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Roche announces new results from EMBARK demonstrating significant sustained benefits of Elevidys in ambulatory individuals with Duchenne muscular dystrophy (DMD)

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Roche (RHHBY) announced positive two-year results from the EMBARK trial for Elevidys, its gene therapy for Duchenne muscular dystrophy (DMD). The study demonstrated statistically significant and clinically meaningful improvements across three key motor function measures compared to an untreated control group.

Key findings after two years of treatment include improvements in North Star Ambulatory Assessment (+2.88 points), Time to Rise (-2.06 seconds), and 10-meter walk/run (-1.36 seconds). The functional differences between treated individuals and the control group increased between years one and two.

Patients who crossed over from placebo to Elevidys in part two showed similar improvements after one year. Muscle biopsies taken at 64 weeks showed sustained micro-dystrophin expression, with MRI data supporting functional benefits. No new safety concerns were identified.

Elevidys is currently approved in multiple countries, including the US, UAE, Brazil, and Israel, with pending applications in Europe, Japan, and other regions.

Roche (RHHBY) ha annunciato risultati positivi a due anni dallo studio EMBARK per Elevidys, la sua terapia genica per la distrofia muscolare di Duchenne (DMD). Lo studio ha dimostrato miglioramenti statisticamente significativi e clinicamente rilevanti in tre misure chiave della funzione motoria rispetto a un gruppo di controllo non trattato.

I principali risultati dopo due anni di trattamento includono miglioramenti nella North Star Ambulatory Assessment (+2,88 punti), nel tempo necessario per alzarsi (-2,06 secondi) e nella corsa/passeggiata di 10 metri (-1,36 secondi). Le differenze funzionali tra i soggetti trattati e il gruppo di controllo sono aumentate tra il primo e il secondo anno.

I pazienti che sono passati dal placebo a Elevidys nella seconda parte hanno mostrato miglioramenti simili dopo un anno. Le biopsie muscolari effettuate a 64 settimane hanno mostrato un'espressione sostenuta di micro-distrofina, con dati da risonanza magnetica che supportano i benefici funzionali. Non sono stati identificati nuovi problemi di sicurezza.

Elevidys è attualmente approvato in diversi paesi, tra cui Stati Uniti, UAE, Brasile e Israele, con domande pendenti in Europa, Giappone e altre regioni.

Roche (RHHBY) anunció resultados positivos a dos años del ensayo EMBARK para Elevidys, su terapia génica para la distrofia muscular de Duchenne (DMD). El estudio demostró mejoras estadísticamente significativas y clínicamente relevantes en tres medidas clave de la función motora en comparación con un grupo de control no tratado.

Los hallazgos clave después de dos años de tratamiento incluyen mejoras en la North Star Ambulatory Assessment (+2,88 puntos), en el tiempo para levantarse (-2,06 segundos) y en la carrera/paseo de 10 metros (-1,36 segundos). Las diferencias funcionales entre los individuos tratados y el grupo de control aumentaron entre el primer y el segundo año.

Los pacientes que cruzaron del placebo a Elevidys en la segunda parte mostraron mejoras similares después de un año. Las biopsias musculares tomadas a las 64 semanas mostraron una expresión sostenida de micro-distrofina, con datos de resonancia magnética que respaldan los beneficios funcionales. No se identificaron nuevos problemas de seguridad.

Elevidys está actualmente aprobado en múltiples países, incluidos EE. UU., UAE, Brasil e Israel, con solicitudes pendientes en Europa, Japón y otras regiones.

로슈 (RHHBY)엘레비디스(Elevidys)에 대한 EMBARK 시험의 긍정적인 2년 결과를 발표했습니다. 이는 뒤센 근육 디스트로피(DMD)에 대한 유전자 치료법입니다. 이 연구는 치료받지 않은 대조군에 비해 세 가지 주요 운동 기능 측정에서 통계적으로 유의미하고 임상적으로 의미 있는 개선을 보여주었습니다.

치료 후 2년 동안의 주요 발견에는 노스 스타 보행 평가(North Star Ambulatory Assessment)에서의 개선(+2.88점), 일어나는 시간에서의 개선(-2.06초), 10미터 걷기/달리기에서의 개선(-1.36초)이 포함됩니다. 치료를 받은 개인과 대조군 간의 기능적 차이는 1년차와 2년차 사이에 증가했습니다.

