Ligand Announces Positive Top Line Results from Phase 1 Clinical Trial of Captisol-enabled Iohexol

Study achieved primary endpoint demonstrating pharmacokinetic bioequivalence between Captisol-enabled Iohexol and OMNIPAQUE™

SAN DIEGO, CA, USA I July 10, 2019 I Ligand Pharmaceuticals Incorporated (NASDAQ: LGND) today announced positive top line results from a Phase 1 clinical trial of its internal Captisol-enabled (CE) Iohexol program. The CE-Iohexol program was established in January 2018 to develop a Captisol-enabled, next-generation contrast agent for diagnostic imaging with a reduced risk of renal toxicity. Based on top line data, the trial achieved the primary endpoint demonstrating pharmacokinetic bioequivalence between CE-Iohexol injection and a reference Iohexol injection (OMNIPAQUE™) after intravenous (IV) administration in healthy adults. CE-Iohexol injection was safe and well tolerated, and adverse events were in line with the known safety profile of OMNIPAQUE. Details and data from the Phase 1 trial have been submitted for presentation at future scientific conferences.

“Our team did an excellent job executing this trial ahead of schedule, and we are very encouraged by the top line results of this Phase 1 trial,” said John Higgins, Chief Executive Officer of Ligand. “We have confidence in the continued development of CE-Iohexol with the goal to advance it to additional studies to support a registration filing. After the full data is published later this year, we look forward to exploring potential commercial partnerships for this program.”

“This trial represents a promising milestone in the pursuit of a safer agent for patients who receive intravenous contrast for their radiology and cardiology tests and procedures,” said Peter A. McCullough, MD, MPH, Vice Chief of Medicine, Baylor University Medical Center, Dallas TX, and President, Cardiorenal Society of America. “Top line results showed that this unique product incorporating a patented formulation ingredient had the expected pharmacokinetic profile compared to the reference standard agent, yet it potentially offers less kidney injury when given in patients with baseline kidney disease, diabetes, and multiple associated risk factors.”

Overview:

  • Contrast agents are used to enhance diagnostic imaging. Despite their benefits and widespread use, contrast agents may place patients at an increased risk for acute kidney injury (AKI), especially those with certain risk factors undergoing cardiac interventional procedures utilizing intravascular iodinated contrast.1
  • CE-Iohexol is designed to reduce the risk of AKI during imaging procedures where iodinated contrast agents are administered.
  • In preclinical studies using an animal model of AKI, CE-Iohexol administered at a dose similar to the clinical usage of iohexol in humans significantly reduced renal injury compared to iohexol alone and increased survival from 50% to 88%.2 These data support the further development of this new formulation of iohexol.

Clinical Trial:

  • The goal of the Phase 1 trial was to establish pharmacokinetic bioequivalence to support subsequent clinical trials that could support the submission of a 505(b)(2) new drug application (NDA) to the U.S. Food and Drug Administration (FDA).
  • The trial design consisted of a single-center, randomized, double-blind, two-period crossover study to determine relative bioavailability of CE-Iohexol and a reference Iohexol injection (OMNIPAQUE) after IV administration in a population of 24 healthy adults (NCT03869983).
  • Based on top line results, bioequivalence between CE-Iohexol and OMNIPAQUE was demonstrated for the key pharmacokinetic parameters of the area under the concentration-time curve for time 0-infinity (AUC0-inf) and the maximum concentration (Cmax) with 94% confidence intervals around unity (1.0) of 0.98-1.02 and 0.95-1.06, respectively. No subject had a serious adverse event or discontinued from the study due to an adverse event. All adverse events were mild to moderate in severity, with the most common being a sensation of warmth, which is an adverse event known to occur during IV administration of iodinated contrast agents such as OMNIPAQUE.3

About Captisol-enabled Iohexol

More than 30 million imaging procedures are performed each year in the United States. Iodinated contrast agents represent more than 60% of all X-ray imaging agents sold with an annual U.S. market of approximately $1.5 billion.4 Iohexol (marketed as OMNIPAQUE™ by GE Healthcare), the most widely-used injectable diagnostic contrast agent for imaging procedures, has global sales exceeding $500 million and no generic competition in the United States.

Contrast-induced acute kidney injury (CI-AKI) is the acute impairment of renal function following intravascular administration of an iodinated contrast agent, and occurs most frequently following coronary angiography, percutaneous coronary intervention and contrast-enhanced computed tomography, especially among patients at risk of renal injury such as those with advanced age, diabetes or heart failure. CI-AKI is an issue with broad medical visibility as more than 50% of cardiovascular imaging procedures are performed in patients age 65 or older.5

Currently no products are approved to prevent or treat CI-AKI in this setting, and therefore Ligand believes a significant opportunity exists for a safer formulation of contrast agents. The goal is for CE-Iohexol to establish a new safety standard that enables a future partner to gain meaningful market share.

About Captisol®

Captisol is a patent-protected, chemically modified cyclodextrin with a structure designed to optimize the solubility and stability of drugs. Captisol was invented and initially developed by scientists in the laboratories of Dr. Valentino Stella, University Distinguished Professor at the University of Kansas’ Higuchi Biosciences Center, for specific use in drug development and formulation. This unique technology has enabled several FDA-approved products, including Amgen’s KYPROLIS®, Baxter International’s NEXTERONE®, Acrotech Biopharma L.L.C.’s EVOMELA® and Melinta Therapeutics’ BAXDELA™ and Sage Therapeutics’ ZULRESSO™. There are many Captisol-enabled products currently in various stages of development.

About Ligand Pharmaceuticals

Ligand is a biopharmaceutical company focused on developing or acquiring technologies that help pharmaceutical companies discover and develop medicines. Ligand’s business model creates value for stockholders by providing a diversified portfolio of biotech and pharmaceutical product revenue streams that are supported by an efficient and low corporate cost structure. Ligand’s goal is to offer investors an opportunity to participate in the promise of the biotech industry in a profitable, diversified and lower-risk business than a typical biotech company. Ligand’s business model is based on doing what we do best: drug discovery, early-stage drug development, product reformulation and partnering. Ligand partners with other pharmaceutical companies to leverage what they do best (late-stage development, regulatory management and commercialization) to ultimately generate our revenue. Ligand’s Captisol® platform technology is a patent-protected, chemically modified cyclodextrin with a structure designed to optimize the solubility and stability of drugs. OmniAb® is a patent-protected transgenic animal platform used in the discovery of fully human mono-and bispecific therapeutic antibodies. Ligand has established multiple alliances, licenses and other business relationships with the world's leading pharmaceutical companies including Amgen, Merck, Pfizer, Celgene, Gilead, Janssen, Baxter International and Eli Lilly.

References

  1. McCullough, J Am College of Cardiology 2016;68:1465-73
  2. Rowe ES, et al. Journal of Neuroimaging 2016; 26(5):511-8
  3. OMNIPAQUE (iohexol) injection [prescribing information]. GE Healthcare, Inc.; April 2018.
  4. Contrast Agents/Media Global Market – Forecast to 2025 IQ4I Research & Consultancy Pvt. Ltd., 2018
  5. See: http://www.onlinejacc.org/content/71/11_Supplement/A1637

SOURCE: Ligand Pharmaceuticals

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