First Oral Drug for Uveitis Reduces Both Inflammation and
Recurrence Rate in Potentially Blinding Eye Disease, Reports Lux Biosciences
-- LX211
Phase 3 Data from LUMINATE Trials Presented at ARVO--
-- If
Approved, LX211 Would Address an Important Unmet Medical Need for Patients
with Uveitis--
Fort
Lauderdale, FL (May 4, 2009): Uveitis, or
inflammation within the eye, is a group of diseases responsible for years of
visual loss roughly comparable to that caused by diabetes. Now, results from
a pioneering international Phase 3 program in uveitis, the LUMINATE trials
sponsored by Lux Biosciences,
demonstrate the ability of LX211 (LUVENIQ™, voclosporin oral capsule) to
significantly improve this chronic eye inflammation. Additionally, in
patients who are discontinuing potentially toxic medications for uveitis,
such as the corticosteroid prednisone, LX211 actively reduces the rate of
inflammatory exacerbations by 50% at six months, compared to placebo. The
study results also show a safety profile for LX211 at the 0.4 mg/kg bid dose
that suggests the experimental drug would be suitable for chronic use as the
first oral treatment for this sight-threatening inflammatory eye disease,
while also providing a means to greatly reduce the serious health risks
associated with long-term corticosteroid use. LX211 is a novel and
proprietary next-generation calcineurin inhibitor that Lux Biosciences is
developing for ophthalmic uses.
Dr. James T. Rosenbaum, M.D., Professor of Ophthalmology, Medicine and Cell
Biology and Vice-Chair of the Department of Ophthalmology of the
Casey Eye Institute – Oregon Health
Sciences University (OHSU), represented the LUMINATE Investigator Network in
presenting the Phase 3 LUMINATE program results for the first time at the
2009 annual meeting of the Association for Research in Vision and
Ophthalmology (ARVO). The LUMINATE program, consisting of three randomized,
double-masked, dose-ranging and placebo-controlled trials that enrolled a
total of 558 patients at 56 sites in 7 countries (United States, Canada,
United Kingdom, France, Germany, Austria and India), is the largest clinical
program ever conducted in uveitis.
“Uveitis, a term used to classify a group of autoimmune diseases
characterized by chronic inflammation of the eye, is the 4th leading cause
of blindness and often affects patients under the age of 40, but the disease
remains frequently mistreated,” commented Dr. Rosenbaum. “Uveitis has many
causes and experts often disagree about what constitutes successful
treatment. Accordingly, no pharmaceutical company previously has attempted
to demonstrate that an oral medication can successfully treat uveitis, and
there are currently no FDA-approved oral medications for this condition.
Treating physicians often prescribe corticosteroids, which are burdened with
a variety of serious systemic side effects when given orally. Even if
applied as drops to the eye, corticosteroids can cause cataract formation
and glaucoma. Based on the results of the LUMINATE trial program, LX211
appears to offer a therapeutic and safety profile that would meet the
critical need for an oral medication for uveitis. LX211 is not a
corticosteroid, but allows the reduced use of corticosteroids like
prednisone, which in turn reduces the serious side-effects associated with
those drugs.”
Dr. Rosenbaum noted that a poster presentation at ARVO from a survey of U.S.
ophthalmologists and rheumatologists from 27 states, presented by
researchers from the Wilmer Eye Institute of Johns Hopkins University,
Baltimore, found that the dose of oral corticosteroids used commonly to keep
chronic inflammation within the eye under control is in the range of 25
mg/day. This compares to a recommended chronic dose by the uveitis community
of 10 mg/day or less. Of additional note, patients enrolled in the LX211-02
protocol, which evaluated the use of LX-211 in subjects with treated but
quiescent disease, received doses of corticosteroids that were more than 50%
higher than this recommendation. It is well documented that systemic
steroids at doses above 10 mg/day cause a myriad of adverse effects, such as
osteoporosis, resulting in increased risk for hip or spinal fractures, and
metabolic disturbances including obesity, heart disease, and diabetes. Mood
disturbances are also associated with chronic corticosteroid use.
“The tapering of systemic corticosteroids to 5 mg or less per day, as
implemented successfully in the LUMINATE studies, provides for additional
safety from steroid morbidities,” Dr. Rosenbaum commented.