플라시보에서 엘레비디스로 전환한 환자들은 1년 후 유사한 개선을 보였습니다. 64주에 실시한 근육 생검에서는 미세 디스트로핀의 지속적인 발현이 관찰되었으며, MRI 데이터는 기능적 이점을 뒷받침합니다. 새로운 안전성 문제는 확인되지 않았습니다.

엘레비디스는 현재 미국, UAE, 브라질 및 이스라엘을 포함한 여러 국가에서 승인되었으며, 유럽, 일본 및 기타 지역에 대한 신청이 대기 중입니다.

Roche (RHHBY) a annoncé des résultats positifs après deux ans de l'essai EMBARK pour Elevidys, sa thérapie génique pour la dystrophie musculaire de Duchenne (DMD). L'étude a démontré des améliorations statistiquement significatives et cliniquement pertinentes sur trois mesures clés de la fonction motrice par rapport à un groupe témoin non traité.

Les résultats clés après deux ans de traitement incluent des améliorations dans l'évaluation ambulatoire North Star (+2,88 points), le temps pour se lever (-2,06 secondes) et la marche/course de 10 mètres (-1,36 secondes). Les différences fonctionnelles entre les individus traités et le groupe témoin ont augmenté entre la première et la deuxième année.

Les patients qui sont passés du placebo à Elevidys dans la deuxième partie ont montré des améliorations similaires après un an. Les biopsies musculaires effectuées à 64 semaines ont montré une expression soutenue de micro-dystrophine, avec des données IRM soutenant les bénéfices fonctionnels. Aucune nouvelle préoccupation en matière de sécurité n'a été identifiée.

Elevidys est actuellement approuvé dans plusieurs pays, y compris les États-Unis, les Émirats Arabes Unis, le Brésil et Israël, avec des demandes en attente en Europe, au Japon et dans d'autres régions.

Roche (RHHBY) gab positive Ergebnisse nach zwei Jahren aus der EMBARK-Studie für Elevidys, seine Gentherapie für die Duchenne-Muskeldystrophie (DMD), bekannt. Die Studie zeigte statistisch signifikante und klinisch relevante Verbesserungen bei drei wichtigen motorischen Funktionsmessungen im Vergleich zu einer unbehandelten Kontrollgruppe.

Wichtige Ergebnisse nach zwei Jahren Behandlung umfassen Verbesserungen bei der North Star Ambulatory Assessment (+2,88 Punkte), bei der Zeit zum Aufstehen (-2,06 Sekunden) und bei der 10-Meter-Geh-/Laufzeit (-1,36 Sekunden). Die funktionalen Unterschiede zwischen behandelten Personen und der Kontrollgruppe nahmen zwischen dem ersten und dem zweiten Jahr zu.

Patienten, die in Teil zwei von Placebo auf Elevidys umgestiegen sind, zeigten nach einem Jahr ähnliche Verbesserungen. Biopsien, die nach 64 Wochen entnommen wurden, zeigten eine nachhaltige Mikro-Dystrophin-Expression, während MRT-Daten die funktionalen Vorteile unterstützen. Es wurden keine neuen Sicherheitsbedenken identifiziert.

Elevidys ist derzeit in mehreren Ländern, einschließlich der USA, VAE, Brasilien und Israel, zugelassen, mit ausstehenden Anträgen in Europa, Japan und anderen Regionen.

Positive
  • Statistically significant improvements in all three key motor function measures after two years
  • Increasing functional benefits between year one and two post-treatment
  • Successful crossover results in part two patients
  • Sustained micro-dystrophin expression confirmed through muscle biopsies
  • Consistent and manageable safety profile with no new concerns
Negative
  • None.
  • Across three key functional outcomes, North Star Ambulatory Assessment (NSAA), Time to Rise (TTR) and 10-meter walk/run (10MWR), results were statistically significant and clinically meaningful two years after treatment with Elevidys, compared to a pre-specified propensity-weighted untreated external control group
  • Functional differences between individuals treated with Elevidys and those in the external control group increased between one year and two years after treatment
  • No new safety signals observed further reinforcing the consistent and manageable safety profile observed with Elevidys to date

