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Biogen 和 Ionis 因研究失败暂停 ALS 药物的研发

已有 1 次阅读2025-10-11 10:13 |个人分类:菜磊

Biogen 和 Ionis 因研究失败暂停 ALS 药物的研发

https://www.biopharmadive.com/news/biogen-ionis-als-drug-discontinue-study-results/716345/

虽然研究结果表明该药物发挥了预期作用,但它对一种已成为许多 ALS 研究项目不可或缺的蛋白质的疗效不足。

Jacob Bell 高级记者 2024 年 5 月 16 日

Biogen 和 Ionis Pharmaceuticals 因新的临床试验结果未达到预期而暂停了一款用于治疗 ALS 的实验性药物的研发。

这项试验招募了近 100 名患有这种神经破坏性疾病的患者,结果发现该药物确实发挥了预期作用。Biogen 和 Ionis 最初设计该药物的目的是降低与肌萎缩侧索硬化症相关的蛋白质“ataxin-2”的水平,从这一指标来看,该药物是成功的。周四公布的详细研究结果显示,接受名为 BIIB105 的药物(而非安慰剂)治疗的受试者在六个月的治疗期内,ATXN2 蛋白水平显著下降。

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然而,该药物似乎并未改变疾病的发展轨迹。它并未影响呼吸、力量和整体功能——这些关键的健康指标会随着 ALS 的进展而逐渐减弱。BIIB105 也没有显著降低另一种蛋白质——“神经丝轻链”,这种蛋白质最近在该研究领域变得尤为重要。Biogen 和 Ionis 联合开发的另一种 ALS 药物 Qalsody 去年因其降低该蛋白质的能力而获得上市批准。

Biogen 神经肌肉发育部门负责人 Stephanie Fradette 在一份声明中表示:“虽然 BIIB105 降低了 ATXN2 蛋白水平,但它并没有减少神经丝,这让我们确信 BIIB105 并没有减缓疾病进程。”

在试验中,完成六个月主要治疗期的参与者随后被安排进入“开放标签扩展”阶段,在此期间,所有参与者均可接受 BIIB105 治疗。Biogen 和 Ionis 表示,该阶段的数据与研究早期观察到的结果相似,即 ATXN-2 蛋白“持续降低”,但对神经丝或临床结果指标“没有影响”。

两家公司表示,没有证据表明任何接受药物治疗的患者亚组在临床上受益。

数据分析仍在进行中。Biogen 和 Ionis 计划下个月在斯德哥尔摩举行的 ALS 研究大会上展示更详细的研究结果。

BIIB105 的搁置是这个饱受失败困扰的药物研发领域的最新挫折。ALS 与许多中枢神经系统疾病一样,复杂且难以治疗。科学家们在一个多世纪前首次发现了这种疾病;然而,迄今为止,只有少数药物被批准用于治疗这种疾病。 (今年的名单变得更短了,因为Amylyx Pharmaceuticals公司一款曾经前景光明的药物被撤出市场。)

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Qalsody于2023年4月获批,是最新的药物,尽管它只适用于极少数携带特定基因突变的ALS患者。Biogen和Ionis合作进行了该疗法的早期开发,使用了后者的反义寡核苷酸制药技术。

Qalsody本质上是阻碍了一种名为SOD1的ALS相关蛋白的产生。实际上,该疗法未能达到FDA批准该疗法的最初研究目标。在那次试验中,Qalsody在减缓病情进展方面并不比安慰剂好。然而,它在降低神经丝轻链(神经损伤的生物标志物)方面表现更佳。

FDA 的决定实际上为 ALS 制药商开辟了一条新的审批途径。自 Qalsody 案判决以来,这些制药商一直优先考虑在临床试验中展示其对神经丝的作用。

迄今为止,Qalsody 是百健 (Biogen) 和 Ionis 在 ALS 研究中取得的唯一明显胜利。2022 年,在一项早期试验结果令人失望后,两家合作伙伴停止了另一款代号为 BIIB078 的反义药物的研发。同样在周四,Ionis 透露,尽管 Ionis 称其结果积极,但百健仍选择不批准两家公司一直在研发的用于治疗天使综合征 (Angelman syndrome) 的药物。

