Muscle Spasticity

SL-1002 demonstrated a favorable safety profile in adult patients with limb spasticity, achieving the primary safety endpoint of this first-in-human study. Key secondary efficacy endpoints were also met, including a statistically significant reduction in the Modified Ashworth Score at 6 months. ROSWELL, Ga. and DUBLIN and HAMILTON, Bermuda, Oct. 30, 2024 /PRNewswire/ -- Saol Therapeutics, a privately held, clinical-stage pharmaceutical company, today announced positive topline results from its SL-1002 RAISE Limb Spasticity Trial (NCT05311215). The data were recently presented at the Spasticity X Symposium in Houston, Texas. Dr. Sheng Li, MD, PhD, Professor in the Department of Physical Medicine and Rehabilitation (PM&R) at McGovern Medical School at UTHealth Houston and Director of Stroke Rehabilitation and Recovery Research at TIRR Memorial Hermann Hospital, along with Dr. Gerard Francisco, MD, professor and The Wulfe Family Chair of Physical Medicine and Rehabilitation at McGovern Medical School at UTHealth Houston and Chief Medical Officer at TIRR Memorial Hermann, presented the findings. SL-1002 is a novel chemoneurolytic injection utilizing Saol's proprietary CYCLOPHLEX™ technology. In the RAISE Limb Spasticity Trial, patients were randomized (3:1) into a double-blind, vehicle-controlled, single-ascending-dose escalation study designed to assess the safety and efficacy of a single SL-1002 treatment in patients with mild to severe limb spasticity. The study period lasted 26 weeks post-randomization, and the primary endpoint was to evaluate the overall safety profile of SL-1002 compared to vehicle. A total of 32 patients were randomized in the trial (24 receiving SL-1002, 8 receiving vehicle). Five serious adverse events (SAEs) were reported, all determined by investigators to be unrelated to the treatment. Fourteen non-serious treatment-emergent adverse events (TEAEs) determined by the investigators to be possibly, probably, or definitely related to treatment were observed, all were considered mild. There were other mild and moderate non-serious treatment-emergent adverse events (TEAEs) considered by the investigators to be unrelated to the treatment. Overall, SL-1002 was deemed well-tolerated, with no therapy- or program-limiting adverse events. Key secondary endpoints included assessments using the Modified Ashworth Scale (MAS), the most widely used efficacy measurement in spasticity trials. Despite the trial not being powered for efficacy, SL-1002 demonstrated a statistically significant improvement over vehicle at multiple time points throughout the trial. At 6 months, the SL-1002 arm showed a statistically significant reduction in MAS compared to baseline, with a decrease of -1.18, compared to -0.33 reduction in the vehicle arm (p=0.0060). "We are thrilled to share the positive results from the RAISE Limb Spasticity Trial," said Dave Penake, CEO of Saol Therapeutics. "Spasticity can be an incredibly debilitating condition, and the need for new treatment options has been voiced by patients and clinicians. We are especially encouraged by the strong safety profile observed in the RAISE study, alongside the efficacy shown by SL-1002 lasting at least 6 months. Achieving a 1–2-point reduction in MAS is a significant, positive, clinical outcome, and the durability of