Basel, 27 January 2025 - Roche (SIX: RO, ROG; OTCQX: RHHBY) announced today positive topline results from year two of the EMBARK trial, a global, randomised, double-blind phase III study of Elevidys™ (delandistrogene moxeparvovec), the first approved gene therapy for the treatment of individuals with Duchenne muscular dystrophy. Two years after treatment with Elevidys, statistically significant and clinically meaningful improvements were observed across three key motor function measures of NSAA, TTR and 10MWR, when compared to a pre-specified propensity-weighted untreated external control group.* Functional differences between individuals treated with Elevidys and those in the external control group increased between one and two years after dosing. Together, these results demonstrate consistent, sustained benefit in favour of Elevidys.

Detailed results from year two of the EMBARK study will be shared at an upcoming medical meeting and discussed with health authorities. One-year data from part one of the EMBARK study were published in Nature Medicine in October 2024.

“After two years of treatment with Elevidys, we are seeing multiple sustained benefits in the day-to-day lives of these young boys, all of which are indicators of its disease modifying potential in Duchenne,” said Levi Garraway, M.D., Ph.D., Roche’s Chief Medical Officer and Head of Global Product Development. "These results, which include improvements in standing, walking and running, represent meaningful progress and we plan to share them with health authorities as quickly as possible.”

Individuals treated in part one of EMBARK (n=63) showed clinically meaningful and statistically significant improvements on the NSAA were sustained two years after treatment with Elevidys.

“As Duchenne progresses, children will lose the ability to walk, have difficulty breathing, and develop heart problems, all of which severely impact their health and ability to fully participate in life,” said Professor Francesco Muntoni, Director of Dubowitz Neuromuscular Centre, Great Ormond Street Hospital for Children, UK. “Encouraging results from year two of the EMBARK trial suggest that with innovative treatments like Elevidys, the period of mobility and independence can potentially be improved, reducing the physical and emotional challenge Duchenne poses for these young boys and their families.”

For individuals treated in part one, two years after treatment, functional motor improvements include:

Functional endpoints (treated in part one) Measure compared to the external control group (LSM mean difference)
NSAA +2.88 points (improvement), P<0.0001
TTR -2.06 seconds (improvement), P<0.0033
10MWR -1.36 seconds (improvement), P<0.0028


Individuals who received a placebo in part one crossed over at 52 weeks and were treated with Elevidys in part two. Despite being one year older than those treated in part one, the crossover treated group (n=59) experienced similar changes 52 weeks after treatment, favouring Elevidys compared to the external control. Individuals treated in part one were between the ages of four and seven years, and in part two, individuals were between the ages of five and nine years.

For individuals treated in part two, one year after treatment, functional motor improvements include:

Functional endpoints (treated in part two) Measures compared to the external control (pre-therapy baseline; LSM mean difference)
NSAA +2.34 points (improvement), P<0.0001
TTR -2.70 seconds (improvement), P<0.0001
10MWR -1.07 seconds (improvement), P=0.0001


Muscle biopsies from a subset of patients taken 64 weeks after dosing in part one showed consistent and sustained expression of micro-dystrophin, as measured by western blot. Muscle pathology on MRI continues to show minimal progression in underlying muscle pathology and remains highly consistent with the functional benefits shown.

No new safety signals were observed, reinforcing the consistent and manageable safety profile of Elevidys to date.

Elevidys is approved for people living with Duchenne aged four years old and over regardless of their ambulatory status in the US, United Arab Emirates (UAE), Qatar, Kuwait, Bahrain and Oman. Elevidys is also approved for the treatment of ambulatory individuals aged four through seven years in Brazil and Israel. Filings have also been submitted to the European Medicines Agency (EMA) and regulatory authorities in Japan, Switzerland, Singapore, Hong Kong and Saudi Arabia.

In 2019, Roche entered into a global collaboration agreement with Sarepta Therapeutics, Inc. to commercialise Elevidys in territories outside the U.S.

