Coya Therapeutics Presents ALS Biomarker Data at Society of Neuroimmune Pharmacology Conference
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Insights
The identification of 4-Hydroxynonenal (4-HNE) as a potential biomarker for Amyotrophic Lateral Sclerosis (ALS) progression and survival presents a significant advancement in the field of neurodegenerative disease research. Biomarkers are vital tools for clinicians to diagnose and monitor diseases, as well as to assess the efficacy of treatments. The high sensitivity (91.7%) and specificity (71.1%) reported in the study suggest that 4-HNE could be a reliable indicator of ALS progression, which is critical for patient prognosis and for tailoring personalized treatment strategies.
From a research perspective, the correlation between 4-HNE levels and ALS progression underscores the role of oxidative stress in neurodegeneration. The ability to monitor oxidative stress through a biomarker could lead to earlier intervention and potentially more effective management of the disease. The use of COYA 302, a combination of low dose interleukin-2 (LD IL-2) and CTLA-4 Ig, in reducing 4-HNE levels may represent a novel therapeutic approach, addressing inflammation and immune dysregulation in ALS.
However, it should be noted that the research is still in the clinical stage and further validation in larger cohorts and diverse populations is necessary. Additionally, the translation of biomarker research into clinical practice requires rigorous regulatory review and approval, which can be a lengthy process.
The filing of patent applications by Coya Therapeutics, Inc. for the use of 4-HNE as a biomarker in ALS treatment is an important strategic move. Patents can provide a competitive edge by protecting intellectual property and potentially creating licensing opportunities. The patent applications may cover methods of measuring 4-HNE, its use in predicting disease progression, or its application in evaluating treatment efficacy.
However, the success of such patent applications will depend on the novelty, utility and non-obviousness of the claimed inventions. Given the specificity and sensitivity of 4-HNE as a biomarker, there is a strong argument for its utility. Nonetheless, the biotechnology patent landscape is highly complex and there may be existing patents or publications that could affect the patentability of Coya's applications. Furthermore, the commercial success of the patents will largely depend on the outcome of ongoing clinical trials and the subsequent adoption of 4-HNE as a biomarker in clinical settings.
The announcement by Coya Therapeutics, Inc. regarding the potential of 4-HNE as a biomarker for ALS is likely to be of interest to stakeholders in the biotechnology industry. The development of a new biomarker could open up new markets and drive demand for diagnostic tests and personalized treatment options. For investors, the progress in biomarker development could be an indicator of the company's innovative capabilities and the potential for future growth.
However, the biotech industry is known for its high level of risk, particularly in the clinical-stage development. The successful validation and regulatory approval of 4-HNE as a biomarker are not guaranteed and the commercialization process can be capital-intensive and time-consuming. Stakeholders will need to consider the long-term investment required for research and development, as well as the competitive landscape of ALS treatment options.
Additionally, the impact on the stock market will depend on the perceived value of this advancement and the company's ability to effectively communicate and leverage the findings. Market reactions can be influenced by a variety of factors, including the overall pipeline of the company, the market size for ALS treatments and investor sentiment towards biotech innovation.
4-Hydroxynonenal (4-HNE) levels strongly correlate with rate of Amyotrophic Lateral Sclerosis (ALS) disease progression and survival of patients from onset and diagnosis to death (
4-HNE levels may serve as a potential surrogate biomarker to track efficacy of ALS disease modifying treatments, such as COYA 302
The data presented highlights the strong predictive value of levels of an oxidative stress biomarker (4-HNE) with the rate of disease progression and survival in 50 ALS patients from a longitudinal patient registry cohort. An additional analysis of another random 50 patients from the same patient registry cohort is being finalized and will be presented in the future. In a proof-of-concept study in patients with ALS, the combination of low dose interleukin-2 (LD IL-2) and CTLA-4 Ig appeared to lower 4-HNE and other proinflammatory biomarker levels. Coya intends to finalize the analysis of the initial 50 patients, as well as the additional 50 ALS patients, and publish the results in a peer review journal in the near future. Furthermore, Coya has filed patent applications relating to the use of the biomarker in ALS. The biomarker data can be viewed here.
Stanley Appel, M.D., Chairman of Coya’s SAB, commented: “We believe these studies of the first set of 50 ALS patients from our database document the correlation of 4-HNE with the progression of disease and patient survival and support the potential importance of 4-HNE as a biomarker.”
Fred Grossman, Chief Medical Officer at Coya, commented, “Based on the strength of the biomarker data, Coya plans to discuss with the FDA the goal of validating 4-HNE as a new potential biomarker for predicting progression and survival in patients with ALS.”
