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Ionis announces positive topline results from Phase 3 OASIS-HAE study of investigational donidalorsen in patients with hereditary angioedema

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Ionis Pharmaceuticals, Inc. announced positive Phase 3 OASIS-HAE study results for donidalorsen in treating hereditary angioedema, meeting primary endpoint with significant reduction in attack rate, favorable safety profile, and plans for FDA and EMA submissions. Donidalorsen targets prekallikrein to interrupt HAE attacks, with plans for independent drug launches and presentations of Phase 3 results at medical congress.
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Insights

The recent announcement regarding the successful Phase 3 OASIS-HAE study of donidalorsen presents a significant development in the treatment of hereditary angioedema (HAE), a rare genetic disorder. The efficacy of donidalorsen in reducing the frequency of HAE attacks is a promising advancement, given the current challenges faced by patients, including the unpredictability and severity of attacks despite existing prophylactic treatments.

The data indicating a statistically significant reduction in attack rates and a favorable safety profile is crucial. It suggests that donidalorsen's mechanism of action, targeting the production of prekallikrein (PKK), effectively interrupts the pathway leading to HAE attacks. This precision medicine approach could offer a more targeted and possibly more effective prophylaxis compared to current treatments that may not be as specific in their action.

The implications for stakeholders are multifaceted. For patients, this could mean a substantial improvement in quality of life and a reduction in the healthcare burden associated with managing acute HAE attacks. For Ionis Pharmaceuticals, the successful development of donidalorsen could enhance its market position as a leader in RNA-targeted therapies, potentially boosting investor confidence and stock valuation.

Ionis Pharmaceuticals' announcement of positive topline results from the OASIS-HAE study is likely to have a favorable impact on the company's financial prospects. The preparation to submit a New Drug Application (NDA) with the U.S. FDA and a Marketing Authorization Application in Europe represents a critical step towards commercialization, which could substantially increase Ionis's revenue streams.

The orphan drug designation in the U.S. and the ongoing procedure in the EU could provide market exclusivity benefits, enhancing the potential return on investment. Additionally, the company's mention of a 'steady cadence of potentially transformational medicines' suggests a strong R&D pipeline, which is often a positive indicator for investors looking for long-term growth opportunities.

However, it is essential to monitor the company's expenditure on R&D and the marketing costs associated with launching a new drug, as these could impact short-term profitability. The market's response to Ionis's stock will depend on how well the company manages these expenses and the market's perception of the drug's potential success.

The market for HAE treatments is characterized by a relatively small patient population but with a high unmet medical need, often translating into a willingness to adopt new and effective treatments quickly. The entry of donidalorsen into this market could disrupt current treatment paradigms, especially if its dosing schedule (every 4 or 8 weeks) offers greater convenience compared to existing therapies.

Analyzing competitor products and market dynamics is essential. The impact of donidalorsen's approval will depend on its comparative efficacy, safety profile and cost. If approved, Ionis's marketing strategy and ability to secure favorable reimbursement will be critical in determining its market share.

Furthermore, the upcoming presentation of detailed study results at a medical congress could influence the medical community's perception of donidalorsen, potentially affecting the rate of adoption post-approval. The anticipation of these results may also create volatility in Ionis's stock as investors react to new information.

  • Donidalorsen met the primary endpoint with a statistically significant reduction in the rate of HAE attacks in patients treated every 4 weeks or patients treated every 8 weeks 
  • Donidalorsen demonstrated a favorable safety and tolerability profile
  • Ionis is preparing to submit a New Drug Application with U.S. FDA
  • Data to be presented at an upcoming medical congress

CARLSBAD, Calif., Jan. 22, 2024 /PRNewswire/ -- Ionis Pharmaceuticals, Inc. (Nasdaq: IONS) today announced positive topline results for the Phase 3 OASIS-HAE study of donidalorsen in people with hereditary angioedema (HAE). The trial met its primary endpoint of reduction in rate of angioedema attacks in patients treated with donidalorsen (80mg) via subcutaneous injection dosed every 4 weeks (Q4W) (p<0.001) or every 8 weeks (Q8W) (p=0.004), compared to placebo. In addition, the trial showed donidalorsen achieved statistical significance on all secondary endpoints in the Q4W group and key secondary endpoints in the Q8W group. Donidalorsen demonstrated a favorable safety and tolerability profile in the study, and there were no serious adverse events in the patients treated with donidalorsen.

