Eplontersen

苏州 2024年11月25日 /美通社/ -- 近日，在北京大学第三医院心血管内科监护病房，顺利完成由锐正基因（苏州）有限公司自主研发的基因编辑药物ART001注册I期临床试验的转甲状腺素蛋白淀粉样变心肌病（ATTR-CM）首位受试者用药。主要研究者北京大学第三医院唐熠达副院长及心血管内科陈宝霞主任医师率领的特发性心肌病多学科团队携手完成首例患者给药，标志着临床专家为罕见病治疗策略的积极探索和该创新药研发进程又一重大阶段性进展。1年前确诊为（ATTR-CM）的高女士（化名），本次用药后，有潜力终生只需用药一次即可停止病情进展甚至逆转和"治愈"疾病，给患者带来了新的希望。 ATTR-CM是一种罕见的导致多系统受累的进展致死性疾病，由TTR蛋白在心脏的异常沉积引起，可导致呼吸困难、疲劳、心力衰竭、心律失常等症状，患者发病后的预期生存期仅为2至4年。目前国内仅有的治疗药物为稳定TTR药物（如氯苯唑酸）以及抑制肝脏合成TTR药物（国内均未上市），心内科罕见病团队积极参与新药研发与临床试验，打破了ATTR诊断难治疗难的困局，参与首个ATTR心肌病药物氯苯唑酸在国内上市后的多中心IV期临床研究，反义寡核苷酸药物eplontersen全国多中心Ⅲ期研究，抗淀粉样转甲状腺素蛋白单克隆抗体ALXN2220国际多中心Ⅲ期临床研究的中国分中心研究，提供了上述药物在中国ATTR心肌病患者中有效性和安全性数据。 高女士在2020年基因检测提示TTR存在一处杂合变异，诊断"淀粉样变性周围神经病"，到2023年出现心肌受累，诊断为"转甲状腺素蛋白淀粉样心肌病"，开始使用氯苯唑酸口服治疗，尽管病情得到一定控制，但是还是出现了行走困难以及体位性低血压的表现，生活质量明显下降，ART001注射液这一药物的出现，为像高女士这样的ATTR患者带来了一次用药长期生存和改善生活质量的曙光。高女士为首例用药患者，在用药及住院观察期间未见输注相关反应，已顺利出院，目前患者情况良好。 基于非病毒载体的体内基因编辑是目前全球最具潜力的创新治疗方式，但存在非常高的技术与转化门槛，即使在素以创新疗法开发领先闻名的美国，包括锐正基因在内，目前也仅有四家公司获得美国FDA临床试验许可，目前全球尚未有产品上市。锐正基因开发的ART001是全球首款获得中美临床试验许可的非病毒载体体内基因编辑药物，在前期已经开展的IIT研究显示，一次性用药即可实现90%以上的TTR敲降，截止至今药效已经稳定维持1年，有效性达到行业领先水平。与国内外其他类似产品相比，ART001在IIT临床试验中未见发热等输注相关反应，并且在脱靶安全性上表现优异，即使在几十倍饱和剂量下，也未检测到脱靶编辑的现象，显示出其在安全性和疗效方面的卓越潜力。 此次北京大学第三医院唐熠达副院长团队与研发者共同推进此项意义重大的临床研究，为高女士这样的罕见病患者提供了全球领先的创新疗法，为更多的患者提供了新的治疗希望。 北京大学第三医院唐熠达副院长表示："ATTR-CM是一种致死性的罕见病，患者通常在出现严重心脏症状或心力衰竭后才被确诊，且确诊后的平均生存期为2至4年，堪称‘杀手级’罕见病。ART001在开展注册I期临床试验之前，已经在IIT研究中显示了很好的安全性和TTR敲降能力。此次我院第一位ATTR-CM患者ART001的用药过程也非常顺利，到目前为止，安全性与在IIT研究中的表现相似，我们期待它能够为ATTR-CM患者带来临床益处。" 北京大学第三医院心内科简介 北京大学第三医院心内科成立于1958年，是教育部重点学科和全国知名的心血管疾病诊疗、科研和教学单位。经过几十年艰苦奋斗，已经发展成为国家临床重点专科，是国家级冠心病介入治疗、起搏电生理和心脏康复培训基地，也是国家胸痛中心、心衰中心和房颤中心建设单位。心内科-血管医学研究所是心血管分子生物学与调节肽卫健委重点实验室和心血管受体研究北京市重点实验室。医院和科室团队一直致力于提供最先进的医疗服务，并在罕见病治疗领域不断探索和创新。此次首例基因治疗药物的成功给药，不仅是医院在罕见病治疗领域的又一重要探索，也有望为全球ATTR-CM患者带来新的治疗选择添砖加瓦。 锐正基因（苏州）有限公司简介 锐正基因（苏州）有限公司成立于2021年7月，是一家专注于全球领先的非病毒载体基因编辑技术及其产品开发与商业化的创新型生物技术公司。公司汇聚了一支拥有生物药全生命周期成功经验的专业团队，在基因编辑领域快速崛起，多个产品管线正在稳步推进。其中，ART001（ATTR）和ART002（PCSK9）已进入人体临床试验阶段，其安全性和有效性数据显著优于全球同类产品，具有成为First-in-class和Best-in-class突破性药物的潜力。 锐正基因在短短3年内已申请近10项国际专利，并成功建立了中美唯一的产业级端到端体内基因编辑技术平台。作为中国首个将脂质纳米颗粒（LNP）载体应用于体内基因编辑并推进至人体临床试验的企业，锐正基因在非病毒载体体内基因编辑领域确立了领先地位。 凭借全球领先的技术创新和卓越的临床数据，锐正基因已成为全球唯一一家可以在中美两地同时开展非病毒载体体内基因编辑产品临床试验的公司。这一成就不仅彰显了公司在行业中的领先地位，也进一步巩固了中国在全球基因编辑技术前沿的战略地位。 展望未来，锐正基因将继续以创新驱动发展，以全球视野引领行业，致力于推动基因编辑技术的商业化应用，为全球患者带来革命性治疗方案，助力人类健康事业的进步。 商务合作: Accuredit@accuredit.com 媒体联络: tingting.zhang@accuredit.com

A BridgeBio Pharma drug developed for an increasingly prevalent cardiovascular condition has won FDA approval, marking a comeback for a company and a molecule with a turbulent history. But BridgeBio’s challenges aren’t over. The biotech’s new product must now compete against a blockbuster Pfizer medication already well established as the standard of care and fend off new competition on the way. The late Friday approval for the drug, acoramidis, covers the treatment of adults with cardiomyopathy caused by transthyretin-mediated amyloidosis, or ATTR. The disease stems from a genetic mutation though it can also develop as a consequence of aging. The FDA approval covers both types. BridgeBio’s twice-daily pill will be marketed under the brand name Attruby. In ATTR, abnormal versions of a liver protein called transthyretin lead to a buildup of amyloid protein in tissues and organs. When this buildup affects the heart, it can lead to cardiomyopathy, making