NGM282, NAS and fibrosis in NASH: a phase 2 study

Slides:



Advertisements
Similar presentations
Treating to New Targets Study TNT Trial Presented at The American College of Cardiology Scientific Sessions 2005 Presented by Dr. John C. LaRosa.
Advertisements

Comparison of PI vs PI  ATV/r vs DRV/rATADAR. ATV/r 300/100 mg + TDF/FTC qd N = 91 N = 89 DRV/r 800/100 mg + TDF/FTC qd  Design Randomisation 1: 1 Open-label.
Downloaded from Slide 1 Ezetimibe Coadministered with Atorvastatin in Patients with Hypercholesterolemia and Coronary Heart.
Clinical experience with ezetimibe/simvastatin in a Mediterranean population The SETTLE Study I. Migdalis a, A. Efthimiadis b, St. Pappas c, D. Alexopoulos.
THE PRESENCE OF HEPATIC STEATOSIS WHEN NO OTHER CAUSES FOR SECONDARY HEPATIC FAT ACCUMULATION NAFLD MAY PROGRESS TO CIRRHOSIS AND IS LIKELY AN IMPORTANT.
Slide 1 EZT 2002-W-6022-SS Ezetimibe Co-administered with Statins: Efficacy and Tolerability Copyright © 2003 MSP Singapore Company, LLC. All rights reserved.
Management of Elevated Cholesterol in the Primary Prevention Group of Adult Japanese (MEGA) Trial MEGA Trial Presented at The American Heart Association.
Switch NNRTI to NNRTI  Switch EFV to ETR –CNS toxicity study –Patient’s preference study.
Laura Mucci, Pharm.D. Candidate Mercer University 2012 Preceptor: Dr. Rahimi February 2012.
Incremental Decrease in Clinical Endpoints Through Aggressive Lipid Lowering (IDEAL) Trial IDEAL Trial Presented at The American Heart Association Scientific.
Arterial Biology for the Investigation of the Treatment Effects of Reducing Cholesterol 2 ARBITER-2 Trial Presented at The American Heart Association Scientific.
Collaborative Atorvastatin Diabetes Study CARDS Dr Sachin Kadoo.
4S: Scandinavian Simvastatin Survival Study
OBV/PTV/r + DSV Open label Chronic HCV infection Genotype 1 Treatment-naïve HCV RNA > 1,000 IU/ml Chronic kidney disease with eGFR < 30 ml/min/1.73m 2.
Downloaded from Slide 1 Dual Inhibition of Two Sources of Cholesterol: Absorption and Production Results of a Clinical Trial.
Date of download: 7/5/2016 From: Long-Term Pioglitazone Treatment for Patients With Nonalcoholic Steatohepatitis and Prediabetes or Type 2 Diabetes Mellitus:
Statins The AURORA Trial Reference Fellstrom BC. Rosuvastatin and cardiovascular events in patients undergoing hemodialysis. N Engl J Med. 2009;360. A.
FOURIER Further Cardiovascular Outcomes Research With PCSK9 Inhibition in Subjects With Elevated Risk
ARV-trial.com RUBY-II Study: ombitasvir/paritaprevir/ritonavir + dasabuvir for HCV genotype 1a or 4 with severe renal impairment Design Open label W12.
Switch from TDF to TAF GS-US Study GS-US Study
No HBV or HIV co-infection
Ocaliva™ - obeticholic acid
NRTI-sparing SPARTAN PROGRESS RADAR NEAT001/ANRS 143 A VEMAN
ARV-trial.com C-CREST study, Part B: uprifosbuvir (MK-3682)/GZR/ruzasvir (MK-8408) fixed-dose combination + RBV for genotypes 1, 2 and 3 - Phase II Randomisation.
The American College of Cardiology Presented by Dr. Steven E. Nissen
GEODE-II Study: OBV/PTV/r + DSV + low dose RBV in genotype 1a
GARNET Study: OBV/PTV/r + DSV 8 weeks in genotype 1b
Comparison of INSTI vs INSTI
Creatinine clearance ≥ 50 ml/min No HBV or HIV co-infection
The European Society of Cardiology Presented by Dr. Bo Lagerqvist
ARV-trial.com RUBY-I Study, cohort 2: ombitasvir/paritaprevir/ritonavir + dasabuvir + RBV for HCV genotype 1 with renal impairment Design Open label W12.
QUARTZ II-III : OBV/PTV/r + SOF RBV in genotype 2 or 3
Pravastatin in Elderly Individuals at Risk of Vascular Disease
Effects of Anacetrapib on the Incidence of New-Onset Diabetes Mellitus and on Vascular Events in People With Diabetes Louise Bowman & Martin Landray on.
The American Heart Association Presented by Dr. Steven E. Nissen
Senior Medical Director, Cardiovascular
First time a CETP inhibitor shows reduction of serious CV events
Scandinavian Simvastatin Survival Study (4S)
The ASSERT Study.
Jane Armitage on behalf of the HPS2-THRIVE Collaborative Group
Switch to BIC/FTC/TAF GS-US GS-US GS-US
The results of the SHARP trial
Case 1: A 73-year-old white female with carotid disease
Section 7: Aggressive vs moderate approach to lipid lowering
EXPEDITION-V Study: GLE/PIB in patients with renal impairment
This series of slides highlights a report based on a presentation at the Late-Breaking Trial Sessions of the 2005 American Heart Association Scientific.
Marina Cuchel, Dirk J. Blom, Maurizio R. Averna 
WHAT’S NEW WITH THE TREATMENTS FOR HIGH-RISK DYSLIPIDEMIA?
Rational Order of Laboratory Tests in Cardiovascular Diseases
Screening, Lipid Stabilization, and Placebo Run-in
Volume 155, Issue 5, Pages e6 (November 2018)
Comparison of INSTI vs EFV
Comparison of PI vs PI ATV vs ATV/r BMS 089
Comparison of PI vs PI ATV vs ATV/r BMS 089
NGM282 in NASH: 3 mg vs 6 mg QD (phase 2)
Comparison of INSTI vs INSTI
CENTAUR Study: cenicriviroc in NASH (phase 2b)
Comparison of NNRTI vs PI/r
The Heart Rhythm Society Meeting Presented by Dr. Johan De Sutter
Major classes of drugs to reduce lipids
ARREST Study: Phase 2b of Aramchol in NASH
Selonsertib in NASH: phase 2
NGM282 in NASH: 3 mg QD (phase 2)
GS-9674 in NASH: a phase 2 study
Comparison of NRTI combinations
VK2809 in NAFLD: a phase 2 study
The results of the SHARP trial
The following slides highlight a report on a presentation at the American College of Cardiology 2004, Scientific Sessions, in New Orleans, Louisiana on.
Specific Dyslipidemias: Very High LDL Cholesterol (>190 mg/dL)
Late-Breaking Data on LDL-C Reduction
Presentation transcript:

