As 2015 draws to a close, it seems likely that 2016 will bring progress in complement therapeutics development toward clinical use. Since a hallmark of aHUS is chronic, uncontrolled complement activation, we’re looking forward to what happens in a rapidly moving field which seems promise advancement soon. (FMI Click Here) As with eculizumab (Soliris ®, from Alexion Pharmaceuticals), we likely will see clinical trials for PNH patients prior to involvement of the aHUS patient population.
To keep pace with what seems to be a drug development landscape that is rapidly changing, the 2015 aHUS Alliance meeting in London produced the first overview of the expanding drug landscape in 2016 , with differences in anti-complement agent approaches (monoclonal antibody, small molecule, peptide, protein or biologic, or nucleic acid-based therapy). Differences in drug delivery also seem in the works, from intravenous to subcutaneous (self-administered shots) and mention of an oral delivery method for patients as well. In the article Complement, a Target for Therapy in Inflammatory and Degenerative D... by B. Paul Morgan and Claire L. Harris (Nature Reviews Drug Discovery | AOP, published online 23 October 2015; doi:10.1038/nrd4657):
”Among the monoclonal antibodies, TNT003 and TNT009 (True North Therapeutics) target complement fragment C1s; OMS721 (Omeros) targets MBL-associated serine protease 2 (MASP2); Lampalizumab (Roche/Genentech) targets Factor D (FD), Bikaciomab (Novelmed) targets FB; IFX‑1 (InflaRx) targets C5a; eculizumab (Soliris; Alexion Pharmaceuticals), LFG316 (Novartis), ALXN1210 and ALXN550 (Alexion) all target C5. Regenesance are developing an antibody that targets C6, and Novelmed are developing an antibody (NM9401) against properdin. Among the protein biologics, Berinert (CSL Behring), Ruconest (Salix Pharmaceuticals) and Cinryze (Shire Pharmaceuticals) are all C1INH preparations that target C1; AMY‑201 (Amyndas) is a mini FH; TT30 (ALXN1102; Alexion) is a CR2–FH hybrid; TP10 (CDX‑1135; Celldex Therapeutics) is a soluble form of complement receptor type 1 (CR1); Coversin (Volution Immuno Pharmaceuticals) is a C5‑binding protein; Mirococept is a targeted CR1 fragment developed by AdProTech and currently in clinical trials led by King’s College London; and the affibody SOBI002 (Swedish Orphan Biovitrum) targets C5 (programme recently terminated). Small-molecule inhibitors include CCX‑168 (ChemoCentryx) and DF2593A (Dompé Pharmaceutical), which target C5aR; FD inhibitors from Achillion and Novartis; and a properdin inhibitor from Novelmed. Among the peptide-based therapeutics, Cp40 (Amyndas), APL‑1 and APL‑2 (Apellis Pharmaceuticals) are compstatin derivatives targeting C3; and RA101348 (RaPharma) is a C5 blocking peptide. Nucleic acid-based drugs include ARC1905 (Zimura; Ophthotech), a C5 aptamer; ALN‑CC5 (Alnylam Pharmaceuticals), a C5 RNA interference (RNAi) molecule; and the Spiegelmers NOX‑D19 to NOX‑D21 (Noxxon Pharma), targeting C5a. Regenesance are developing a C6 antisense molecule.”
The American Society of Hematology meeting held December 5-8, 2015 in Orlando Florida brought a wealth of new information about potential drugs in the orphan drug pipeline. Poster abstracts, research, and sessions available to medical professionals at the 2015 ASH conference gained a broader audience with these reports for the aHUS community, containing links to corporate sites, news releases and research about each company’s orphan drug in development.
* FDA grants 'Fast Track' Status for Omeros OMS721, * July 2015, prior to ASH mtg.
*Update re OMS721: March 8, 2016*
Click Title Below to read the March 8, 2016 Business Wire Press Release:
The Atypical HUS Foundation and the aHUS Alliance of nations looks forward to bringing you more information of interest to patients, caregivers, and aHUS families. We’re aware of other developments, such as Alexion’s entry this November 2015 with clinical trial NCT02598583 of ALXN1210 for PNH Patients, and will present factual information as events unfold and information becomes available. With innovation that seems ready to burst on the horizon, we wish you a New Year filled with hope and new possibilities for a brighter future in 2016.
FMI about potential new treatments for aHUS, click the link below: