AveXis Announces New England Journal of Medicine Publication of Phase 1 Data of AVXS-101 Gene Replacement Therapy in Spinal Muscular Atrophy Type 1
– Patients who received a single dose of AVXS-101 resulted in longer survival, superior achievement of motor milestones, and better motor function than in historical cohorts –
– As of
– As of
“It is incredibly encouraging to see that all children who have received
AVXS-101 remain event-free and demonstrate a durable treatment effect at
20 months of age and older, including in many cases achievement of new
The NEJM publication provides detailed data as of
Event-free Survival and Safety
Data as of
August 7, 2017, showed no new events, and 15 of 15 (100%) patients were event-free at 20 months of age. The expected event-free survival rate at 20 months of age based on the natural history of the disease is eight percent. The median age at last follow-up was 25.7 months and 30.7 months for patients in the proposed therapeutic-dose cohort (Cohort 2) and low-dose cohort (Cohort 1), respectively.
- As has been previously reported, a total of five adverse events (AEs) in four patients were deemed treatment-related. Of these, two were serious adverse events (SAEs) experienced by two patients, and three were non-serious AEs experienced by two patients. All consisted of clinically asymptomatic liver enzyme elevations and were resolved with prednisolone treatment. There were no clinically significant elevations of gamma-glutamyl transferase, alkaline phosphatase or bilirubin and, as such, Hy’s Law was not met. Other non-treatment-related AEs were expected and were associated with SMA.
A cumulative total of 297 AEs (five treatment-related AEs and 292
non-treatment related AEs) were reported as of
August 7, 2017, following monitoring and source verification. Of these, 56 were determined to be SAEs and 241 were non-serious AEs.
- AVXS-101 appeared to have a favorable safety profile and to be generally well tolerated, with no new treatment-related safety or tolerability concerns identified.
Treatment Durability and Motor Milestone Achievement
August 7, 2017, 11 of 12 patients (92%) in Cohort 2 have achieved and maintained CHOP-INTEND scores of ≥40 points.
August 7, 2017, 11 of 12 patients (92%) in Cohort 2 achieved head control, nine of 12 patients (75%) could roll over and 11 of 12 patients (92%) could sit with assistance.
August 7, 2017, 11 of 12 patients (92%) in Cohort 2 could sit unassisted for at least five seconds, 10 of 12 patients (83%) could sit unassisted for at least 10 seconds and nine of 12 patients (75%) could sit unassisted for 30 seconds or more.
August 7, 2017, two patients in Cohort 2 could crawl, pull to a stand and stand and walk independently.
- All motor milestones have been assessed and adjudicated by an independent third-party reviewer using video evidence.
|Event-free Survival and Motor and Other Milestones Among the 12 Patients in Cohort 2 as of August 7, 2017*|
|Sits Unassistedc||Other Achievements|
8 by 20
8 by 20
|*At baseline, none of the patients in Cohort 2 had achieved any of the listed motor milestones except for bringing a hand to the mouth. As of August 7, 2017, the majority of these patients had reached at least one major motor milestone. No patients in Cohort 1 are listed, since none attained any motor milestones. NA denotes not available, and NIV noninvasive ventilation. Plus signs indicate achievement of milestone.|
|a.||Event-free survival (the primary efficacy outcome) was defined as the age at the end of the study at which patients were free of ventilatory support, which was defined as the need for ventilation for at least 16 hours per day for at least 14 consecutive days.|
|b.||According to item 20 on the Bayley Scales of Infant and Toddler Development, rolling over is defined as movement of at least 180 degrees both left and right from a position of lying on the back.|
|c.||Sitting unassisted for at least 5 seconds is in accordance with the criteria of item 22 on the Bayley Scales of Infant and Toddler Development gross motor subtest and surpasses the 3-second count that is used as a basis for sitting (test item 1) on the Hammersmith Functional Motor Scale–Expanded for Spinal Muscular Atrophy (SMA). Sitting unassisted for at least 10 seconds is in accordance with the criteria used in the World Health Organization Multicentre Growth Reference Study. Sitting unassisted for at least 30 seconds defines functional independent sitting and is in accordance with the criteria of item 26 on the Bayley Scales of Infant and Toddler Development gross motor subtest.|
|d.||Nutritional support refers to the placement of either a gastrostomy tube or a nasogastric tube, as determined by the preference of the parents or the primary physician. Once enrolled in the study, all the patients who required nutritional support underwent gastrostomy-tube placement, and none were removed during the study.|
|e.||Data are from Finkel et al.|
|** Data are from De Sanctis et al.|
Nutritional and Respiratory Support
- According to natural history of the disease, nearly all Type 1 patients require nutritional and respiratory support by 12 months of age, and are not able to swallow or speak effectively.
