Alnylam
Pharmaceuticals, Inc. (Nasdaq: ALNY), a leading RNAi therapeutics
company, and The Medicines Company (Nasdaq: MDCO), a global
biopharmaceutical company focused on hospital care, announced today that
Alnylam has initiated a Phase 1 clinical trial with ALN-PCSsc, an
investigational agent for the treatment of hypercholesterolemia. The
initiation of this trial has triggered a $10 million milestone from The
Medicines Company to Alnylam. ALN-PCSsc is a subcutaneously administered
RNAi therapeutic targeting the gene proprotein convertase
subtilisin/kexin type 9 (PCSK9), a target validated by human genetics
that is involved in the metabolism of low-density lipoprotein
cholesterol (LDL-C, or “bad” cholesterol). The Phase 1 trial of
ALN-PCSsc is being conducted in the U.K. as a randomized, single-blind,
placebo-controlled, single ascending- and multi-dose study, enrolling up
to 76 volunteer subjects with elevated baseline LDL-C (≥ 100 mg/dL). As
previously guided, the companies expect to report initial clinical data
from the trial in mid-2015.
“As a first-in-class PCSK9 synthesis inhibitor, we believe that
ALN-PCSsc represents an innovative, differentiated, and well-validated
approach for the treatment of hypercholesterolemia. First, recent
pre-clinical studies in non-human primates have confirmed the potential
for a once-monthly, and possibly once-quarterly, low volume subcutaneous
dose regimen. Further, the mechanism of action for ALN-PCSsc enables
LDL-C lowering independent of baseline PCSK9 plasma levels, which we
believe could result in additive or even synergistic activity in
combination with statins,” said Akshay Vaishnaw, M.D., Ph.D., Executive
Vice President and Chief Medical Officer of Alnylam. “We are very
excited to be advancing this investigational RNAi therapeutic – notably,
our third that utilizes our proprietary, clinically validated GalNAc
conjugate delivery platform, and the second that utilizes our optimized
ESC-GalNAc technology – into a Phase 1 trial. Together with The
Medicines Company, we look forward to the continued advancement of
ALN-PCSsc, including the expected presentation of initial clinical
results in mid-2015.”
“The field of LDL research generally – and this project in particular –
are moving fast. The recent IMPROVE-IT study results demonstrated the
importance of LDL-C as a major risk factor for coronary artery disease
and the benefit of further LDL-C reductions on top of statin therapy. In
addition there is a clear need for new therapies for patients who are
refractory or intolerant to current approaches for management of their
LDL-C levels,” said David Kallend, MB.BS (Lon), Vice President and
Global Medical Director for the lipid programs at The Medicines Company.
“Together with recent progress in our other efforts, ALN-PCSsc is a key
program in our pipeline of innovative medicines for hypercholesterolemia
and atherosclerosis. Based on its mechanism of action and pre-clinical
results, we believe that ALN-PCSsc has a highly competitive profile as
compared with anti-PCSK9 monoclonal antibodies and a potential for a
less frequent, small volume dosing regimen, and we look forward to
confirming this potential in the clinic. Assuming positive results, The
Medicines Company will lead the collaborative effort in subsequent
stages of development and commercialization.”
The Phase 1 trial of ALN-PCSsc is being conducted as a randomized,
single-blind, placebo-controlled, single ascending- and multi-dose,
subcutaneous dose-escalation study. The study is designed to enroll up
to 76 volunteer subjects with elevated baseline LDL-C (≥ 100 mg/dL),
with subjects randomized 3:1, drug:placebo. The study will be performed
in two phases: a single ascending dose (SAD) phase and a multiple dose
(MD) phase. In the MD phase, subjects will receive two subcutaneous
doses of either ALN-PCSsc or placebo administered four weeks apart. The
MD phase will also include subjects both on and off statin
co-medication. The primary objective of the Phase 1 study is to evaluate
the safety and tolerability of ALN-PCSsc. Secondary objectives include
assessment of clinical activity as determined by knockdown of plasma
PCSK9 levels and serum LDL-C levels, as well as pharmacokinetics of
ALN-PCSsc. In support of the Clinical Trial Application (CTA) to begin
the Phase 1 trial, Alnylam completed toxicology studies in rodents and
non-human primates (NHPs). In both species, the no observed adverse
effect level (NOAEL) was determined to exceed 250 mg/kg, the top dose in
both studies, with no adverse findings in clinical, hematology,
laboratory chemistry, and histopathology assessments.
ALN-PCSsc is a subcutaneously administered investigational RNAi
therapeutic that utilizes Alnylam’s proprietary Enhanced Stabilization
Chemistry (ESC)-GalNAc-siRNA conjugate delivery platform.
