Lathia et al., 2014; ASCPT Annual Meeting; Abstract
#387
2 Seelen et al., J Immunol Methods;296:187-198 (2005)
3 Cugno et al., J Thromb Haemost;12:1440-8 (2014)
4 Hill et al., Blood;106:2559-2565 (2005)
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