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Sarepta Therapeutics Announces Eteplirsen Demonstrates Continued Stability on Walking Test through 120 Weeks in Phase IIb Study in Duchenne Muscular Dystrophy
01/15/14 4:05 PM EST
Company to present today at the 32nd Annual
At 120 weeks, patients in the 30 mg/kg and 50 mg/kg eteplirsen cohorts who were able to perform the 6MWT (modified Intent-to-Treat or mITT population; n=6) experienced a decline of 13.9 meters, or less than 5 percent, from baseline in walking ability. A statistically significant treatment benefit of 64.9 meters (p ≤0.006) was observed for the mITT population compared with the placebo/delayed-treatment cohort (n=4), which initiated treatment at Week 25 following 24 weeks of placebo. After experiencing a substantial decline earlier in the study, the placebo/delayed-treatment cohort also demonstrated stabilization in walking ability for more than 1.5 years, from Week 36 through 120, the period from which meaningful levels of dystrophin were likely produced, with a decline of 9.5 meters over this timeframe. These analyses were based on the maximum 6MWT score when the test was performed on two consecutive days.
“We now have more than two years of data with eteplirsen on the 6-minute
walk test, the most accepted clinical outcome measure in Duchenne
muscular dystrophy, which demonstrates walking stability that we believe
would not be expected based on the natural history of this disease over
the same time period,” said
Through 120 weeks, eteplirsen was well tolerated and there were no reported clinically significant treatment-related adverse events and no treatment-related serious adverse events. In addition, there were no treatment-related hospitalizations or discontinuations.
Summary of Additional 6MWT Analyses
Patients performed two 6MWT evaluations on consecutive days at time points coinciding with a muscle biopsy procedure at baseline and Weeks 12, 24 and 48. Two 6MWT evaluations were also performed at Week 120, and will be performed at all future functional assessment visits. All other evaluations were a single 6MWT. The pre-specified primary analysis included the maximum distance walked at those clinic visits where repeated tests were taken. Other analyses of the repeated 6MWT results assessed mean, minimum, and Day 1 (first measure) scores. Results from these additional 6MWT analyses confirm the treatment effect observed in the primary analysis.
Summary of 6MWT: Week 120 Treatment Results*
| Analysis of Repeated 6MWT Values† | Baseline 6MWT (meters) |
Adjusted Mean 6MWT |
Estimated Treatment |
P-Value | ||||||||||||
|
Maximum Score Eteplirsen (n=6) |
399.7 | -13.9 | 64.9 | 0.006 | ||||||||||||
|
Maximum Score Placebo/delayed-Tx (n=4) |
394.5 | -78.8 | ||||||||||||||
|
Mean Score Eteplirsen (n=6) |
388.6 | -9.8 | 58.0 | 0.016 | ||||||||||||
|
Mean Score Placebo/delayed-Tx (n=4) |
380.3 | -67.8 |
|
|||||||||||||
|
Minimum Score Eteplirsen (n=6) |
377.5 | -5.7 | 51.0 | 0.042 | ||||||||||||
|
Minimum Score Placebo/delayed-Tx (n=4) |
366.0 | -56.7 | ||||||||||||||
|
Day 1 Score Eteplirsen (n=6) |
379.7 | +3.6 | 59.4 | 0.021 | ||||||||||||
|
Day 1 Score Placebo/delayed-Tx (n=4) |
371.5 | -55.8 | ||||||||||||||
* All 6MWT analyses are based on a Mixed Model Repeated Measures test.
† All 6MWT analyses include the mITT population
‡ The pre-specified primary analysis of the 6MWT results was based on the maximum score.
Mr. Garabedian will present these data today at the 32nd
Annual
About the Phase IIb Eteplirsen Program (Studies 201 and 202)
Study 201 was a randomized, double-blind, placebo-controlled clinical
study conducted at Nationwide Children’s Hospital in
At Week 25, all patients rolled over to Study 202, a long-term open-label extension study, and placebo-treated patients initiated eteplirsen treatment at 30 mg/kg (n=2) or 50 mg/kg (n=2).
The primary efficacy endpoint in Study 201 and Study 202 was the increase in novel dystrophin as assessed by muscle biopsy at Weeks 12 and 24 and at Week 48, respectively. The primary clinical endpoint was the 6MWT, a well-accepted measure of ambulation and clinical function in DMD. Long-term follow up in Study 202 continues to evaluate safety and clinical outcomes including the 6MWT.