Elevidys clinical development programme

  • Study 101 (NCT03375164), a Phase I/II study evaluating the safety of Elevidys in four ambulatory participants aged 4 to <8 years old with Duchenne. The study is complete.
  • Study 102 (NCT03769116), a Phase II clinical trial evaluating the safety and efficacy of Elevidys in patients with Duchenne aged 4 to <8 years. The study is complete.
  • ENDEAVOR (Study 103, NCT04626674), a two-part, open-label, Phase Ib study assessing Elevidys micro-dystrophin protein expression and safety of Elevidys in seven cohorts of boys with Duchenne, across different ages, mutations and stages of disease progression.
  • Study 104 (NCT06241950), a Phase I open-label, systemic gene delivery study to evaluate the safety, tolerability and expression of Elevidys in association with imlifidase in individuals aged 4 to 9 years with pre-existing antibodies to recombinant adeno-associated virus serotype, rAAVrh74.
  • HORIZON (Study 105, NCT06597656), a Phase I open-label, systemic gene delivery study to evaluate the safety, tolerability and expression of Elevidys following plasmapheresis in individuals aged 4 to 8 years with pre-existing antibodies to adeno-associated virus serotype, AAVrh74.
  • EMBARK (Study 301, NCT05096221), a multinational, Phase III, randomised, double-blind, placebo-controlled study assessing the safety and efficacy of Elevidys in ambulatory boys aged 4 to 7 years. The study duration is two years.
  • ENVOL (Study 302, NCT06128564), a Phase II study evaluating the safety of Elevidys and expression of Elevidys micro-dystrophin protein in young children, including babies and newborns.
  • ENVISION (Study 303, NCT05881408), a global Phase III study investigating the safety and efficacy of Elevidys in participants who are ambulatory (aged 8 to <18 years old) and non-ambulatory (no age limitation). The study Is recruiting.
  • EXPEDITION (Study 305, NCT05967351), a Phase III long-term five-year follow-up study evaluating the safety and efficacy of Elevidys in those who have received Elevidys in a previous clinical study. EXPEDITION is enrolling by invitation.


About EMBARK
EMBARK is a multinational, phase III, randomised, double-blind, two-part crossover, placebo-controlled study assessing the safety and efficacy of Elevidys in ambulatory boys with a confirmed mutation in the DMD gene, aged four to seven years at the beginning of the trial.

Eligible participants received a single dose of Elevidys during either part one or part two of the study. The study is complete.

Participants (n=126) received 1.33x1014 vector genomes per kilogram bodyweight (vg/kg) of Elevidys or placebo. In part one, participants were randomised according to age (4-5y or 6-7y) or NSAA total score at screening (≤22 or >22) to receive either Elevidys or placebo, with a follow-up period for 52 weeks. In part two, participants crossed over - meaning, those who were previously treated with placebo in part one received Elevidys and participants who were previously treated with Elevidys received placebo, with a follow-up period for 52 weeks.

The primary endpoint of the trial was change from baseline in NSAA total score at week 52. Secondary endpoints included:

  • The quantity of Elevidys micro-dystrophin protein expression at Week 12 as measured by western blot of biopsied muscle tissue
  • Change from baseline to Week 52 in time to rise from floor
  • Change from baseline to Week 52 in 10-metre walk/run (10MWR)
  • Change from baseline to Week 52 in stride velocity 95th centile (as measured by Syde®, a wearable device)
  • Change from baseline to Week 52 in 100-metre walk/run
  • Change from baseline to Week 52 in time to ascend four steps

NSAA is a 17-item rating scale that is used to measure functional motor abilities and monitor disease progression in ambulant children with DMD.

About ELEVIDYS™
Elevidys™ (delandistrogene moxeparvovec, also known as SRP-9001) is the first approved disease-modifying gene therapy for Duchenne and is designed to address the underlying cause of Duchenne through targeted skeletal, respiratory and cardiac muscle expression of shortened dystrophin produced by Elevidys. Elevidys is a one-time treatment administered through a single intravenous dose. Elevidys is contraindicated in individuals with any deletion in exons 8 and/or 9 in the DMD gene.

