– ALN-RSV01 Meets Primary Study Objective of Safety and Tolerability –
Alnylam Pharmaceuticals, Inc. (Nasdaq: ALNY), a leading RNAi
therapeutics company, and Cubist Pharmaceuticals, Inc. (Nasdaq: CBST),
an acute care focused therapeutics company, today reported preliminary
data from their Phase II study of ALN-RSV01, an RNAi therapeutic in
development for the treatment of respiratory syncytial virus (RSV)
infection. The Phase II study was a randomized, double-blind study of
inhaled ALN-RSV01 or placebo in adult lung transplant patients infected
with RSV. The primary objective of the study was safety and
tolerability. Secondary objectives of the study included measurements of
viral dynamics and clinical symptoms.
In the Phase II study, conducted at 11 sites in 4 countries, 24 lung
transplant patients with confirmed RSV infection were randomized to
receive inhaled ALN-RSV01 (N=16) or placebo (N=8) once daily for three
consecutive days. Overall, the study achieved its primary objective of
demonstrating safety and tolerability of ALN-RSV01 over 30 days post
treatment. In particular, there were no drug-related serious adverse
events or discontinuations, and there were no clinically significant
differences in the overall adverse event profile between ALN-RSV01 and
placebo. Further, patients treated with ALN-RSV01 showed no significant
increases in plasma cytokine levels and showed no changes in lung
function post-dosing as determined by spirometry. Importantly, there was
no evidence of disease exacerbation related to ALN-RSV01 treatment.
“We are pleased with the preliminary results of our Phase II study as we
have documented for the first time the safety and tolerability of
inhaled ALN-RSV01 in naturally infected patients, which we consider an
important step forward in the advancement of our overall ALN-RSV program
toward both pediatric and adult patient populations,” said Akshay
Vaishnaw, M.D., Ph.D., Senior Vice President, Clinical Research of
Alnylam. “In the current study, we achieved our primary study objective.
We also collected data on viral dynamics and clinical symptoms, although
these measurements are secondary endpoints that are exploratory in
nature due to the small study size and an imbalance in certain baseline
characteristics between treatment groups.”
“We are encouraged by these important safety results in this program in
support of the continued advancement of our overall ALN-RSV program,”
said Steven C. Gilman, Ph.D., Senior Vice President, Chief Scientific
Officer, for Cubist Pharmaceuticals. “In the next several months, we
will be reviewing data from these and other studies related to specific
plans for the advancement of our overall ALN-RSV program.”
Key results related to safety and tolerability are listed below.
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Number of patients with:
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ALN-RSV01 (N=16)
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Placebo (N=8)
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Serious Adverse Events
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2 (12.5%)
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1 (12.5%)
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Other Adverse Events
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Severe
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2 (12.5%)
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3 (37.5%)
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Moderate
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6 (37.5%)
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1 (12.5%)
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Mild
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8 (50%)
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4 (50%)
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The current study was not powered for efficacy outcomes. Data on viral
dynamics and clinical symptoms were collected, although these
measurements were considered exploratory due to the small sample size.
Viral measurements, performed daily from baseline to Day 14, included
analysis of virus load by quantitative RT-PCR from nasal swab samples.
Patient-reported clinical symptoms were collected twice daily from Day 0
to Day 14. Additional clinical data from a 90-day secondary endpoint are
pending.
Key results related to baseline characteristics, viral parameters, and
clinical symptom data are provided below. There were imbalances in
baseline viral load and time from symptom onset to first dose that were
higher and shorter, respectively, in the placebo group; these imbalances
were not statistically significant, but confound interpretation of
activity findings.
