AveXis, a Novartis company, today announced interim data from ongoing trials of the investigational product Zolgensma (onasemnogene abeparvovec-xioi; AVXS-101)1 that showed positive results across a broad spectrum of patients with spinal muscular atrophy (SMA). These included the first presentation of data from the Phase 1 STRONG trial, which showed motor function gains and milestone achievements in patients with SMA Type 2 via intrathecal (IT) delivery; new data from the Phase 3 STR1VE trial, which continued to show prolonged event-free survival, increases in motor function and significant milestone achievement consistent with the Phase 1 START trial; and the first presentation of data from the Phase 3 SPR1NT trial, which showed motor milestone achievement consistent with normal development in SMA patients treated pre-symptomatically. These data were presented during the 2019 American Academy of Neurology (AAN) Annual Meeting.
"With just a single, one-time dose, we are seeing Zolgensma provide prolonged survival, rapid motor function improvement and milestone achievements that patients never experience if their disease is left untreated," said David Lennon, President of AveXis. "These robust data presented at AAN represent a growing body of evidence that support the use of Zolgensma as a potential foundational therapy for the treatment of SMA across a variety of populations."
Phase 1 STRONG Data as of March 8, 2019
STRONG is a Phase 1, open-label, dose-comparison, multi-center trial designed to evaluate the safety and tolerability of one-time IT administration of Zolgensma in patients with SMA Type 2 who have three copies of the SMN2 gene, and who are able to sit but cannot stand or walk at the time of study entry. Patients were stratified into two groups based on age at time of dosing: patients who are >=6 months but <24 months, and patients who are >=24 months but <60 months. The primary efficacy outcome for patients who were >=6 to <24 months is the ability to stand without support >=3 seconds; the primary efficacy outcome for patients who were >=24 to >60 months is change in Hammersmith Functional Motor Scale-Expanded (HFMSE) score from baseline. Three dosing strengths are being evaluated. Only 3/34 (8.8 percent) patients were excluded due to elevated AAV9 antibodies.
Patients in the STRONG study showed improvement in motor function, with 19 patients (12/12 dosed at >=24 to <60 months and 7 who were dosed at >=6 to <24 months who then became old enough to be evaluated on the HSMSE) having a mean 4.2-point increase from baseline in HFMSE as of their most recent study visit (5-12 months post-treatment). Half of the patients (6/12) who were >=24 months at dosing experienced a >=3-point improvement from baseline in HFMSE by one-month post dosing.
Since dosing, 22 motor milestones in 10 patients have been achieved according to the Bayley-III Gross Motor Milestone Scale across the Dose A and Dose B treatment groups, including two patients who gained the ability to stand independently, one of whom went on to walk alone in the younger group, and one additional patient who gained the ability to walk with assistance in the older group. The median duration of follow-up was 6.5 months. Efficacy data from Dose C are not presented because enrollment is not complete.
All patients (n=30) were alive. There were two serious treatment-related adverse events. Both were of transaminase elevation. The frequency of patients with adverse events of transaminase elevation appeared to be lower than that seen with intravenous (IV) administration of Zolgensma.
"With an average of just over six months of data available for these Type 2 patients following treatment with Zolgensma, we are pleased to see they are achieving motor milestones, including the ability to stand and walk," said Olga Santiago, M.D., Chief Medical Officer of AveXis. "Based on these early promising data, we plan to approach regulators to define the path to registration for intrathecal administration of Zolgensma."
Phase 3 STR1VE Data as of March 8, 2019
STR1VE is an ongoing, open-label, single-arm, single-dose, multi-center trial in the U.S. designed to evaluate the efficacy and safety of a one-time IV infusion of Zolgensma in patients with SMA Type 1 who are <6 mo...
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