HAE is a rare and life-threatening genetic disease that causes unpredictable and frequent severe swelling of the skin, gastrointestinal (GI) tract, upper respiratory system, face and throat. Donidalorsen is an investigational RNA-targeted prophylactic medicine designed to precisely target and silence the production of prekallikrein (PKK), interrupting the pathway that leads to HAE attacks.

Based on these data, Ionis is preparing to submit a New Drug Application with the U.S. Food and Drug Administration. Otsuka, which has exclusive rights to commercialize donidalorsen in Europe, is preparing to submit a Marketing Authorization Application to the European Medicines Agency. Donidalorsen received Orphan Drug Designation in the U.S., and the Orphan Drug Designation procedure in the EU is ongoing.  

"We are very pleased with the positive topline results from the Phase 3 OASIS-HAE study of donidalorsen," said Kenneth Newman, M.D., senior vice president, head of clinical development at Ionis. "Based on these results and the durable efficacy and favorable safety data seen in the ongoing Phase 2 open-label extension study, we believe donidalorsen, if approved, could be an attractive new treatment option for patients with HAE, many of whom continue to experience unpredictable, painful and severe breakthrough attacks despite currently available prophylactic treatments. We are grateful to the patients, caregivers, investigators and study teams who participated in the OASIS-HAE study."

"These data represent our third highly positive Phase 3 readout over the last 12 months, underscoring the strength of our LICA platform for RNA-targeted medicines," said Brett P. Monia, Ph.D., chief executive officer of Ionis. "Following the recent launch of WAINUA™ (eplontersen), we are now well on our way to independently launching medicines from our wholly owned pipeline with regulatory submissions this year for olezarsen in familial chylomicronemia syndrome and donidalorsen in HAE. These achievements, coupled with our robust R&D pipeline, position Ionis to continue to deliver a steady cadence of potentially transformational medicines to people with serious diseases for years to come."

Ionis plans to present the Phase 3 OASIS-HAE results at an upcoming medical congress by mid-year. Ionis also plans to share results from the Phase 3 OASIS-Plus study by mid-year, which includes both the open-label extension of the Phase 3 trial and a separate cohort of patients who have transitioned to donidalorsen from another prophylactic HAE medication (switch cohort).

About the OASIS-HAE Study

The global, multicenter, randomized, double-blind, placebo-controlled Phase 3 OASIS-HAE study (NCT05139810) enrolled 91 participants, age 12 and above, with Type 1 and Type 2 hereditary angioedema (HAE). Participants were randomized in a 2:1 ratio to receive donidalorsen 80 mg or placebo via subcutaneous injection once every four weeks for 24 weeks or donidalorsen 80 mg or placebo via subcutaneous injection once every eight weeks for 24 weeks. Within each cohort, participants were randomized in a 3:1 ratio to receive donidalorsen or matching-placebo. The primary endpoint was the time-normalized number of investigator-confirmed HAE attacks from week one to week 25 compared to placebo. More than 90% of patients completed the OASIS-HAE study. Following completion of the treatment period, over 90% of randomized patients entered the Phase 3 OASIS-Plus open-label extension study.

About the OASIS-Plus Study

The Phase 3 OASIS-Plus open-label extension (OLE) study is a 53-week global, multicenter study of subcutaneous injections of donidalorsen administered every four weeks (80mg) and every eight weeks (80mg) in patients completing the OASIS-HAE trial. These are patients aged 12 and above, with Type 1 and Type 2 hereditary angioedema (HAE). The study is designed to evaluate the safety and efficacy of extended dosing of donidalorsen following completion of the Phase 3 OASIS-HAE study. The OASIS-Plus switch cohort is evaluating the safety and efficacy of long-term dosing of donidalorsen every four weeks in patients who were previously treated with another prophylactic HAE medication. Additional information about OASIS-Plus (NCT04307381) may be found at ClinicalTrials.gov.