it harder for the organ to pump blood. Attruby is a small molecule designed to bind to the abnormal TTR, stabilizing the protein and preventing it from leading to the amyloid buildup characterized by the disease. Pfizer’s ATTR cardiomyopathy drug, tafamidis, approved in 2019 and marketed as the four-times daily capsule Vyndaqel and the once-daily capsule Vyndamax, is also a TTR stabilizer. But Palo Alto, California-based BridgeBio set out to show its drug is the better stabilizer. That effort was almost derailed. Health IT Reducing Clinical and Staff Burnout with AI Automation As technology advances, AI-powered tools will increasingly reduce the administrative burdens on healthcare providers. By Dr. Michael Blackman, Chief Medical Officer at Greenway Health Nearly three years ago, BridgeBio reported preliminary data showing its drug failed to beat a placebo in the first part of a Phase 3 clinical trial, which assessed patients after 12 months. The company attributed the failure to a high placebo response. The disappointing results sank shares of the biotech by more than 70%. But the study’s design included a second part that would assess patients after 30 months of treatment. BridgeBio opted to continue the study, hoping longer treatment would lead to better outcomes. FDA approval of Attruby is based on the 30-month data from the Phase 3 study, which enrolled 632 patients with ATTR cardiomyopathy. Results showed the drug met the main goal of showing statistically significant improvement on a composite endpoint comprised of four measures of the disease. The results were published in the New England Journal of Medicine early this year. Speaking during a Friday evening webcast, BridgeBio CEO Neil Kumar drew distinctions between Attruby and Pfizer’s product. “This is the only oral stabilizer with the verbiage ‘near-complete stabilization’ in the label,” he said. “Almost all of benefits described downstream in the label stem from this near-complete stabilization. As early as three months, the earliest time point that we know of, this medicine begins to take action against a composite endpoint of cardiovascular hospitalization and death.” BridgeBio estimates 500,000 patients in the U.S. and European Union have ATTR cardiomyopathy, which represents a market opportunity of $15 billion to $20 billion. Right now, that market is dominated by Pfizer, which reported $3.9 billion in tafamidis sales in the first nine months of 2024, a more than 65% increase compared to the same period in 2023. But this market could soon be split among several products. Consumer / Employer Health Executives on Digital Transformation in Healthcare Hear executives from Quantum Health, Surescripts, EY, Clinical Architecture and Personify Health share their views on digital transformation in healthcare. By MedCity News Alnylam Pharmaceuticals develops drugs that silence genes, preventing them from causing disease-causing proteins. The biotech already markets Amvuttra for treating polyneuropathy caused by ATTR. But Alnylam has also tested Amvuttra, administered as a subcutaneous injection every three months, as a treatment for ATTR cardiomyopathy. On Monday, Alnylam announced the FDA accepted the company’s supplemental new drug application in this indication, setting a March 23, 2025 target date for a