4-HNE Relevance in Disease Pathophysiology
Reactive oxygen species (ROS) are generated mainly as byproducts of mitochondrial respiration and are tightly controlled by multiple anti-oxidant mechanisms. In neurodegenerative diseases, such as ALS, when the antioxidant system is overwhelmed by overproduction of ROS, oxidative stress occurs. 4-HNE, an abundant and reactive oxygen species, is thought to exert neuronal toxicity ultimately through formation of toxic protein aggregates, such as those seen in ALS patients. Additionally, 4-HNE appears to be causally involved in multiple pathophysiologic events associated with disease pathophysiology, including motor neuron death.
Summary of Study Results
Data was collected from a previously established biobank at Houston Methodist to monitor and track ALS patient outcomes with biomarkers. Serial longitudinal sampling of serum was assessed in 50 patients over the duration of their journeys from diagnosis to death. 4-HNE was identified in previous studies as a biomarker of interest relevant to ALS pathophysiology. Thus, serum 4-HNE levels were tracked and monitored during the patients’ treatment journeys, while healthy patients were measured as controls. Results demonstrate that:
- 4-HNE serum levels are significantly elevated in ALS patients compared to healthy controls
- 4-HNE serum levels correlate with the rate of disease progression in ALS patients (ALSFRS points/month) - The higher the 4-HNE serum level, the faster the progression
- 4-HNE serum levels correlate with survival from onset and diagnosis to death -The higher the 4-HNE serum level, the shorter the survival
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A receiver operating characteristic curve (ROC) analysis documents a
91.7% sensitivity and71.1% specificity in predicting 24-month survival based on a threshold 4-HNE level of 8 ug/ml: If 4-HNE serum levels are > 8 ug/ml, there is a91.7% chance that patient survival will be less than or equal to 24 months. If 4-HNE serum level is < 8 ug/ml, there is a71.1% chance that patient survival is greater than 24 months - Based on a proof-of-concept study, COYA 302 (combination of LD IL-2 and CTLA-4 Ig) may lower 4-HNE levels and levels of other relevant biomarkers that correlate with disease progression.
About COYA 302
COYA 302 is an investigational and proprietary biologic combination therapy with a dual immunomodulatory mechanism of action intended to enhance the anti-inflammatory function of regulatory T cells (Tregs) and suppress the inflammation produced by activated monocytes and macrophages. COYA 302 is comprised of proprietary low dose interleukin-2 (LD IL-2) and CTLA-4 Ig (abatacept) and is being developed for subcutaneous administration for the treatment of patients with ALS, Frontotemporal Dementia (FTD), Parkinson’s Disease (PD), and Alzheimer’s Disease (AD). These mechanisms may have additive or synergistic effects.
In February of 2023, Coya announced results from a proof-of-concept, open-label clinical study evaluating commercially available LD IL-2 and CTLA-4 Ig in a small cohort of patients with ALS conducted at the Houston Methodist Research Institute (
During the 48-week treatment period, the therapy was well tolerated. The most common adverse event was mild injection-site reactions. No patient discontinued the study, and no deaths or other serious adverse events were reported.
Patients' disease progression was measured using the ALSFRS-R scale, a validated rating tool for monitoring the progression of disability in patients with ALS. The mean (±SD) ALSFRS-R scores at week 24 (33.75 ±3.3) and week 48 (32 ±7.8) after initiation of treatment were not statistically different compared to the ALSFRS-R score at baseline (33.5 ±5.9), suggesting significant amelioration in the progression of the disease over the 48-week treatment period.
Treg suppressive function, expressed as percentage of inhibition of proinflammatory T cell proliferation, showed a statistically significant increase over the course of the treatment period and was significantly reduced at the end of the 8-week washout post-treatment period. Treg suppressive function at 24 weeks (79.9 ±9.6) and 48 weeks (89.5 ±4.1) was significantly higher compared to baseline (62.1 ±8.1) (p<0.01), suggesting enhanced and durable Treg suppressive function over the course of treatment. In contrast, Treg suppressive function (mean ±SD) was significantly decreased at the end of the 8-week washout period compared to end-of-treatment at week 48 (70.3 ±8.1 vs. 89.5 ±4.1, p <0.05).
The study also evaluated serum biomarkers of inflammation, oxidative stress, and lipid peroxides. The available data up to 16 weeks after initiation of treatment suggest a decrease in these biomarker levels, which is consistent with the observed enhancement of Treg function. The evaluation of the full biomarker data is ongoing.