About the 6-Minute Walk Test (6MWT)
The 6-minute walk test (6MWT) was developed as an integrated assessment
of cardiac, respiratory, circulatory, and muscular capacity (
About the Statistical Methodology and the Modified Intent-to-Treat (mITT) Population
The Mixed Model Repeated Measures (MMRM) test was used for all statistical analyses of the 6MWT results. Baseline 6MWT scores and duration since DMD diagnosis were included as covariates.
The mITT population used in the 6MWT analyses consisted of 10 of the 12 enrolled patients, including 4 patients in the 50 mg/kg cohort, 2 patients in the 30 mg/kg cohort and 4 patients in the placebo/delayed-treatment cohort. Two patients in the 30 mg/kg cohort showed rapid disease progression upon enrollment and lost ambulation by Week 24, and thus were excluded since they were no longer evaluable for the 6MWT. All other data were analyzed for all 12 patients.
About Duchenne Muscular Dystrophy
DMD is an X-linked rare degenerative neuromuscular disorder causing severe progressive muscle loss and premature death. One of the most common fatal genetic disorders, DMD affects approximately one in every 3,500 boys born worldwide. A devastating and incurable muscle-wasting disease, DMD is associated with specific errors in the gene that codes for dystrophin, a protein that plays a key structural role in muscle fiber function. Progressive muscle weakness in the lower limbs spreads to the arms, neck and other areas. Eventually, increasing difficulty in breathing due to respiratory muscle dysfunction requires ventilation support, and cardiac dysfunction can lead to heart failure. The condition is universally fatal, and death usually occurs before the age of 30.
About Sarepta’s Proprietary Exon-Skipping Platform Technology
Eteplirsen is Sarepta's lead drug candidate and is designed to address the underlying cause of DMD by enabling the production of a functional dystrophin protein. Data from clinical studies of eteplirsen in DMD patients have demonstrated a broadly favorable safety and tolerability profile and restoration of dystrophin protein expression.
Eteplirsen uses Sarepta's novel phosphorodiamidate morpholino oligomer (PMO)-based chemistry and proprietary exon-skipping technology to skip exon 51 of the dystrophin gene enabling the repair of specific genetic mutations that affect approximately 13 percent of the total DMD population. By skipping exon 51, eteplirsen may restore the gene's ability to make a shorter, but still functional, form of dystrophin from messenger RNA, or mRNA. Promoting the synthesis of a truncated dystrophin protein is intended to stabilize or significantly slow the disease process and prolong and improve the quality of life for patients with DMD.
Sarepta is also developing other PMO-based exon-skipping drug candidates intended to treat additional patients with DMD.
About
Forward-Looking Statements and Information
This press release contains forward-looking statements. These forward-looking statements generally can be identified by use of words such as "believes or belief," "anticipates," "plans," "expects," "will," "intends," "potential," "possible," "advance" and similar expressions. These forward-looking statements include statements about the development of eteplirsen and its efficacy, potency and utility as a potential treatment for DMD, the potential for the creation of ongoing novel dystrophin and its ability to lead to significant clinical benefit, including as measured by the 6MWT and exploratory measures, over a longer course of treatment.
Each forward-looking statement contained in this press release is
subject to risks and uncertainties that could cause actual results to
differ materially from those expressed or implied by such statement.
Applicable risks and uncertainties include, among others: subsequent
clinical trials may fail to demonstrate the safety and efficacy of
eteplirsen or replicate results; treatment of patients with DMD using
eteplirsen over a longer duration may not lead to significant clinical
benefit, including as measured by the 6MWT and exploratory measures; any
of Sarepta's drug candidates, including eteplirsen, may fail in
development, may not receive required regulatory approvals (including
Subpart H accelerated approval), or may not become commercially viable
during projected time frames or at all due to delays or other reasons;
and those identified under the heading "Risk Factors" in Sarepta's
Annual Report on Form 10-K for the full year ended
Any of the foregoing risks could materially and adversely affect
Sarepta's business, results of operations and the trading price of
Sarepta's common stock. For a detailed description of risks and
uncertainties Sarepta faces, you are encouraged to review the Company's
filings with the
Source:
Sarepta Investor Contact:
Erin Cox, 857-242-3714
ecox@sarepta.com
or
Sarepta
Media Contact:
Jim Baker, 857-242-3710
jbaker@sarepta.com
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