NGM282, NAS and fibrosis in NASH: a phase 2 study Design Follow-up Liver biopsy with NASH NAS * ≥ 4 with a score ≥ 1 for each component Stage 1-3 of fibrosis Liver fat content ≥ 8% (MRI-PDFF) NGM282 1 or 3 mg NGM282 1 or 3 mg Rosuvastatin (if needed) D-28 D1 W2 W4 W6 W8 W12 W18 MRI-PDFF X Liver MultiScanTM Liver biopsy * NAS (NAFLD Activity Score): steatosis (0 to 3), lobular inflammation (0 to 3), ballooning (0 to 2) NGM282: engineered variant of human FGF19 Rosuvastatin: started at W2 if LDL-cholesterol rise ≥ 10 mg/dl Endpoints Primary: decrease in absolute liver fat content (MRI-PDFF) ≥ 5% at W12 Exploratory: change in liver histology at W12 NGM282-phase 2 Harrison SA, AASLD 2018, Abs. 104 1

NGM282, NAS and fibrosis in NASH: a phase 2 study Baseline characteristics, mean (SD) NGM282 1 mg N = 24 NGM282 3 mg N = 19 Age, years (SD) 49.4 (10.7) 51.4 (12.6) Male/ Female, N 5 / 19 4 / 15 Liver fat content, MRI-PDFF (proton density fat fraction), % 19.2 (7.1) 17.1 (5.6) AST, U/L 70 (39) 64 (32) ALT, U/L 92 (53) 82 (39) Fibrosis stage 2.3 (0.8) 2.5 (0.8) NAFLD activity score 5.4 (1.5) 5.7 (1.5) LDL cholesterol, mg/dL 103 (24) 97 (27) Statin naïve/experienced 20 / 4 13 / 6 7α-hydroxyl-4-cholesten-3-one (C4), ng/mL (SD) 35.6 (27.0) 35.1 (24.2) NGM282-phase 2 Harrison SA, AASLD 2018, Abs. 104 2

NGM282, NAS and fibrosis in NASH: a phase 2 study Mean C4 levels (ng/ml) Mean total serum bile acids (µmol/L) 40 10 35 30 25 20 15 5 NGM282 1 mg Baseline W6 W12 * NGM282 3 mg 40 10 35 30 25 20 15 5 Baseline W6 W12 * NGM282 1 mg 6 2 5 4 3 1 Baseline W6 W12 * NGM282 3 mg 6 2 5 4 3 1 Baseline W6 W12 * * p < 0.001 vs baseline NGM282-phase 2 Harrison SA, AASLD 2018, Abs. 104