August 7, 2017, patients who were free of respiratory or feeding support on January 20, 2017, continued without the need for supportive care.
August 7, 2017, six of seven (86%) patients in Cohort 2 that did not require feeding support before treatment continued without feeding support after treatment; seven of 10 (70%) patients that did not require bi-level positive airway pressure (BiPAP) support before treatment did not require BiPAP support at last assessment.
August 7, 2017, eleven of 12 (92%) patients in Cohort 2 were fed orally, and six of 12 (50%) patients were exclusively fed orally.
- As of
Further, as of
August 7, 2017, eleven of 12 (92%) patients were able to speak; three more patients than previously reported on April 25, 2017at the American Academy of Neurology.
“AveXis and my team at Nationwide Children’s Hospital have worked
tirelessly to alter the inevitable course of SMA Type 1,”
AVXS-101 is currently being evaluated in a pivotal trial for the treatment of SMA Type 1.
SMA is a severe neuromuscular disease characterized by the loss of motor neurons leading to progressive muscle weakness and paralysis. SMA is caused by a genetic defect in the SMN1 gene that codes SMN, a protein necessary for survival of motor neurons. The incidence of SMA is approximately one in 10,000 live births and is the leading genetic cause of infant mortality.
The most severe form of SMA is Type 1, a lethal genetic disorder characterized by motor neuron loss and associated muscle deterioration, which results in mortality or the need for permanent ventilation support before the age of two for greater than 90 percent of patients. SMA Type 2 typically presents between six and 18 months of age and affected patients can sit unassisted but never walk or stand without support.
AVXS-101 is a proprietary gene therapy candidate of a one-time treatment for SMA Types 1 and 2, designed to address the monogenic root cause of SMA and prevent further muscle degeneration by addressing the defective and/or loss of the primary SMN gene. AVXS-101 also targets motor neurons, providing rapid onset of effect and crossing the blood brain barrier to allow effective targeting of both central and systemic features.
For additional information, please visit www.avexis.com.
This press release contains "forward-looking statements," within the
meaning of the Private Securities Litigation Reform Act of 1995,
regarding, among other things, AveXis’ research, development and
regulatory plans for AVXS-101, including the potential of AVXS-101 to
alter the course of disease in patients with SMA Type 1, AveXis’ ongoing
clinical trial of AVXS-101 in SMA Type 1 and plans to expand AveXis’
research, development efforts to explore potential treatments of RTT and
genetic ALS. Such forward-looking statements are based on current
expectations and involve inherent risks and uncertainties, including
factors that could delay, divert or change any of them, and could cause
actual results to differ materially from those projected in its
forward-looking statements. Meaningful factors which could cause actual
results to differ include, but are not limited to, the scope, progress,
expansion, and costs of developing and commercializing AveXis’ product
candidates; regulatory developments in the U.S. and EU, as well as other
factors discussed in the "Risk Factors" and the "Management's Discussion
and Analysis of Financial Condition and Results of Operations" sections
of AveXis’ Annual Report on Form 10-K for the year ended
All forward-looking statements contained in this press release are
expressly qualified by the cautionary statements contained or referred