About Hereditary Angioedema (HAE)

HAE is a rare and life-threatening genetic disease characterized by unpredictable and frequently severe swelling of the skin, gastrointestinal (GI) tract, upper respiratory system, face, and throat, which can be life-threatening1,2,3,4,5. HAE is estimated to affect more than 20,000 people in the U.S. and Europe6. In the U.S., doctors frequently use prophylactic treatment approaches to prevent and reduce the severity of HAE attacks in patients.

About Donidalorsen

Donidalorsen is an RNA investigational LIgand-Conjugated Antisense (LICA) medicine designed to precisely target and silence the production of prekallikrein (PKK), interrupting the pathway that leads to HAE attacks. PKK plays an important role in activating inflammatory mediators associated with acute attacks of hereditary angioedema (HAE). By silencing the production of PKK, donidalorsen could be an effective prophylactic approach to treating HAE.

About Ionis Pharmaceuticals, Inc.

For more than 30 years, Ionis has been a leader in RNA-targeted therapy, pioneering new markets and changing standards of care. Ionis currently has five marketed medicines and a promising late-stage pipeline highlighted by cardiovascular and neurological franchises. Our scientific innovation began and continues with the knowledge that sick people depend on us, which fuels our vision to become the leader in genetic medicine, utilizing a multi-platform approach to discover, develop and deliver life-transforming therapies.

To learn more about Ionis visit www.ionispharma.com and follow us on X (Twitter) @ionispharma and LinkedIn.

Ionis' Forward-looking Statements

This press release includes forward-looking statements regarding Ionis' business and the therapeutic and commercial potential of donidalorsen, Ionis' technologies and other products in development. Any statement describing Ionis' goals, expectations, financial or other projections, intentions or beliefs is a forward-looking statement and should be considered an at-risk statement. Such statements are subject to certain risks and uncertainties including those related to our commercial products and the medicines in our pipeline, and particularly those inherent in the process of discovering, developing and commercializing medicines that are safe and effective for use as human therapeutics, and in the endeavor of building a business around such medicines. Ionis' forward-looking statements also involve assumptions that, if they never materialize or prove correct, could cause its results to differ materially from those expressed or implied by such forward-looking statements. Although Ionis' forward-looking statements reflect the good faith judgment of its management, these statements are based only on facts and factors currently known by Ionis. As a result, you are cautioned not to rely on these forward-looking statements. These and other risks concerning Ionis' programs are described in additional detail in Ionis' annual report on Form 10-K for the year ended Dec. 31, 2022, and the most recent Form 10-Q quarterly filing, which are on file with the Securities and Exchange Commission. Copies of these and other documents are available from the Company.

In this press release, unless the context requires otherwise, "Ionis," "Company," "we," "our," and "us" all refer to Ionis Pharmaceuticals and its subsidiaries.

Ionis Pharmaceuticals® is a registered trademark of Ionis Pharmaceuticals, Inc.

1 Manning ME. Dermatol Ther (Heidelb). 2021; 11:1829-1838.
2 Valerieva A, et al. Balkan Med J. 2021;8:89-103.
3 Santacroce R, et al. J Clin Med. 2021;10:2023.
4 Pines JM, et al. J Emerg Med. 2021;60:35-43.X
5 Maurer M, et al. World Allergy Organ J. 2022;15:100627.
6 Weller K, et al. Allergy. 2016;71(8): 1203-1209.

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SOURCE Ionis Pharmaceuticals, Inc.

FAQ

What are the positive results of the Phase 3 OASIS-HAE study for donidalorsen?

The trial met its primary endpoint with a statistically significant reduction in the rate of angioedema attacks in patients treated with donidalorsen every 4 weeks or every 8 weeks, compared to placebo. It also demonstrated a favorable safety and tolerability profile.

What is the target of donidalorsen in treating hereditary angioedema?

Donidalorsen is designed to precisely target and silence the production of prekallikrein (PKK) to interrupt the pathway that leads to HAE attacks.

What are the plans for regulatory submissions for donidalorsen?

Ionis is preparing to submit a New Drug Application with the U.S. Food and Drug Administration, and Otsuka is preparing to submit a Marketing Authorization Application to the European Medicines Agency.

When will the Phase 3 OASIS-HAE results be presented?

Ionis plans to present the Phase 3 OASIS-HAE results at an upcoming medical congress by mid-year.

Ionis Pharmaceuticals, Inc.

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