COYA 302 is an investigational product not yet approved by the FDA or any other regulatory agency.
About Amyotrophic Lateral Sclerosis
Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig's Disease, is a rare neurological disease that affects motor neurons, the nerve cells in the brain and spinal cord that control voluntary muscle movement. About 20,000 people live with ALS in
ALS has no cure, and the currently approved drug treatments provide limited benefit to patients. ALS is a type of motor neuron disease. As motor neurons degenerate and die, they stop sending messages to the muscles, which causes the muscles to weaken, start to twitch (fasciculations), and waste away (atrophy). Eventually, the brain loses its ability to initiate and control voluntary movements. Most people with ALS die from respiratory failure, usually within three to five years from when the symptoms first appear.2
References
- Atassi N, et al. The PRO-ACT database: design, initial analyses, and predictive features. Neurology, 2014;83:1719–1725. doi: 10.1212/WNL.0000000000000951.
- National Institutes of Health (NIH) Website (https://www.ninds.nih.gov), accessed on January 8, 2024.
About Coya Therapeutics, Inc.
Headquartered in
Coya’s investigational product candidate pipeline leverages multiple therapeutic modalities aimed at restoring the anti-inflammatory and immunomodulatory functions of Tregs. Coya’s therapeutic platforms include Treg-enhancing biologics, Treg-derived exosomes, and autologous Treg cell therapy.
COYA 302 – the Company’s lead biologic investigational product or "Pipeline in a Product" – is a proprietary combination of COYA 301 (Coya’s proprietary LD IL-2) and CTLA4-Ig for subcutaneous administration with a unique dual mechanism of action that is now being developed for the treatment of Amyotrophic Lateral Sclerosis, Frontotemporal Dementia, Parkinson’s Disease, and Alzheimer’s Disease. Its multi-targeted approach enhances the number and anti-inflammatory function of Tregs and simultaneously lowers the expression of activated microglia and the secretion of pro-inflammatory mediators. This synergistic mechanism may lead to the re-establishment of immune balance and amelioration of inflammation in a sustained and durable manner that may not be achieved by either low-dose IL-2 or CTLA4-Ig alone.
For more information about Coya, please visit www.coyatherapeutics.com
Forward-Looking Statements
This press release contains “forward-looking” statements that are based on our management’s beliefs and assumptions and on information currently available to management. Forward-looking statements include all statements other than statements of historical fact contained in this presentation, including information concerning our current and future financial performance, business plans and objectives, current and future clinical and preclinical development activities, timing and success of our ongoing and planned clinical trials and related data, the timing of announcements, updates and results of our clinical trials and related data, our ability to obtain and maintain regulatory approval, the potential therapeutic benefits and economic value of our product candidates, competitive position, industry environment and potential market opportunities. The words “believe,” “may,” “will,” “estimate,” “continue,” “anticipate,” “intend,” “expect,” and similar expressions are intended to identify forward-looking statements.
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We have based these forward-looking statements largely on our current expectations and projections about future events and trends that we believe may affect our financial condition, results of operations, business strategy, short-term and long-term business operations and objectives, and financial needs. Moreover, we operate in a very competitive and rapidly changing environment, and new risks may emerge from time to time. It is not possible for our management to predict all risks, nor can we assess the impact of all factors on our business or the extent to which any factor, or combination of factors, may cause actual results to differ materially from those contained in any forward-looking statements we may make. In light of these risks, uncertainties and assumptions, the forward-looking events and circumstances discussed herein may not occur and actual results could differ materially and adversely from those anticipated or implied in the forward-looking statements. Although our management believes that the expectations reflected in our forward-looking statements are reasonable, we cannot guarantee that the future results, levels of activity, performance or events and circumstances described in the forward-looking statements will be achieved or will occur. We undertake no obligation to publicly update any forward-looking statements, whether written or oral, that may be made from time to time, whether as a result of new information, future developments or otherwise.
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Source: Coya Therapeutics, Inc.
FAQ
How do 4-Hydroxynonenal (4-HNE) levels correlate with Amyotrophic Lateral Sclerosis (ALS) disease progression and patient survival?
What is the potential role of 4-Hydroxynonenal (4-HNE) as a biomarker in ALS treatment?
What is the significance of the biomarker data presented by Coya Therapeutics, Inc. at the Society of Neuroimmune Pharmacology Conference?
What is the proof-of-concept study involving COYA 302 in ALS patients?
What are the key findings regarding 4-Hydroxynonenal (4-HNE) serum levels in ALS patients compared to healthy controls?