Primary endpoint: mean absolute liver fat content at W12, % NGM282, NAS and fibrosis in NASH: a phase 2 study Primary endpoint: mean absolute liver fat content at W12, % 40 5 15 10 Baseline W6 W12 *** NGM282 1 mg NGM282 3 mg 40 5 15 10 Baseline W6 W12 *** Absolute and relative changes in LFC at W12: -11.2 % and -67% (3 mg) ; -10.9% and -57% (1 mg) 100% (3 mg) and 92% (1 mg) of subjects achieved primary endpoint of ≥ 5% absolute LFC reduction 100% (3 mg) and 92% (1 mg) had a relative decrease in LFC ≥ 30% at W12 63% (3 mg) and 33% (1 mg) of subjects normalized LFC (≤ 5%) by W12 NGM282-phase 2 Harrison SA, AASLD 2018, Abs. 104

Mean transaminases (IU/L) NGM282, NAS and fibrosis in NASH: a phase 2 study Mean transaminases (IU/L) NGM282 1 mg 100 Baseline 80 60 40 20 W2 W4 W6 W8 W10 W12 NGM282 3 mg 100 80 60 40 20 Baseline W2 W4 W6 W8 W10 W12 ALT AST NGM282-phase 2 Harrison SA, AASLD 2018, Abs. 104

Histological parameters, % NGM282, NAS and fibrosis in NASH: a phase 2 study Histological parameters, % NGM282 1 mg NGM282 3 mg Improved No change Worsened -1.9 (1.7) 20 40 60 80 100 -1.0 (0.9) -0.4 (0.6) -0.5 (0.9) Mean change at W12 (SD) NAS Steatosis Inflammation Ballooning 8% 17% 75% 33% 67% 46% 42% 12% NAS Steatosis Inflammation Ballooning -2.3 (1.8) -1.1 (0.9) -0.4 (0.7) -0.7 (0.9) 84% 74% 26% 53% 42% 5% 20 40 60 80 100 11% NGM282-phase 2 Harrison SA, AASLD 2018, Abs. 104

Fibrosis at baseline and W12 in the NGM282 1 mg group NGM282, NAS and fibrosis in NASH: a phase 2 study Fibrosis at baseline and W12 in the NGM282 1 mg group Fibrosis Stage at baseline, % Fibrosis Histologic Response at W12, % Mean fibrosis stage = 2.3 F4 F1 F2 F3 38 % 42 % 16 % 4 % Improved No change Worsened (1 point) Mean change from baseline in fibrosis stage: - 0.1 One subject had a 2-stage improvement in fibrosis: F2 to F0 NGM282-phase 2 Harrison SA, AASLD 2018, Abs. 104

Mean LDL-cholesterol changes during treatment, mg/dL NGM282, NAS and fibrosis in NASH: a phase 2 study Mean LDL-cholesterol changes during treatment, mg/dL Baseline 200 100 50 W2 W4 W6 W8 W10 W12 150 NGM282 1 mg NGM282 1 mg + rosuvastatin (if needed, titration at W4, W8) NGM282 3 mg NGM282 3 mg + r0osuvastatin (if needed, titration at W4, W8) LDL-C levels drop below baseline with rosuvastatin Decreased C4 and increased LDL-cholesterol reflect potent CYP7A1 inhibition Lipid particle change primarily driven by increase in large LDL particles Significant reductions in serum triglycerides: -25 % (1 mg) and -34 % (3 mg) at W12 NGM282-phase 2 Harrison SA, AASLD 2018, Abs. 104

Safety and tolerability NGM282, NAS and fibrosis in NASH: a phase 2 study Safety and tolerability Favorable safety and tolerability profile consistent with other NGM282 studies: no new safety signals identified Mild gastrointestinal symptoms (loose/frequent stools) were the most common treatment emergent adverse events Majority were mild and resolved during treatment phase No subject withdrew from treatment due to any drug-related AEs Gastrointestinal symptoms were largely mitigated with separating the timing of injection around meals and decreasing meal size Five severe adverse events, all unrelated to study drug: Pneumonia Pleurisy Chest tightness Cardiac arrest (non myocardial infarction) Renal mass NGM282-phase 2 Harrison SA, AASLD 2018, Abs. 104

NGM282, NAS and fibrosis in NASH: a phase 2 study Summary Potent C4 and bile acid suppression consistent with FGF19 hormone activity Significant and clinically meaningful reductions across non-invasive markers of NASH-related disease Large percentage of patients demonstrated histological improvement at W12 Statin co-administration rapidly mitigates LDL-cholesterol elevations Treatment was safe and well tolerated NGM282-phase 2 Harrison SA, EASL 2018, Abs. GS-014