不过,这项长期合作在其他领域也取得了丰硕成果。百健已生产出一款重磅药物 Spinraza,用于治疗一种罕见的肌肉萎缩症。在过去几年中,百健还强调了另一款实验性药物 BIIB080 的潜力,该药物目前正处于中期试验阶段,可能成为治疗阿尔茨海默病的一种药物。

Biogen, Ionis shelve ALS drug following study failure

https://www.biopharmadive.com/news/biogen-ionis-als-drug-discontinue-study-results/716345/

While results indicated the drug works as intended, it didn’t have enough of an effect on a protein that’s become integral to many ALS research programs.

Jacob Bell Senior Reporter  May 16, 2024 

Biogen and Ionis Pharmaceuticals are stopping development of an experimental drug for ALS following new clinical trial results that didn’t meet the companies’ expectations.

The trial, which enrolled almost 100 people with the nerve-destroying disorder, found the drug actually worked as intended. Biogen and Ionis had designed it to lower levels of “ataxin-2,” a protein tied to amyotrophic lateral sclerosis, and on that measure it was successful. High-level results released Thursday showed participants who received the drug, named BIIB105, rather than a placebo experienced significant decreases in the protein over a six-month treatment period.

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However, the drug didn’t appear to change the trajectory of the disease. It didn’t impact breathing, strength and overall function — key health measures that diminish as ALS progresses. BIIB105 also didn’t substantially reduce a different protein, “neurofilament light chain,” that recently became important across this area of research. Qalsody, another ALS medicine developed by Biogen and Ionis, won marketing approval last year based on its ability to lower that protein.

“While BIIB105 lowered ATXN2 protein, it did not reduce neurofilament, which gives us confidence that BIIB105 did not slow the disease process,” said Stephanie Fradette, head of Biogen’s Neuromuscular Development Unit, in a statement.

In the trial, participants who completed the main six-month treatment period were then offered entry into an “open-label extension” phase, in which they all could receive BIIB105. Biogen and Ionis said data from that phase were similar to what was seen earlier in the study, with “sustained reductions” in the ataxin-2 protein but “no impact” on neurofilament or clinical outcome measures.

The companies said there was no evidence that any subgroup of drug-treated patients benefited clinically.

Analysis of the data remains ongoing. Biogen and Ionis plan to present more detailed study results next month at an ALS research convention in Stockholm.

The shelving of BIIB105 is the latest setback for a field of drug development marred by failure. ALS, like many central nervous system disorders, is complex and difficult to combat. Scientists first discovered the disease over a century ago; and yet, just a few medicines have ever been approved to treat it. (The list got even smaller this year, as a once-promising medication from Amylyx Pharmaceuticals is being pulled from the market.)

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Approved in April 2023, Qalsody is the newest offering, though it’s for a very small fraction of ALS patients with specific genetic mutations. Biogen and Ionis collaborated on early development of the therapy, using the latter’s antisense oligonucleotide drugmaking technology.

Qalsody essentially gums up the production of an ALS-associated protein called SOD1. The therapy actually failed to hit the central goal of the study that led the Food and Drug Administration to clear it. In that trial, Qalsody wasn’t any better than a placebo at slowing disease progression. It was, however, better at lowering neurofilament light chain — a biological marker of neurological damage.

The FDA’s decision effectively created a new route to approval for ALS drugmakers, who, since the Qalsody decision, have prioritized showing an effect on neurofilament in their clinical tests.

So far, Qalsody is the only clear victory to come out of Biogen and Ionis’ ALS research. In 2022, the partners discontinued another antisense drug, code-named BIIB078, after an early-stage trial disappointed. Also on Thursday, Ionis revealed that Biogen has opted against licensing a drug the companies have been working on for Angelman syndrome, despite results Ionis described as positive.

The longstanding partnership has been fruitful in other areas, though. It’s produced a blockbuster medicine in Spinraza, a treatment for a rare, muscle-wasting illness. And over the past couple years, Biogen has highlighted the potential of another experimental drug, BIIB080, which is in mid-stage testing as a possible treatment for Alzheimer’s disease.


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