Avenue Therapeutics Announces Completion of Enrollment in Phase 1b/2a Clinical Trial of AJ201 for the Treatment of Spinal and Bulbar Muscular Atrophy (Kennedy's Disease)
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Insights
The enrollment completion of Avenue Therapeutics' Phase 1b/2a clinical trial for AJ201 represents a significant milestone in the development of treatments for spinal and bulbar muscular atrophy (SBMA), a rare and currently untreatable neurodegenerative disease. The focus on both safety and tolerability, as well as secondary endpoints that include biomarkers for target engagement, is a strategic approach to early-stage drug development. These biomarkers, particularly the measurement of mutant androgen receptor protein levels and changes in body composition, are critical in assessing the drug's mechanism of action and potential efficacy.
For stakeholders, the potential success of AJ201 could mean addressing a significant unmet medical need, which could translate into a substantial market opportunity. However, it is important to note that the disease's slow progression may pose challenges in demonstrating efficacy in a short-term trial. The long-term implications hinge on sustained clinical benefit and safety profiles observed in later-phase trials. The focus on precision medicine, by targeting genetically defined SBMA, may also enhance the drug's value proposition in a niche market.
Avenue Therapeutics' progress is a key indicator of the company's pipeline strength and its potential impact on the biotech sector. The successful enrollment of a Phase 1b/2a trial is often a positive sign for investors, as it indicates the company's capability to execute its clinical development plans. However, investors should be cautious and consider the high attrition rates typical in early-stage drug development.
From a market perspective, the rarity of SBMA means that AJ201 could qualify for orphan drug designation, potentially offering benefits such as market exclusivity and tax credits. The anticipation of topline data in the second quarter of 2024 is likely to be a significant catalyst for Avenue's stock price, as positive results could lead to increased investor confidence and potential partnerships or licensing deals. On the other hand, any negative outcomes could have a converse effect, underscoring the inherent risks of investing in clinical-stage biotech companies.
The design of the Phase 1b/2a clinical trial for AJ201, with its focus on a double-blind, randomized control group, is indicative of the rigorous standards in pharmaceutical development. The chosen dosage of 600 mg/day will be scrutinized for its safety profile, which is paramount in early-stage trials. The inclusion of pharmacodynamic data and MRI scans as part of the secondary endpoints is a forward-thinking approach that may provide early signals of the drug's activity and potential benefits before clinical efficacy can be fully evaluated.
Understanding the complexities of drug development for neurodegenerative diseases, especially those with genetic underpinnings like SBMA, is essential. The methodology of assessing drug impact on protein levels and body composition could pave the way for novel therapeutic benchmarks in this field. Moreover, the trial's outcomes may have broader implications for the treatment strategies of similar neurologic conditions, potentially expanding the scope of AJ201's impact beyond SBMA.
- Topline data remains on track for second quarter of 2024 -
MIAMI, Jan. 02, 2024 (GLOBE NEWSWIRE) -- Avenue Therapeutics, Inc. (Nasdaq: ATXI) (“Avenue” or the “Company”), a specialty pharmaceutical company focused on the development and commercialization of therapies for the treatment of neurologic diseases, today announced that all patients have been enrolled in the Phase 1b/2a clinical trial of AJ201 for the treatment of spinal and bulbar muscular atrophy (“SBMA”), also known as Kennedy's Disease. AJ201 is currently the lead drug candidate in the clinic for SBMA, and topline data are anticipated in the second quarter of 2024.
“We are pleased with the speed of enrollment in our Phase 1b/2a study evaluating AJ201 for the treatment of SBMA, reflecting the large unmet need in this debilitating neurodegenerative disease,” said Alexandra MacLean, M.D., Chief Executive Officer of Avenue. “We are intently focused on advancing this much needed drug for patients and their caregivers, and we look forward to reporting topline data in the second quarter of 2024.”
The 12-week, multicenter, randomized, double-blind Phase 1b/2a clinical trial of AJ201 enrolled 25 patients, randomly assigned to AJ201 (600 mg/day) or placebo. The primary endpoint of the study is to assess safety and tolerability of AJ201 in subjects with clinically and genetically defined SBMA. Although the disease is slow in progression, limiting the potential to demonstrate clinical efficacy over 12 weeks, Avenue has included as secondary endpoints various biomarkers addressing proof of target engagement, which could reflect the likelihood of clinical success. These biomarkers include the pharmacodynamic data measuring change from baseline in mutant androgen receptor protein levels in skeletal muscle and changes in the fat and muscle composition as seen on MRI scans. Further details about this study can be found at ClinicalTrials.gov (Identifier: NCT05517603).
About Spinal and Bulbar Muscular Atrophy
Spinal and bulbar muscular atrophy (“SBMA”) is a rare, X-linked genetic neuromuscular disease primarily affecting men. The condition is caused by the trinucleotide CAG repeat expansion in the androgen receptor (“AR”) which leads to production of a mutant polyglutamine (“polyQ”) AR protein that forms aggregates responsible for muscular atrophy focused in the limbs and bulbar region of the body. The weakening of the bulbar muscles affects chewing, speech and swallowing, with patients prone to choking or inhaling foods or liquids, resulting in airway infection. SBMA also affects muscles in the limbs, leading to difficulty walking and injury caused by falling. Although there is a range of cited prevalence rates in scientific literature, a recent study used genetic analysis to estimate disease prevalence of 1:6,887 males.1 Currently, there are no treatments approved by the U.S. Food and Drug Administration or European Medicines Agency available for patients. For more information about SBMA, also known as Kennedy’s Disease, please visit https://kennedysdisease.org/.