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Assessment
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Statistic
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ALN-RSV01
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Placebo
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Certain Baseline Characteristics
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Baseline viral load (log10 PFUe1/mL)
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Mean
SD
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1.95
2.01
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3.60
2.36
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Time from symptom onset to first dose (days)
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Mean
SD
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5.33
2.66
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3.63
1.60
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Viral Parameters
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Duration of viral shedding (days)
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Mean
SD
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5.35
3.41
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8.01
4.47
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Area under the curve for viral load, days 0-6 (log10
PFUe/mL/day)
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Mean
SD
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6.60
6.40
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13.63
10.11
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Maximum viral load post 1st dose (log10
PFUe/mL)
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Mean
SD
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2.34
1.87
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4.16
1.76
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Time to maximum viral load (days)
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Mean
SD
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3.73
3.40
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4.57
4.98
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Viral Clearance (log10
PFUe/mL/day)
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Days 0-1
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Mean
SD
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-0.46
1.67
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-0.29
1.30
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Days 0-2
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Mean
SD
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-0.31
0.52
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-0.64
0.96
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Days 0-3
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Mean
SD
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-0.40
0.57
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-0.60
0.65
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Days 0-6
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Mean
SD
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-0.22
0.25
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-0.40
0.30
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Clinical Symptoms
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Daily total symptom score2
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Mean
SD
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9.26
4.98
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13.36
5.98
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Cumulative daily total symptom score2
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Mean
SD
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113.2
65.06
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189.3
99.59
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1
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PFUe, plaque forming unit equivalents, is a PCR-based measure of
viral quantity.
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2
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Clinical symptoms were measured by a patient self-assessment method;
lower values indicate a decreased incidence and/or severity of
symptoms.
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“RSV infection in lung transplant patients is the cause of significant
morbidity and even mortality in patients with lung transplants due to
the potential for acute and chronic lung rejection as well as other
complications,” said Martin Zamora, M.D., Professor of Medicine, and
Medical Director, Lung Transplant Program, University of Colorado Health
Sciences Center, and Principal Investigator for the trial in the U.S. “I
am encouraged with the findings from this study.”
Results of the study will be presented at a medical conference in the
second half of 2009. Also, the companies plan to evaluate these and
additional data from the broader ALN-RSV program, including its
second-generation compounds, to determine the optimal development
strategy and specific plans for all RSV indications.
Alnylam’s partnership with Cubist is a 50-50 co-development and profit
share arrangement in North America, and a milestone- and royalty-bearing
license arrangement in the rest of the world outside of Asia, where
ALN-RSV is partnered with Kyowa Hakko Kirin.
About RNA Interference (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. RNAi
therapeutics target the cause of diseases by potently silencing specific
messenger RNAs (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 applying its
therapeutic expertise in RNAi to address significant medical needs, many
of which cannot effectively be addressed with small molecules or
antibodies, the current major classes of drugs. Alnylam is leading the
translation of RNAi as a new class of innovative medicines with
peer-reviewed research efforts published in the world’s top scientific
journals including Nature, Nature Medicine, and Cell.
The company is leveraging these capabilities to build a broad pipeline
of RNAi therapeutics; its most advanced program is in Phase II human
clinical trials for the treatment of respiratory syncytial virus (RSV)
infection and is partnered with Cubist and Kyowa Hakko Kirin. In
addition, the company is developing RNAi therapeutics for the treatment
of a wide range of disease areas, including liver cancers,
hypercholesterolemia, Huntington’s disease, and TTR amyloidosis. The
company’s leadership position in fundamental patents, technology, and
know-how relating to RNAi has enabled it to form major alliances with
leading companies including Medtronic, Novartis, Biogen Idec, Roche,
Takeda, Kyowa Hakko Kirin, and Cubist. To reflect its outlook for key
scientific, clinical, and business initiatives, Alnylam established “RNAi
2010” in January 2008 which includes the company’s plan to
significantly expand the scope of delivery solutions for RNAi
therapeutics, have four or more programs in clinical development, and to
form four or more new major business collaborations, all by the end of
2010. Alnylam and Isis are joint owners of Regulus Therapeutics Inc., a
company focused on the discovery, development, and commercialization of
microRNA-based therapeutics. Founded in 2002, Alnylam maintains
headquarters in Cambridge, Massachusetts. For more information, please
visit www.alnylam.com.
About Cubist
Cubist Pharmaceuticals, Inc. is a biopharmaceutical company focused on
the research, development, and commercialization of pharmaceutical
products that address unmet medical needs in the acute care environment.