ESC-GalNAc-siRNA conjugates are designed to achieve targeted delivery of
RNAi therapeutics to hepatocytes through uptake by the
asialoglycoprotein receptor, and enable subcutaneous dosing with
increased potency and durability and a wide therapeutic index. At the
American Heart Association Scientific Sessions 2014 in November, the
company presented pre-clinical
data in NHPs showing that monthly subcutaneous administration of
ALN-PCSsc resulted in PCSK9 knockdown of up to 92% and LDL-C lowering,
in the absence of statin co-administration, of up to 77%; mean maximum
knockdown of PCSK9 was 83.2% +/- 7.2%, and mean maximum LDL-C reduction
was 59.0% +/- 13.3%. As a PCSK9 synthesis inhibitor, ALN-PCSsc showed
rapid, durable, and clamped knockdown of PCSK9 and reduction of LDL-C,
which contrasts with the cyclical variation in LDL-C observed with
monthly dose regimens of anti-PCSK9 monoclonal antibodies (Stein, Curr
Opin Lipidol 2013, 24:510–517). Based on current human translational
data with ESC-GalNAC-conjugates, the projected human dose levels are
expected to be less than 1 mg/kg at a subcutaneous injection volume of
less than 1 mL administered once-monthly. In aggregate, these
pre-clinical data are supportive of a once-monthly, and possibly
once-quarterly, dosing regimen for ALN-PCSsc, which the company believes
could represent a highly competitive target product profile.
Alnylam and collaborators previously published complete study results
from a Phase 1 trial with ALN-PCS02 in The Lancet (Fitzgerald, et
al., The Lancet, doi:10.1016/S0140-6736(13)61914-5). ALN-PCS02 is an
intravenously administered investigational RNAi therapeutic targeting
PCSK9. The paper showed that ALN-PCS02 administration resulted in rapid,
dose-dependent knockdown of plasma PCSK9 of up to 84% relative to
baseline and placebo, with a corresponding reduction in serum levels of
LDL-C of up to 57% relative to baseline and placebo. The knockdown of
PCSK9 and lowering of LDL-C were also found to be durable, with effects
lasting for weeks after a single dose. ALN-PCS02 was shown to be well
tolerated in this Phase 1 study and there were no serious adverse events
related to study drug administration.
Alnylam and The Medicines Company are collaborating in the advancement
of ALN-PCSsc per the companies’ agreement formed in early 2013. Under
the terms of the agreement, Alnylam will complete certain pre-clinical
studies and a Phase 1 clinical study of ALN-PCSsc and The Medicines
Company is responsible for leading and funding development from Phase 2
forward as well as potential commercialization.
About Hypercholesterolemia
Hypercholesterolemia is a
condition characterized by very high levels of cholesterol in the blood
which is known to increase the risk of coronary artery disease, the
leading cause of death in the U.S. Some forms of hypercholesterolemia
can be treated through dietary restrictions, lifestyle modifications
(e.g., exercise and smoking cessation) and medicines such as statins.
However, a large proportion of patients with hypercholesterolemia are
not achieving adequate LDL-C levels with currently available therapies
including statins, including genetic familial hypercholesterolemia (FH)
patients, acute coronary syndrome patients, high-risk patient
populations (e.g., patients with coronary artery disease, diabetics,
symptomatic carotid artery disease, etc.) and other patients that are
statin intolerant. Severe forms of hypercholesterolemia are estimated to
affect more than 500,000 patients worldwide, and as a result, there is a
significant need for novel therapeutics to treat patients with
hypercholesterolemia whose disease is inadequately managed by existing
therapies.
About GalNAc Conjugates and Enhanced Stabilization Chemistry (ESC)
GalNAc Conjugates
GalNAc-siRNA conjugates are a proprietary
Alnylam delivery platform and are designed to achieve targeted delivery
of RNAi therapeutics to hepatocytes through uptake by the
asialoglycoprotein receptor. Alnylam’s Enhanced Stabilization Chemistry
(ESC) GalNAc-conjugate technology enables subcutaneous dosing with
increased potency, durability, and a wide therapeutic index, and is
being employed in several of Alnylam’s genetic medicine programs,
including programs in clinical development.
