Allakos Announces Positive Phase 2 Results in Patients with Cholinergic Urticaria and Symptomatic Dermographism
- Category: Small Molecules
- Published on Tuesday, 29 January 2019 18:35
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-- 82% (9 of 11) response rate in patients with cholinergic urticaria –
-- 70% (7 of 10) response rate in patients with symptomatic dermographism --
REDWOOD CITY, CA, USA I January 29, 2019 I Allakos Inc. (NASDAQ: ALLK), a biotechnology company developing AK002 for the treatment of eosinophil and mast cell related diseases, today announced positive Phase 2 results from two additional chronic urticaria cohorts: patients with cholinergic urticaria and symptomatic dermographism (also referred to as dermatographic urticaria). Earlier this month, Allakos reported that 12 of 13 patients (92%) in the Xolair-naïve chronic spontaneous urticaria (CSU) cohort achieved a complete response with AK002. Top-line results for the remaining urticaria cohort, patients with chronic spontaneous urticaria who failed to respond to Xolair, are expected later in the first quarter of 2019.
“We are excited by these data especially since there are no approved treatments for patients with cholinergic urticaria and symptomatic dermographism. Furthermore, the activity observed in patients with CSU and these patient cohorts suggests that AK002 may be used across multiple types of urticaria,” said principal investigator of the study, Dr. Marcus Maurer, M.D., Professor of Dermatology and Allergy at Charité University in Berlin.
The study is being conducted at four sites in the U.S. and Germany. The cholinergic urticaria and symptomatic dermographism cohorts enrolled 11 and 10 patients, respectively, with uncontrolled urticaria despite treatment with H1 antihistamines at doses of up to four times the labeled antihistamine dosage. Antihistamine medication was maintained throughout the screening period and during the study. Baseline symptom scores, as measured by Urticaria Control Test (UCT)* were collected over a 4-week screening period. Patients with baseline UCT scores of less than 12, indicative of poorly-controlled urticaria, were enrolled in the study and treated with up to six doses of AK002 given once monthly. Patients received an initial dose of 0.3 mg/kg at baseline, followed by a dose of 1.0 mg/kg on day 28, and then received monthly doses of either 1.0 or 3.0 mg/kg, depending on response, for a total of six doses. The primary efficacy endpoint was change from baseline in UCT assessed at week 22, two weeks after the last dose of AK002.
Top-line data are presented below; more detailed results from the study will be presented at an upcoming medical conference.
|Cholinergic Urticaria Cohort||Baseline||Week 22|
|Average UCT Score||5.4||11.8|
|UCT Complete Response||-||9/11 (82%)|
|UCT Partial Response||-||0/11 (0%)|
|UCT No Response||-||2/11 (18%)|
|Symptomatic Dermographism Cohort|
|Average UCT Score||5.7||9.1|
|UCT Complete Response||-||4/10 (40%)|
|UCT Partial Response||-||3/10 (30%)|
|UCT No Response||-||3/10 (30%)|
*UCT is an established patient-reported outcome scale for assessing urticaria control and measuring key symptoms.
UCT is a scale between 0 and 16, with higher scores indicating greater urticaria control.
UCT Complete Response was defined as a greater than 3-point improvement from baseline and a score of 12 or greater. UCT Partial Response was defined as a greater than 3-point improvement from baseline but less than 12.
AK002 was generally well tolerated. The most common adverse event was mild to moderate infusion-related reactions (flushing, feeling of warmth, headache, nausea, and dizziness) which occurred mostly during the first infusion.
Phase 2 Chronic Urticaria Study
The open-label Phase 2 study is being conducted at four sites in the U.S. and Germany. The study enrolled 45 patients with uncontrolled chronic urticaria with a UCT score less than 12 despite treatment with H1 antihistamines at doses up to four times the labeled dosage. Patients were enrolled in four cohorts depending on the form of urticaria and prior treatment: chronic spontaneous urticaria Xolair naïve (N=13), chronic spontaneous urticaria Xolair failures (N=11), cholinergic urticaria (N=11) and symptomatic dermographism (N=10). Antihistamine medication was maintained throughout the screening period and study. Baseline symptom scores, including UCT, were collected over a 4-week screening period. Patients with baseline UCT scores of less than 12 were enrolled in the study and treated with up to six doses of AK002 given monthly. Patients received an initial dose of 0.3 mg/kg, 1.0 mg/kg on day 28, and then received monthly doses of either 1.0 or 3.0 mg/kg for a total of six doses. Efficacy was assessed at week 22 using the urticaria control test (UCT) and UAS7 (for patients with chronic spontaneous urticaria only).
About Chronic Urticarias
Chronic urticarias are a group of inflammatory skin diseases that are believed to be caused by the inappropriate activation of the mast cells in the skin. Symptoms of urticaria include severe itching, hives, and edema with symptoms lasting for many years. Whereas there is no identified trigger for chronic spontaneous urticaria, other chronic urticarias are caused by triggers such as physical contact with the skin (symptomatic dermographism), or passive or active increases in body temperature (cholinergic urticaria). It has been estimated that 0.5 to 1.0 percent of the U.S. population suffers from a form of chronic urticaria. First-line treatment consists of antihistamine medication, however a significant number of patients do not receive adequate benefit even at four times the labeled dose. Xolair is the only agent approved for antihistamine refractory chronic spontaneous urticaria but is not indicated for other forms of chronic urticaria. Allakos estimates that approximately 200,000 to 500,000 patients with severe, uncontrolled chronic urticaria could be candidates for therapy with AK002.
Allakos is a clinical stage biotechnology company developing antibodies that target immunomodulatory receptors present on immune effector cells involved in allergic, inflammatory, and proliferative diseases. The Company’s lead antibody, AK002, targets Siglec-8, an inhibitory receptor selectively expressed on human mast cells and eosinophils. Inappropriately activated eosinophils and mast cells have been identified as key drivers in a number of severe diseases affecting the gastrointestinal tract, eyes, skin, lungs and other organs. AK002 has completed two Phase 1 trials, one in healthy volunteers and a single ascending dose trial in patients with indolent systemic mastocytosis. AK002 demonstrated pharmacodynamic activity in both trials and in the trial involving patients with indolent systemic mastocytosis, patients reported improvements in their symptoms. AK002 is being tested in a double-blind, placebo-controlled Phase 2 trial for the treatment of eosinophilic gastritis and eosinophilic gastroenteritis. In addition, Allakos is conducting multiple-dose trials with AK002 in chronic urticaria, indolent systemic mastocytosis, and severe allergic conjunctivitis. For more information, please visit the Company's website at www.allakos.com.