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Data from Pivotal FIREFISH and SUNFISH Studies Demonstrate Clinical Benefit of Risdiplam in Type 1, 2, & 3 Spinal Muscular Atrophy Patients
"The magnitude of the benefit observed in all SMA types in both trials is very compelling," said
In Part 1 of the FIREFISH study, at 12 months of treatment, among the infants who received the dose selected for the confirmatory Part 2 of the study, (n=17), 7 (41.2%) were able to sit without support for at least 5 seconds, assessed by the Gross Motor Scale of the Bayley Scales of Infant and
Part 1 of SUNFISH includes a broad patient population aged 2-25 years with Type 2 or 3 SMA and with baseline functional status ranging from individuals unable to sit to those capable of walking. Scoliosis ranged from none to severe. An exploratory efficacy analysis of Part 1 of the SUNFISH study assessed motor function, using the Motor Function Measure-32 (MFM32) scale. The results demonstrate that among the patients for which the MFM32 test has been completed at all visits up to month 12 (n=43), 58% saw an improvement of at least 3 points on the scale from baseline, compared to 7.6% for a matched natural history cohort (n=39). The change from baseline in total MFM32 score is the primary efficacy endpoint in the ongoing Part 2 of the trial. In addition, a sustained median increase from baseline in SMN protein of greater than two-fold, as measured in blood, was seen after 12 months of treatment with risdiplam.
Risdiplam is an investigational small molecule SMN2 splicing modifier targeting the survival motor neuron 2 (SMN2) RNA, restoring a functional transcript. In preclinical studies, risdiplam given orally, crossed the blood brain barrier, and showed systemic distribution to all organs and tissues.
The table below depicts improvements across the FIREFISH and SUNFISH dose-finding studies after 12 months of treatment:
FIREFISH ( |
|
Motor milestone achievement |
|
Survival |
|
Pulmonary function and swallowing |
|
CHOP-INTEND |
|
The most common adverse events included fever (pyrexia; 52.4%), upper respiratory tract infections (42.9%), diarrhea (28.6%), vomiting (23.8%), cough (23.8%) pneumonia (19.0%) and constipation (19.0%). No significant ophthalmological findings to date. Data cutoff
SUNFISH |
|||
MFM32 |
Aged 2-11 |
Aged 12-25 |
Aged 2-25 |
Total MFM change from baseline, mean (SD) |
3.47 (3.77) |
1.64 (3.43) |
2.66 (3.70) |
Total MFM change from baseline, |
4.17 (-6.3, -9.4) |
2.08 (-7.3, -6.3) |
3.13 (-7.3, -9.4) |
Proportion of patients who achieve |
70.8 (17/24) |
42.1 (8/19) |
58.1 (25/43) |
*Excludes 7 patients who performed the MFM20 assessment (only patients who performed the full MFM32 assessment are included in the analysis) and one patient who had dropped out of the study prior to the Month 12 visit. |
The most common adverse events in Part 1 of the SUNFISH study were fever (pyrexia; 41%), cough (33%), vomiting (29%), upper respiratory tract infections (26%), persistent sore throat (oropharyngeal pain; 22%) and cold (nasopharyngitis; 20%). The most common serious adverse event that occurred in two of the 51 patients exposed to risdiplam was pneumonia. To date there have been no treatment-related safety findings leading to withdrawal from any study. No significant ophthalmological findings to date. Data cutoff
About Spinal Muscular Atrophy (SMA)
Spinal muscular atrophy (SMA) is a genetic neuromuscular disorder that is the leading genetic cause of mortality in infants and toddlers caused by deletion or mutation in the survival of motor neuron 1 (SMN1) gene, which results in reduced levels of SMN protein. The related SMN2 pre-mRNA is alternatively spliced producing only small amounts of functional SMN protein. Insufficient levels of SMN protein result in the progressive loss of motor neurons leading to muscle atrophy and death in its most severe form. It is estimated that 1 in every 11,000 newborn children will develop SMA.
About the SMA Clinical Trials
FIREFISH: An open-label, two-part clinical trial. Part 1 was a dose finding study in 21 infants and is now in the open label extension phase. The primary objective of Part 1 was to assess the safety profile of risdiplam in infants and determine the dose for Part 2. Part 2 is a single-arm study using the dose selected in Part 1 in 41 infants with Type 1 SMA for 24 months, followed by an open label extension.
SUNFISH: A double‐blind, two‐part, placebo‐controlled trial. Part 1 enrolled patients with Type 2 or 3 SMA to evaluate the safety, tolerability, and PK/PD of several risdiplam dose levels. The pivotal SUNFISH Part 2, in non‐ambulant patients with Type 2 or 3 SMA, is evaluating safety and efficacy of the risdiplam dose level selected from Part 1 for 24 months, followed by an open label extension. This study has finished recruiting globally.
JEWELFISH: An ongoing, exploratory, open-label study to establish the safety and tolerability of risdiplam in people with SMA who have previously participated in a study with another therapy to treat SMA.
RAINBOWFISH: An open-label, single-arm, multicenter clinical study to investigate the efficacy, safety, pharmacokinetics, and pharmacodynamics of risdiplam in infants aged from birth to 6 weeks who have been genetically diagnosed with SMA but are not yet presenting with symptoms.
About the SMA collaboration
The SMA program was initiated by
About
PTC is a science-led, global biopharmaceutical company focused on the discovery, development and commercialization of clinically-differentiated medicines that provide benefits to patients with rare disorders. PTC's ability to globally commercialize products is the foundation that drives investment in a robust pipeline of transformative medicines and our mission to provide access to best-in-class treatments for patients who have an unmet medical need.
For More Information:
Investors:
+1 (908) 912-9327
ehill@ptcbio.com
Media:
+1 (908) 912-9167
jbaj@ptcbio.com
Forward-Looking Statements:
This press release contains forward-looking statements within the meaning of The Private Securities Litigation Reform Act of 1995. All statements contained in this release, other than statements of historic fact, are forward-looking statements, including statements regarding: any advancement of the joint development program in SMA with PTC,
PTC's actual results, performance or achievements could differ materially from those expressed or implied by forward-looking statements it makes as a result of a variety of risks and uncertainties, including those related to: the enrollment, conduct and availability of data from either the SUNFISH or FIREFISH studies and the outcome of such studies; events during, or as a result of, these studies that could delay or prevent further development of risdiplam, including future actions or activities under the SMA joint development program; our expectations for regulatory approvals; PTC's scientific approach and general development progress; and the factors discussed in the "Risk Factors" sections of PTC's most recent Quarterly Report on Form 10-Q and Annual Report on Form 10-K as well as any updates to these risk factors filed from time to time in PTC's other filings with the
As with any pharmaceutical under development, there are significant risks in the development, regulatory approval and commercialization of new products, including with respect to PTC's joint development program in SMA with
The forward-looking statements contained herein represent PTC's views only as of the date of this press release and PTC does not undertake or plan to update or revise any such forward-looking statements to reflect actual results or changes in plans, prospects, assumptions, estimates or projections, or other circumstances occurring after the date of this press release except as required by law.
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