the treatment give us great confidence in the future of this program." Penake added, "None of this would have been possible without the patients who volunteered for this study and the dedicated investigators and clinical trial site teams. Their collaboration and commitment are what drive medical progress, and we are deeply grateful for their contributions." Dr. Gerard Francisco, the Principal Investigator for the trial, commented, "Treating spasticity is complex, and there is an urgent need for more innovative therapies. These early results show that SL-1002 appears to be safe, effective, and durable. " The RAISE Limb Spasticity Trial was conducted at UTHealth Houston in Houston, TX, where Dr. Sheng Li and Dr. Gerard Francisco served as the investigators, and at the Medical College of Wisconsin in Milwaukee, WI, where Dr. John McGuire served as the Principal Investigator. Saol Therapeutics plans to meet with the FDA in the first half of 2025 to determine the next steps in the SL-1002 spasticity program. SL-1002 is also being investigated for the treatment of pain related to osteoarthritis of the knee in the COMPASS Osteoarthritis Knee Pain Trial, with results yet to be released. About RAISE Limb Spasticity Trial The RAISE Limb Spasticity trial is a Randomized double-blind, vehicle-controlled, single Ascend Ing dose escalation study to assess the Safety, Pharmacokinetics and Efficacy of SL-1002 in adult patients with limb spasticity. (NCT05311215). About COMPASS Osteoarthritis Knee Pain Trial In addition to the RAISE Spasticity Trial, SL-1002 is also being investigated for the treatment of pain related to osteoarthritis of the knee. The COMPASS Osteoarthritis Knee Pain Trial is a multicenter, randomized, double-blind, vehicle- COntrolled, single-ascending dose escalation study to assess the safety and efficacy of SL-1002 injectable for treat Ment of PAin a SSociated with Osteo Arthritis of the knee. (NCT05470608). About SL-1002 SL-1002 is a novel, chemoneurolytic injection, that utilizes Saol's proprietary CYCLOPHLEX™ technology. It is currently being developed for the treatment of chronic knee pain related to osteoarthritis and limb spasticity, both in the adult population (18+) in the United States. About Saol Therapeutics Saol Therapeutics (pronounced "Sail") is a privately held, clinical-stage, pharmaceutical company with operations in Roswell, GA, Dublin, Ireland, and Hamilton, Bermuda. Saol is focused on development activity in CNS disorders such as spasticity and pain management, and orphan diseases. Saol is committed to providing and advancing therapeutic options for patients and the physicians treating these populations. For more information, visit . Saol Therapeutics Contact Senior Vice President, Strategy Brian Nappi [email protected] SOURCE Saol Therapeutics WANT YOUR COMPANY'S NEWS FEATURED ON PRNEWSWIRE.COM? 440k+ Newsrooms & Influencers 9k+ Digital Media Outlets 270k+ Journalists Opted In GET STARTED