regulatory decision. Meanwhile, partners AstraZeneca and Ionis Pharmaceuticals market antisense oligonucleotide drug eplontersen, brand name Wainua, for treating polyneuropathy caused by ATTR. A Phase 3 trial is underway testing the drug in ATTR cardiomyopathy. In a note sent to investors, Leerink Partners analyst Mani Foroohar said Attruby’s label was the best-case scenario as the indication statement includes cardiovascular mortality and hospitalization, consistent with Pfizer’s product. Furthermore, Attruby can stake the claim of being the first and only product with a label specifying near-complete stabilization of TTR. That said, cracking Pfizer’s established market presence will be difficult. In results of a Leerink survey released in September, the Pfizer drug was physicians’ treatment of choice for cardiomyopathy caused by ATTR, given long their long experience with the product. There was an uptick in preference for gene silencing therapies, but mainly for treating polyneuropathy caused by the disease, the survey showed. Many physicians stated they would switch to another product only if a patient’s condition is not well controlled by the Pfizer drug. William Blair analyst Myles Minter said language in Attruby’s label stating the drug’s ability to reduce cardiovascular death is “a clear win for BridgeBio.” But Minter noted the absence on the label of any standalone all-cause mortality data, which is different than the Pfizer product’s label. Attruby did not lead to a statistically significant benefit on all-cause mortality compared to a placebo in its pivotal study. Minter said clinicians the firm spoke with at recent cardiovascular conferences continue to suggest the importance of not only the magnitude of cardiovascular event risk reduction, but also the timing of the onset of the drug’s effect given that cardiomyopathy can progress rapidly. He added that TTR-silencing drugs are best positioned for market differentiation. “We continue to view a reduction in all-cause mortality on label as a necessary distinction to gain major market share in ATTR-CM alongside Pfizer’s tafamidis,” Minter said. “Given the lack of all-cause mortality data included in the Attruby label, we believe Pfizer could start marketing more specifically around mortality benefit claims.” BridgeBio set Attruby’s wholesale price at $18,759.12 for a 28-day supply, which works out to about $244,500 annually. That’s a slight discount to Pfizer’s product, priced at $267,987 annually. But it’s still well above the $13,600 to $39,000 cost-effectiveness price range calculated by the Institute for Clinical and Economic Review, a non-profit organization that researches the value of drugs in order to determine what would be a fair price. Kumar said all patients who participated in Attruby’s Phase 3 study will continue to receive the drug for free for the rest of their lives. Attruby is still under review in Europe with a regulatory decision expected in 2025. Under a deal struck earlier this year, Bayer has exclusive rights to market the drug in Europe for ATTR cardiomyopathy. Bayer shelled out $310 million in upfront and near-term milestone payments; additional sales-based milestones were not disclosed. BridgeBio will also earn royalties from Bayer’s sales of the product. Image: Magicmine, Getty Images