About AJ201
AJ201 is a novel, first-in-class asset in development for the treatment of spinal and bulbar muscular atrophy. It was designed to modify SBMA through multiple mechanisms including degradation of the abnormal androgen receptor protein and by stimulating the Nrf1 and Nrf2 pathways, which are involved in protecting cells from oxidative stress which can lead to cell death. A first-in-human Phase 1 study of AJ201 in 72 healthy volunteers revealed an excellent safety and pharmacokinetic profile. It is currently being studied in a Phase 1/2a multicenter, randomized, double-blind clinical trial in six clinical sites across the U.S., which aims to evaluate the safety, PK/PD data and clinical response of AJ201 in patients suffering from SBMA. AJ201 has been granted Orphan Drug Designation by the FDA for multiple polyQ diseases, including SBMA, Huntington’s disease and spinocerebellar ataxia. Avenue exclusively licensed AJ201 from AnnJi Pharmaceuticals in the United States, Canada, European Union, Great Britain, and Israel.
About Polyglutamine diseases
Polyglutamine diseases are a group of neurodegenerative disorders caused by expanded CAG repeats encoding a long polyQ tract in the affected proteins. To date, a total of nine polyQ disorders have been described. Mutant protein aggregation in affected tissues is the pathological hallmark of polyQ diseases. Neuroinflammation, oxidative stress and dysregulated protein quality control are thought to be key pathological factors that are either direct results of mutant protein aggregations and/or exacerbate the severity and progression of the diseases. Modulating multiple cellular pathways in enhancing degradation of mutant AR aggregates, inducing antioxidant and heat shock responses, and increasing proteasome expression simultaneously provide the rationale to develop AJ201 for the treatment of SBMA and potentially other polyQ diseases.
About Avenue Therapeutics
Avenue Therapeutics, Inc. (Nasdaq: ATXI) is a specialty pharmaceutical company focused on the development and commercialization of therapies for the treatment of neurologic diseases. It is currently developing three assets including AJ201, a first-in-class asset for spinal and bulbar muscular atrophy, BAER-101, an oral small molecule selective GABAA α2/3 receptor positive allosteric modulator for CNS diseases, and IV tramadol, which is in Phase 3 clinical development for the management of acute postoperative pain in adults in a medically supervised healthcare setting. Avenue is headquartered in Miami, FL and was founded by Fortress Biotech, Inc. (Nasdaq: FBIO). For more information, visit www.avenuetx.com.
Forward-Looking Statements
This press release contains predictive or “forward-looking statements” within the meaning of the Private Securities Litigation Reform Act of 1995. All statements other than statements of current or historical fact contained in this press release, including statements that express our intentions, plans, objectives, beliefs, expectations, strategies, predictions or any other statements relating to our future activities or other future events or conditions are forward-looking statements. The words “anticipate,” “believe,” “continue,” “could,” “estimate,” “expect,” “intend,” “may,” “plan,” “predict,” “project,” “will,” “should,” “would” and similar expressions are intended to identify forward-looking statements. These statements are based on current expectations, estimates and projections made by management about our business, our industry and other conditions affecting our financial condition, results of operations or business prospects. These statements are not guarantees of future performance and involve risks, uncertainties and assumptions that are difficult to predict. Therefore, actual outcomes and results may differ materially from what is expressed or forecasted in, or implied by, the forward-looking statements due to numerous risks and uncertainties. Factors that could cause such outcomes and results to differ include, but are not limited to, risks and uncertainties arising from: expectations for increases or decreases in expenses; expectations for the clinical and pre-clinical development, manufacturing, regulatory approval, and commercialization of our pharmaceutical product candidate or any other products we may acquire or in-license; our use of clinical research centers and other contractors; expectations for incurring capital expenditures to expand our research and development and manufacturing capabilities; expectations for generating revenue or becoming profitable on a sustained basis; expectations or ability to enter into marketing and other partnership agreements; expectations or ability to enter into product acquisition and in-licensing transactions; expectations or ability to build our own commercial infrastructure to manufacture, market and sell our product candidates; acceptance of our products by doctors, patients or payors; our ability to compete against other companies and research institutions; our ability to secure adequate protection for our intellectual property; our ability to attract and retain key personnel; availability of reimbursement for our products; estimates of the sufficiency of our existing cash and cash equivalents and investments to finance our operating requirements, including expectations regarding the value and liquidity of our investments; the volatility of our stock price; expected losses; expectations for future capital requirements; and those risks discussed in our filings which we make with the SEC. Any forward-looking statements speak only as of the date on which they are made, and we undertake no obligation to publicly update or revise any forward-looking statements to reflect events or circumstances that may arise after the date of this press release, except as required by applicable law. Investors should evaluate any statements made by us in light of these important factors.
Contact:
Jaclyn Jaffe
Avenue Therapeutics, Inc.
(781) 652-4500
ir@avenuetx.com
1 M. Zanovello et al., Unexpected frequency of the pathogenic ARCAG repeat 2 expansion in the general population. Brain, 2023 Jul 3;146(7):2723-2729.
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