About Duchenne muscular dystrophy
Duchenne is a rare, genetic, muscle-wasting disease that progresses rapidly from early childhood. Approximately 1 in 5,000 boys worldwide are born with Duchenne, while Duchenne in girls is very rare. Everyone who has Duchenne will lose the ability to walk, upper limb, lung and cardiac function and mean life expectancy is 28 years. A diagnosis of Duchenne will require full-time caregiving which is most often provided by parents, the majority of whom will find it difficult to carry out usual work or household activities and suffer from depression and physical pain.

Duchenne is caused by mutations of the DMD gene, which affects the production of the muscle protein, dystrophin. Dystrophin is a critical component of a protein complex that strengthens muscle fibers and protects them from injury during muscle contraction. Due to a genetic mutation in the DMD gene, people with Duchenne do not make functional dystrophin; their muscle cells are more sensitive to injury and muscle tissue is progressively replaced with scar tissue and fat. As dystrophin is also deficient in vital organ systems such as the cardiovascular and respiratory systems, the effect is thus inevitably fatal, with an average survival limited to the third decade of life.

About Roche in Neuroscience
Neuroscience is a major focus of research and development at Roche. Our goal is to pursue groundbreaking science to develop new treatments that help improve the lives of people with chronic and potentially devastating diseases.

Roche is investigating more than a dozen medicines for neurological disorders, including multiple sclerosis, spinal muscular atrophy, neuromyelitis optica spectrum disorder, Alzheimer’s disease, Huntington’s disease, Parkinson’s disease and Duchenne muscular dystrophy. Together with our partners, we are committed to pushing the boundaries of scientific understanding to solve some of the most difficult challenges in neuroscience today.

About Roche
Founded in 1896 in Basel, Switzerland, as one of the first industrial manufacturers of branded medicines, Roche has grown into the world’s largest biotechnology company and the global leader in in-vitro diagnostics. The company pursues scientific excellence to discover and develop medicines and diagnostics for improving and saving the lives of people around the world. We are a pioneer in personalised healthcare and want to further transform how healthcare is delivered to have an even greater impact. To provide the best care for each person we partner with many stakeholders and combine our strengths in Diagnostics and Pharma with data insights from the clinical practice.

For over 125 years, sustainability has been an integral part of Roche’s business. As a science-driven company, our greatest contribution to society is developing innovative medicines and diagnostics that help people live healthier lives. Roche is committed to the Science Based Targets initiative and the Sustainable Markets Initiative to achieve net zero by 2045.

Genentech, in the United States, is a wholly owned member of the Roche Group. Roche is the majority shareholder in Chugai Pharmaceutical, Japan.

For more information, please visit www.roche.com.

* The pre-specified external control used contemporary datasets taken from three separate studies in Duchenne, two randomised controlled clinical trials and one natural history study, creating a prospectively defined consolidated comparison group of individuals with Duchenne, matched for variables, including age, steroid usage, baseline NSAA and timed function tests with the EMBARK part one treated patients. The prospectively defined propensity score analysis allows for a robust and rigorous balancing of multiple variables.

All trademarks used or mentioned in this release are protected by law.


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FAQ

What were the key efficacy results of RHHBY's Elevidys in the 2-year EMBARK trial?

After two years, Elevidys showed improvements in NSAA (+2.88 points), Time to Rise (-2.06 seconds), and 10-meter walk/run (-1.36 seconds) compared to the control group, with all results being statistically significant.

In which countries is Roche's Elevidys (RHHBY) currently approved?

Elevidys is approved in the US, United Arab Emirates, Qatar, Kuwait, Bahrain, and Oman for patients aged 4 and over, and in Brazil and Israel for ambulatory patients aged 4-7 years.

What were the safety findings for RHHBY's Elevidys in the EMBARK trial?

No new safety signals were observed in the trial, reinforcing the consistent and manageable safety profile of Elevidys to date.

How did the crossover patients perform in the RHHBY EMBARK trial for Elevidys?

Crossover patients who received Elevidys in part two showed similar improvements after one year of treatment, despite being one year older than the part one group.

What evidence supports the sustained efficacy of RHHBY's Elevidys?

Muscle biopsies at 64 weeks showed sustained micro-dystrophin expression, and MRI data showed minimal progression in muscle pathology, supporting the functional benefits observed.
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