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 RNAi and 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 with a core focus on RNAi therapeutics as genetic
medicines, including programs as part of the company’s “Alnylam 5x15™”
product strategy. Alnylam’s genetic medicine programs are
investigational RNAi therapeutics directed toward genetically defined
targets for the treatment of serious, life-threatening diseases with
limited treatment options for patients and their caregivers. These
include: patisiran (ALN-TTR02) targeting transthyretin (TTR) for the
treatment of TTR-mediated amyloidosis (ATTR) in patients with familial
amyloidotic polyneuropathy (FAP); revusiran (ALN-TTRsc) targeting TTR
for the treatment of ATTR in patients with TTR cardiac amyloidosis,
including familial amyloidotic cardiomyopathy (FAC) and senile systemic
amyloidosis (SSA); ALN-AT3 targeting antithrombin (AT) for the treatment
of hemophilia and rare bleeding disorders (RBD); ALN-CC5 targeting
complement component C5 for the treatment of complement-mediated
diseases; ALN-AS1 targeting aminolevulinic acid synthase-1 (ALAS-1) for
the treatment of hepatic porphyrias including acute intermittent
porphyria (AIP); ALN-PCSsc targeting PCSK9 for the treatment of
hypercholesterolemia; ALN-AAT targeting alpha-1 antitrypsin (AAT) for
the treatment of AAT deficiency-associated liver disease; ALN-HBV
targeting the hepatitis B virus (HBV) genome for the treatment of HBV
infection; ALN-TMP targeting TMPRSS6 for the treatment of
beta-thalassemia and iron-overload disorders; ALN-ANG targeting
angiopoietin-like 3 (ANGPTL3) for the treatment of genetic forms of
mixed hyperlipidemia and severe hypertriglyceridemia; ALN-AC3 targeting
apolipoprotein C-3 (apoC3) for the treatment of hypertriglyceridemia;
ALN-AGT targeting angiotensinogen (AGT) for the treatment of
hypertensive disorders of pregnancy (HDP), including preeclampsia;
ALN-GO1 targeting glycolate oxidase (GO) for the treatment of primary
hyperoxaluria type 1 (PH1); ALN-HDV targeting the hepatitis delta virus
(HDV) genome for the treatment of HDV infection; ALN-PDL targeting
programmed death ligand 1 (PD-L1) for the treatment of chronic liver
infections; and other programs yet to be disclosed. As part of its
“Alnylam 5x15” strategy, as updated in early 2014, the company expects
to have six to seven genetic medicine product candidates in clinical
development – including at least two programs in Phase 3 and five to six
programs with human proof of concept – by the end of 2015. The company’s
demonstrated commitment to RNAi therapeutics has enabled it to form
major alliances with leading companies including Merck, Medtronic,
Novartis, Biogen Idec, Roche, Takeda, Kyowa Hakko Kirin, Cubist,
GlaxoSmithKline, Ascletis, Monsanto, and The Medicines Company. In early
2014, Alnylam and Genzyme, a Sanofi company, formed a multi-product
geographic alliance on Alnylam's genetic medicine programs in the rare
disease field. Specifically, Alnylam will lead development and
commercialization of programs in North America and Europe, while Genzyme
will develop and commercialize products in the rest of world. In
addition, Alnylam and Genzyme will co-develop and co-commercialize
revusiran in North America and Europe. In March 2014, Alnylam acquired
Sirna Therapeutics, a wholly owned subsidiary of Merck. 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, please
visit www.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-PCSsc for the
treatment of hypercholesterolemia, the timing for reporting of data from
the ALN-PSCsc Phase 1 clinical study, the potential therapeutic
opportunities for ALN-PCSsc, as well as its expectations regarding its
“Alnylam 5x15” product strategy, and its plans regarding
commercialization of RNAi therapeutics, including ALN-PCSsc, 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 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.
About The Medicines Company
The Medicines Company's purpose
is to save lives, alleviate suffering and contribute to the economics of
healthcare by focusing on 3000 leading acute/intensive care hospitals
worldwide. Its vision is to be a leading provider of solutions in three
areas: serious infectious disease care, acute cardiovascular care, and
surgery and perioperative care. The company operates in the Americas,
Europe and the Middle East, and Asia Pacific regions with global centers
today in Parsippany, NJ, USA and Zurich, Switzerland.
The Medicines Company Forward-Looking Statements
Statements
contained in this press release about The Medicines Company that are not
purely historical, and all other statements that are not purely
historical, may be deemed to be forward-looking statements for purposes
of the safe harbor provisions under The Private Securities Litigation
Reform Act of 1995. Without limiting the foregoing, the words
"believes," "anticipates" "expects" and “potential” and similar
expressions, are intended to identify forward-looking statements. These
forward-looking statements involve known and unknown risks and
uncertainties that may cause the Company's actual results, levels of
activity, performance or achievements to be materially different from
those expressed or implied by these forward-looking statements.
Important factors that may cause or contribute to such differences
include whether the Company's products will advance in the clinical
trials process on a timely basis or at all, whether the Company will
make regulatory submissions for product candidates on a timely basis,
whether its regulatory submissions will receive approvals from
regulatory agencies on a timely basis or at all, whether physicians,
patients and other key decision makers will accept clinical trial
results and such other factors as are set forth in the risk factors
detailed from time to time in the Company's periodic reports and
registration statements filed with the Securities and Exchange
Commission including, without limitation, the risk factors detailed in
the Company's Quarterly Report on Form 10-Q filed with the SEC on
November 7, 2014, which are incorporated herein by reference. The
Company specifically disclaims any obligation to update these
forward-looking statements.
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