Coya Therapeutics Reports Additional Proof-of-Concept Clinical Biomarker Data in Patients with Alzheimer’s Disease
- The open-label study evaluated the safety and tolerability, biological activity, blood biomarkers and preliminary efficacy of low-dose interleukin 2 (ld IL-2) in 8 patients with Alzheimer’s disease (AD). The academic study was conducted by Dr. Appel and Dr. Faridar at the Houston Methodist Hospital.
- The additional clinical data show a significant decrease in biomarker levels known to be associated with neuroinflammation in AD patients further supporting the initial positive results of the study. Blood levels of CCL4 (CC motif chemokine ligand 4), FLT3LG (FMS-related tyrosine kinase 3 ligand) and TNFα (tumor necrosis factor alpha) were consistently lower following administration of ld IL-2.
- Coya’s investigational ld IL-2 for subcutaneous administration has been designed to enhance the function of regulatory T cells (Tregs) in vivo and it is being developed for the treatment of neurodegenerative and autoimmune diseases, as monotherapy or in combination with other immunomodulatory agents.
- Previously released data showed that treatment with ld IL-2 resulted in a statistically significant improvement in cognitive function, as measured by the Mini-Mental State Examination test (MMSE). In addition, no cognitive decline was observed when it was measured by the Alzheimer’s Disease Assessment Scale–Cognitive Subscale (ADAS-Cog), and the Clinical Dementia Rating-Sum of Boxes scale (CDR-SB).
- Over the course of the study, ld IL-2 demonstrated biological activity by restoring peripheral Treg function and numbers and significantly lowering the blood levels of other well-characterized proinflammatory cytokines and chemokines, such as IL-15 (interleukin 15), CCL2 (monocyte chemoattractant protein-1) and CCL11 (CC motif chemokine ligand 11).
- Treatment with ld IL-2 administered subcutaneously appeared to be safe and well tolerated in patients with AD.
- An ongoing phase 2, double blind, placebo controlled trial (funded by the Gates foundation and Alzheimer’s Association) in approximately 46 patients with mild to moderate AD is almost fully enrolled and should report top line results in July, 2024.
The study enrolled 8 patients with confirmed presence of brain amyloid pathology and baseline MMSE scores between 12 and 25. The patients were treated with five-day-courses of subcutaneous ld IL-2 for four monthly cycles and were followed for two months post-treatment. Treg function and numbers, serum biomarkers of inflammation, safety and tolerability, and cognitive functioning as measured by the ADAS-Cog, CDR-SB and MMSE assessment tools were evaluated.
The additional blood biomarker data showing a significant decrease in the blood levels of the proinflammatory cytokines and chemokines CCL4, FLT3LG and TNFα in AD patients treated with ld IL-2 strengthen the positive results Coya has previously announced in May 2023.
Coya previously reported that the treatment with ld IL-2 significantly expanded Treg population and function. At baseline, the mean (SD) percentage of Tregs was 4.55 (1.97) and was almost double at the end of the treatment [8.68 (2.99), p=0.0004]. Mean (SD) Treg suppressive function was
In addition, evaluation of cognitive function showed that administration of ld IL-2 resulted in a statistically significant improvement in mean MMSE scores during the treatment phase, compared to mean MMSE score at baseline (p=0.015). Consistent with the positive trend in MMSE score, mean scores in ADAS-Cog and CDR-SB scales did not significantly change at the end of treatment with COYA 301, compared to pre-treatment baseline scores, indicating no cognitive decline as measured by these validated instruments.
Overall, administration of ld-IL-2 appeared to be safe and well tolerated. The most common adverse events were mild injection-site reactions and mild leukopenia. No serious adverse events were reported, and no patient discontinued the study.
Following the encouraging results of this open-label proof-of-concept study, a Phase 2 double-blind, placebo-controlled study in approximately 46 patients with mild-to-moderate AD is being conducted at the Houston Methodist Hospital and as of today, is almost fully enrolled with 38 patients in the study. The well-controlled clinical study will evaluate the safety and tolerability, Teg function, blood biomarkers of neuroinflammation, and efficacy of two dose regimens of ld IL-2 compared to placebo, over a 30-week period. Top-line results are anticipated in July 2024. The study is funded by the Gates Foundation and the Alzheimer’s Association.
Stanley Appel, M.D., Professor at Houston Methodist and Chair of Coya’s Scientific Advisory Board commented, “Our research studies documenting a significant reduction of Treg neuroprotective functions in AD led to our use of low dose IL-2 to enhance Treg numbers and suppressive functions. Our 8 patient study in AD was safe and well tolerated, decreased pro-inflammatory signaling, and suggested a beneficial clinical effect. We are optimistic that this approach, now being tested in a larger double-blind placebo-controlled study, may help address the unmet needs of our deserving AD patients.”
About Alzheimer’s Disease
Alzheimer's disease is the most common cause of dementia, a general term for memory loss and other cognitive abilities serious enough to interfere with daily life. Alzheimer's disease accounts for up to
References
- Alzheimer’s Association (www.alz.org).
- Centers for Disease Control and Prevention (www.cdc.gov).
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