关注并星标CPHI制药在线 ActRⅡ存在于脂肪和肌肉细胞中。在脂肪细胞中，激活素通过ActRⅡ进行脂质存储，阻断该信号通路可促进脂肪代谢。在肌肉细胞中，ActRⅡ受体传导的信号通路能够抑制肌肉生长并导致其萎缩，阻断骨骼肌中的激活素信号可以抑制这种萎缩，并可以促进肌肉质量的增加，帮助肥胖患者在减肥的同时改善身体成分和代谢。因此，ActRⅡ认为是下一代热门减肥药物的开发靶点。 关于ActRⅡ ActRII，即激活素Ⅱ型受体，是转化生长因子β（TGF-β）受体家族的成员，包括活化素A和活化素B，以及BMP7、BMP9、BMP10、GDF1、GDF8（Myostatin）、 GDF11和Nodal在内的其他TGF-β家族成员的II型受体。 ActRII有ACVR2A（又称为ActRIIA）和ACVR2B（又称为ActRIIB）两种，其多个配体被证明是骨骼肌质量负调控因子，如Activin和GDF11，其中ActRIIB最初被确定为GDF8的主要受体。 ActRII的生物学功能与激活素I型受体（ActRI）密不可分。激活素、GDF8和GDF11通过ActRII和ActRI触发信号传导。ActRII是主要的配体结合受体，与ActRII结合后，配体和ActRII与ActRI形成复合物，刺激细胞质中Smad2和Smad3转录因子的磷酸化。磷酸化的Smad2/3随后转运至细胞核，调节包括MyoD在内的靶基因的转录。其中GDF8/ActRII通路被确定为调节骨骼肌大小的关键。 激活素与ActRII结合后触发的信号是机体胚胎发育、器官形成、激素合成、细胞分化、免疫调节等重要生理活动的执行者，其异常与多种疾病高度相关，包括代谢性和免疫性等多种疾病类型，如骨骼肌肉萎缩、肥胖、贫血、肺纤维化。 ActRII靶点进展 目前全球监管机构已批准两款ActRII药物，即BMS的ActRIIB-Fc融合蛋白药物Luspatercept和默沙东/Acceleron的ActRIIA-Fc融合蛋白药物Sotatercept。 Luspatercept是一种可溶性融合蛋白,由人免疫 球蛋白G1（IgG1）的Fc结构域与ActRIIB的细胞外结构域融合而成。Luspatercept能够作为TGF-β的配体陷阱，防止TGF-β激活Smad2/3信号通路，进而促进晚期红细胞的分化和成熟，提高血红蛋白水平。目前，Luspatercept已在美国获批三项适应症：需要定期输注红细胞（RBC）的成人β-地中海贫血；骨髓增生异常综合征（MDS）伴环形铁粒幼细胞或骨髓增生异常/骨髓增殖性肿瘤伴环形铁粒幼细胞和血小板增多相关贫血；未经红细胞生成刺激剂（ESA）治疗、需要定期接受红细胞输注（RBC）的中低危MDS成人患者的贫血。该药最初由BMS旗下的新基研发，新基在与BMS整合前，曾与 Acceleron联合开发 Luspatercept。 Sotatercept是一款ActRIIA融合蛋白，其将ActRIIA经过改造的细胞外域与抗体的Fc端融合在一起，可以阻断激活素与细胞膜上的受体结合，从而降低激活素介导的信号传导。2024年3月，该药被FDA批准用于治疗成人肺动脉高压（PAH），以提高运动能力，改善WHO功能分级，并降低临床事件恶化风险。值得一提的是，Sotatercept最初由Acceleron 研发，2021年10月默沙东斥资115亿美元收购Acceleron，将Sotatercept纳入囊中。据Evaluate预测，Sotatercept 2028年销售额有望达到26亿美元，产品的净现值达116亿美元。 此外，据公开资料全球还有多款在研ActRII药物，详见下表。在研ActRII药物适应症多样，涉及骨髓增生异常综合征、肥胖、肺动脉高压等。ActRII药物的药物类型也比较多元化，涉及抗体类融合蛋白、单特异性抗体和双特异性抗体。 研发进度上，在研ActRII药物大多处于临床前阶段。Elritercept和Bimagrumab进展较快，已进入临床III期阶段。其中Elritercept（KER-050）是一种工程化配体陷阱，由ActRIIA的修饰配体结合域与人类抗体Fc结构域部分融合组成。 2021年12月，翰森制药与Keros Therapeutics达成合作协议，获得KER-050的大中华区权益，翰森制药将支付2000万美元预付款以及1.705亿美元里程碑金额，外加两位数比例的销售分成。 2024 EHA上公布的Elritercept在较低风险MDS患者中开展的临床II期试验数据显示：55.6%的患者在治疗的前24周内达到了血液学改善红系反应（HI-E）和/或输血独立，包括50.0%的高输血负担患者。基线促红细胞生成素（EPO）<500U/L的患者与总体患者相比总缓解率（ORR）更高（60.6% vs 55.6%），且非环状铁粒细胞（RS） MDS患者中的8周以上输血独立率显著较高（40% vs 22.2%），特别是在高输血负担患者中（50% vs 23.1%）。同时，基线EPO<500U/L的患者中有26例（32%）维持了≥24周的输血独立性。 数据截止时，输血独立的中位时间仍未达到，维持了≥24周的输血独立性患者中仍有16例患者持续保持输血独立性，11例（11/16）输血独立时间超过52周，其中6例在基线时具有高输血负担。对于输血独立患者，FACIT-疲劳评分的平均改善在24周内超过了临床意义阈值，特别是对于那些输血独立超过24周的患者，研究观察到了血红蛋白和血小板上升。 安全性方面，97.7%的患者经历了治疗期间不良事件（TEAE），大多数为轻度至中度。最常见的TEAE为腹泻（27.6%）、疲劳（25.3%）、呼吸困难（20.7%）、头晕（19.5%）、COVID-19（18.4%）、恶心（18.4%）和贫血（17.2%）。 Bimagrumab是一种靶向ActRII的人单克隆抗体，礼来通过斥资19亿美元收购Versanis将其纳入囊中。Bimagrumab在肥胖或超重2型糖尿病患者中开展的临床II期试验的第48周数据显示：与安慰剂相比，Bimagrumab 组受试者总体脂肪减少（-20.5% vs-0.5%）,去脂体重增加（+3.6%vs-0.8%），腰围减少（-9cm vs +0.5cm），体重减少（-6.5% vs-0.8%）。安全性方面，Bimagrumab组最常报告的不良事件是轻度腹泻(41% vs 11%)和肌肉痉挛(41% vs 3%)，其中首次给药后腹泻频率最高，此后逐渐减少。2024年10月，Bimagrumab联合替尔泊肽增肌减脂的临床II期临床启动。 Cibotercept（KER-012）处于临床II期阶段。该药是Keros Therapeutics开发的一款蛋白质治疗候选产品，由与人类抗体Fc结构域部分融合的ActRIIB的修饰配体结合结构域组成，其被设计用于结合并抑制包括激活素A和激活素B在内的TGF-β配体的信号转导，从而潜在地增加骨骼质量。同时，KER-012介导的对激活素A和激活素B的抑制也具有增加BMP信号通路的潜力。目前，Keros正在针对KER-012开展一项探讨KER-012联合背景疗法治疗成人肺动脉高压(PAH)的安全性和有效性的研究（NCT05975905）。 已公布的KER-012在健康绝经后妇女中开展的临床I期试验数据显示：与安慰剂相比，单次给予KER-012后，受试者中与炎症和结构重塑通路相关的血清蛋白发生了改变，例如纤维化标志物MMP-7和MMP-10减少、促炎细胞因子IL-6和IL-11减少、抗炎细胞因子IL-4和IL-35增加，以及巨噬细胞极化标志物MARCO和sCD163增加。此外，接受KER-012的受试者的心脏功能障碍生物标志物血清N末端脑钠肽前体（NT-proBNP）也持续减少。 LAE102、STM 434处于临床I期，其中LAE102是来凯医药自主研发的一款针对ActRIIA的选择性单克隆抗体，相较Bimagrumab有望提升安全性，公司计划将其开发用于治疗肥胖和代谢疾病、肺动脉高压等。在临床前研究中，LAE102已显示出增加肌肉并减少脂肪的效果。而且，LAE102与GLP-1受体激动剂联用，可进一步减少脂肪，并显著降低GLP-1受体激动剂导致的肌肉流失。2024年上半年，LAE102先后在美国和中国获批临床，针对肥胖。2024年6月，该药在国内针对超重/肥胖的临床I期试验完成首例患者给药。 此外，来凯医药围绕ActRII受体还自主开发两款候选药物，即ActRIIB选择性抗体LAE103和ActRIIA/IIB双靶点抑制剂LAE123，拟用于肌肉再生及与之相关的适应症。 ActRII药物减重增肌潜力看好，引发多起合作 整体来看，ActRII靶点并未取得巨大成功，但已引起多家药企重视，并引发多起交易。 2023年7月，礼来斥资19.25亿美元收购Versanis Bio。