“We are pleased with the demonstrated clinical effect of LX211 (Luveniq™) in
uveitis, coupled with what appears to be an acceptable side effect profile
while reducing the need for systemic corticosteroid to half of the current
guideline recommendation,” commented Ulrich Grau, Ph.D., Lux Biosciences’
President and Chief Executive Officer. “We’re now pursuing regulatory
filings, and if approved for commercialization by the appropriate regulatory
agencies, LX211 would become the first agent in this class available in the
United States and most other markets for the treatment of uveitis.”
The LUMINATE program consists of three protocols that included 218 patients
with active non-infectious uveitis with posterior (behind the lens of the
eye) manifestation of the disease (LX211-01); 232 patients with clinically
quiescent disease (LX211-02); and 108 patients with active uveitis with
anterior (front of the eye) manifestation of the disease (LX211-03). Data
from these trials showed:
Of the three doses studied, the 0.4 mg/kg
BID dose had the most acceptable safety profile relative to effect on
the disease. The adverse effects on the kidney (8.2% of subjects with
decrease from baseline by ≥30% in glomerular filtration rate vs. 4.1 %
in placebo) and blood pressure (mean increase in systolic BP by 6 mm Hg)
will require monitoring, but were overall moderate and manageable.
Triglycerides and cholesterol were not elevated and had no negative
impact on the cardiovascular safety profile. Hair growth (hirsutism) was
observed in 5% of patients. Otherwise the safety profile was similar to
placebo.
In study LX211-01 the 0.4 mg/kg BID dose
fully met the primary endpoint of superiority to placebo at both weeks
16 (p=0.008) and week 24 (p=0.027) for mean change from baseline in
vitreous haze, a validated measure of inflammation of the posterior
segment of the eye. The magnitude of the effect was >1 step change from
baseline, demonstrating a clinically relevant benefit.
In study LX211-02 the 0.4 mg/kg BID dose
showed a reduction by 50% vs. placebo in rate of recurrence of
inflammation at 6 months using a pre-specified analysis that accounted
for data censoring due to non-efficacy-related discontinuations. This
reduction was statistically significant (p=0.045), thus confirming the
positive results from LX211-01.
In study LX211-03, treated patients
reduced the cellular response in the front of the eye from an average of
more than 25 white blood cells per high power microscopic field to an
average of 6 to 10 cells per high power field. However, placebo-treated
patients also improved in this study and it was therefore not possible
to show that LX211 was effective for this rare subset of uveitis
patients, those with refractory disease in the anterior portion of the
eye.
The LUMINATE program was conducted under the
sponsorship of Lux Biosciences.
About Lux Biosciences
Lux Biosciences, Inc. is a privately held biotechnology company focused on
ophthalmic diseases. The company has a staged product portfolio of
potentially first-in-class therapies distinguished by their short-term path
to commercialization and potential to generate high revenue growth. The
portfolio includes:
Two Phase 3 clinical-stage projects
including: i) LUVENIQ™, the oral formulation of a next-generation
calcineurin inhibitor (voclosporin) developed as steroid-sparing therapy
for the treatment of sight-threatening non-infectious uveitis, and ii)
LUMITECT™, a silicone matrix ocular (episcleral) implant that steadily
releases therapeutic doses of cyclosporine A locally to the eye for the
prevention of rejection in corneal transplant recipients. Both the
LUMINATE pivotal clinical program for LUVENIQ for the treatment of
uveitis, as well as the LUCIDA pivotal clinical program with LUMITECT™,
for the prevention of corneal transplant rejection were initiated in
early 2007 and include sites in North America, Europe and India.
Enrollment in the LUMINATE program was completed in June 2008.
Enrollment in the LUCIDA program was completed in March 2009. Lux
Biosciences has licensed voclosporin from Isotechnika, Inc. for
development in ophthalmic indications.
LX214 is a novel topical eye drop
formulation that entered human clinical testing for dry eye syndrome in
February 2009. Based on Lux’s proprietary next-generation calcineurin
inhibitor, LX214 is targeted towards other chronic inflammatory diseases
of the eye, most notably dry eye syndrome, blepharitis and atopic
keratoconjunctivitis.
Several earlier stage projects based on
proprietary product-enabling bio-erodible polymer technologies that
facilitate targeted and sustained delivery of molecules to the eye.
For more information on Lux Biosciences,
please visit the company’s website at
http://www.luxbio.com.
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