In the U.S., Cubist markets CUBICIN® (daptomycin for
injection), the first antibiotic in a new class of anti-infectives
called lipopeptides. In July 2008, Cubist began promoting MERREM®
I.V. (meropenem for injection) in the United States. MERREM is an
established broad spectrum antibiotic developed by AstraZeneca. The
Cubist product pipeline includes ecallantide, a recombinant human
protein in Phase 2 clinical trials — CONSERV™-1 and the planned
CONSERV™-2 — for the reduction of blood loss during
cardiothoracic surgery, and two Phase 1 programs that address unmet
medical needs, one in CDAD (Clostridium difficile-associated
diarrhea) and the other in multi-drug resistant (MDR) Gram-negative
infections. In addition, the Company, in collaboration with Alnylam
Pharmaceuticals, Inc. (Cambridge, MA), has a pre-IND and a Phase 2
program underway in novel treatments for respiratory syncytial virus
infections using Alnylam’s RNA-interference technology. Cubist is
headquartered in Lexington, MA. Additional information can be found at
Cubist’s web site at www.cubist.com.
Alnylam Forward-Looking Statements
Various statements in this release concerning Alnylam’s future
expectations, plans and prospects, including without limitation
statements concerning the timing and scope of clinical trials and
studies, the need for novel RSV therapeutics, and its views with respect
to the potential for RNAi therapeutics, including ALN-RSV01, 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 risks related to: the difficulty drawing conclusions from the
small sample size of patients in the Phase II study described in this
press release; the difficulty drawing conclusions in light of the
confounding differences in certain baseline characteristics between
those patients taking ALN-RSV01 and those patients taking placebo;
Alnylam’s approach to discover and develop novel drugs, which is
unproven and may never lead to marketable products, including ALN-RSV01
or any successor product thereto; obtaining, maintaining, and protecting
intellectual property; Alnylam’s ability to enforce its patents against
infringers and to defend its patent portfolio against challenges from
third parties; Alnylam’s ability to obtain additional funding to support
its business activities; Alnylam’s dependence on third parties for
development, manufacture, marketing, sales and distribution of products,
including Alnylam’s partners for ALN-RSV01, Cubist and Kyowa Hakko
Kirin; obtaining regulatory approval for products in different
jurisdictions; competition from others using technology similar to
Alnylam’s and others developing products for similar uses; Alnylam’s
dependence on collaborators; and Alnylam’s short operating history; as
well as those risks more fully discussed in the “Risk Factors” section
of its most recent quarterly report on Form 10-Q on file with the
Securities and Exchange Commission. 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
does not assume any obligation to update any forward-looking statements.
Cubist Forward-Looking Statement
This press release contains forward-looking statements, including
statements regarding the advancement of the RSV program, further results
from the Phase II study of ALN-RSV01, and Cubist and Alnylam’s plans to
make decisions about the RSV program. There are many factors that could
cause actual results to differ materially from those in these
forward-looking statements. These factors include: (i) Cubist and
Alnylam’s ability to analyze and report on further data from the Phase
II trial as anticipated; (ii) the demonstrated clinical efficacy and
safety of ALN-RSV01 or other RNAi therapeutics that are the subject of
this collaboration as they relate to standards for regulatory approval
and in comparison to competitive products; (iii) technical difficulties
or excessive costs relating to the manufacture of ALN-RSV01 or other
RNAi therapeutics that are the subject of this collaboration; (iv)
obtaining, maintaining, and protecting intellectual property for the
compounds that are the subject of the Cubist and Alnylam collaboration;
and (v) a variety of other risks common to our industry that may be
encountered with respect to the development of ALN-RSV, including
ongoing regulatory review, public and investment community perception of
the industry, legislative or regulatory changes, and Cubist’s ability to
attract and retain talented employees. Drug development involves a very
high degree of risk. Success of a product candidate in early stage
clinical trials or pre-clinical trials does not mean that subsequent
trials will also be successful or that the candidate will be
successfully commercialized. Additional factors that could cause actual
results to differ materially from those projected or suggested in any
forward-looking statements are contained in Cubist’s most recent Form
10-Q filing with the Securities and Exchange Commission, including those
factors discussed under the caption “Risk Factors” in such filing. These
statements speak only as of the date of this release, and Cubist
undertakes no obligation to update or revise these statements, except as
may be required by law.
Cubist and CUBICIN are registered trademarks of Cubist Pharmaceuticals,
Inc.
AstraZeneca and MERREM are registered trademarks of the
AstraZeneca group of companies.
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Alnylam Pharmaceuticals, Inc.
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