Versanis Bio旨在开发一种治疗代谢性疾病和肥胖症的first-in-class疗法，其核心产品Bimagrumab是一种结合激活素II型A和B受体以阻断激活素和肌肉抑制素信号传导的单克隆抗体，目前正在BELIEVE IIb期研究中单独进行评估，并与Semaglutide（司美格鲁肽）联合治疗成人超重或肥胖。 2024年5月，阿斯利康与SixPeaks达成了一项战略合作。据合作协议，阿斯利康参与A轮融资，并承诺提供包括预付款和短期付款在内的最高8000万美元资金。作为交换，阿斯利康获得在公司为其主导抗体提交IND申请时以预定价格收购SixPeaks的选择权。 SixPeaks致力于开发潜在“first-in-class“和“best-in-class”健康减肥疗法，其研发管线中包含一款旨在保存人体骨骼肌质量，靶向激活素（activin）受体IIA/B的抗体。在小鼠模型中进行的临床前研究表明，SixPeaks的主打在研疗法无论是单独使用，还是与GLP-1受体激动剂联用，在保存肌肉质量方面可能具有“best-in-class”的潜力。 而且，SixPeaks还开发出一种与GLP-1肽偶联的抗激活素受体IIA/B抗体，这可能成为一种潜在“first-in-class”疗法，在最大限度发挥GLP-1受体激动剂介导减重效果的同时保存肌肉质量。 2024年6月，Supercede Therapeutics与复旦大学和华东师范大学达成一项全球权益合作。据协议，Supercede Therapeutics将获得复旦大学和华东师范大学共同研发的处于临床前的小分子抗肿瘤恶病质肌萎缩、肌少症和增肌创新药物全球开发和商业化权益。据悉，该药物是一种新型口服小分子ActRII抑制剂，用于治疗肥胖症。 纵观这三项交易，企业都非常看中ActRII靶点在减重领域的潜力。与目前大火的GLP-1类减重疗法相比，ActRII抑制剂在减少脂肪的同时，还可增加身体的肌肉组成，被认为是下一代减肥药物的“种子选手”。 总结 相较大火的GLP-1靶点，ActRII在减重领域还有很长的路要走。目前，ActRII领域的竞争并不算激烈，在研药物也不多，其中Bimagrumab、LAE102在减重领域进展相对较快。期待ActRII药物早日获得重大突破，破解目前减肥药会使肌肉流失的困局。 END 来源：CPHI制药在线 声明：本文仅代表作者观点，并不代表制药在线立场。本网站内容仅出于传递更多信息之目的。如需转载，请务必注明文章来源和作者。 投稿邮箱：Kelly.Xiao@imsinoexpo.com ▼更多制药资讯，请关注CPHI制药在线▼ 点击阅读原文，进入智药研习社~

Analysis of Cerebral Spinal Fluid (CSF) from patients at pre-treatment baseline to post-treatment intervals up to 24 months demonstrates marked decrease in N-Acetylaspartate (NAA) Magnetic Resonance Imaging (MRI) assessments also show increases in brain white matter and myelin volume as well as functional improvements on validated scales The NAA reduction, MRI assessments and encouraging efficacy and safety data support further development of rAAV-Olig001-ASPA and discussions with regulatory authorities for a potential road map to registration NEW YORK, NY, USA I October 10, 2024 I Myrtelle Inc. (“Myrtelle” or the “Company”), a gene therapy company focused on developing transformative treatments for neurodegenerative diseases, today announced clinical trial findings showing a significant biomarker change in patients treated with the Company’s investigational gene therapy for Canavan disease (CD), rAAV-Oligo001-ASPA. Analysis of Cerebral Spinal Fluid (CSF) from seven patients, observed up to 24-month post treatment milestone revealed that each patient demonstrated a decrease of over 80% in N-Acetylaspartate (NAA) from their baseline measurement. Observations of these patients using Magnetic Resonance Imaging (MRI) also demonstrated increases in brain white matter and myelin volume over the same time intervals. The Company’s open-label Phase 1/2 First-in-Human (FIH) clinical trial is being conducted at Dayton Children’s Hospital (Dayton, Ohio) and includes baseline and post treatment assessments at 1, 3, 6, and 12 months the first year after surgery, and then once every 12 months for 5 years. Myrtelle’s FIH trial utilizes the Company’s proprietary rAAV vector to directly target oligodendrocytes, the brain cells affected in CD which are responsible for producing myelin – the insulating material that enables proper neuronal function. In CD, the production of myelin is impaired due to a mutation in the Aspartoacylase gene ( ASPA) that encodes the enzyme Aspartoacylase (ASPA) which is expressed in the brain solely in oligodendrocytes. The deficiency of ASPA enzyme results in multiple biochemical and anatomic changes, including inability to metabolize N-Acetylaspartate (NAA), a neurochemical that is abundant in the brain and plays an important role in myelin synthesis and brain bioenergetics. Myrtelle’s novel oligodendrocyte-targeting rAAV vector-based gene therapy is intended to restore ASPA function and hence the metabolism of NAA and myelination in patients with CD. Patients have also shown functional improvements on validated functional scales. Observed improvements in these treated patients are in contrast to the continuous clinical deterioration expected with the natural progression of CD. “The combination of changes in NAA levels and myelin volume offers a valuable tool for assessing early therapeutic efficacy in Canavan disease. Improvement in such important disease markers like NAA and myelin, together with functional gains in our patients, is encouraging given the progressive nature of Canavan disease. It drives us to continue our work to bring this potentially important therapy to the patients who currently do not have treatment options,” commented Olga Flamini, Co-CMO at Myrtelle. Myrtelle recently announced that rAAV-Olig001-ASPA was selected by the FDA for participation in the START pilot program in which the gene therapy candidate was one of four CBER-regulated products chosen. rAAV-Olig001-ASPA has also received RMAT, Orphan Drug, Rare Pediatric Disease, and Fast Track designations from the FDA, Orphan Drug Designation & Advanced Therapy Medicinal Product (ATMP) classification from the European Medicines Agency, as well as Innovative Licensing and Access Pathway (ILAP) from the United Kingdom Medicines & Healthcare products Regulatory Agency. ABOUT MYRTELLE Myrtelle Inc. is a gene therapy company focused on developing transformative treatments for neurodegenerative diseases. The company has a proprietary platform, intellectual property, and portfolio of programs and technologies supporting innovative gene therapy approaches for neurodegenerative diseases. Myrtelle has an exclusive worldwide licensing agreement with Pfizer Inc. for its Canavan disease program. For more information, please visit the Company’s website at: www.myrtellegtx.com . ABOUT CANAVAN DISEASE Canavan disease (CD) is a fatal childhood genetic brain disease caused by mutations in the ASPA gene ( ASPA ) which prevent the normal expression of aspartoacylase, a critical enzyme produced in oligodendrocytes. The lack of normal aspartoacylase expression negatively impacts brain bioenergetics and development, including myelin production. Patients with CD are impacted at birth but may appear normal until several months old when symptoms begin to develop. Poor head control, abnormally large head size, difficulty in eye tracking, excessive irritability, severely diminished muscle tone, and delays in reaching motor milestones, such as rolling, sitting, and walking, are the typical initial manifestations of CD. As the disease progresses, seizures, spasticity, difficulties in swallowing, and overall muscle deterioration emerge with most affected children developing life-threatening complications by approximately 10 years of age. Currently, there are no cures for CD, and only palliative treatments are available. More information on Myrtelle’s clinical trial in Canavan disease can be found on https://clinicaltrials.gov/ under the identifier NCT04833907 or by emailing PatientAdvocacy@MyrtelleGTX.com . SOURCE: Myrtelle