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Atlas/Oligonucleotides/Rytelo/Skipped studies

Rytelo: genotox, carcinogenicity and repro: done or skipped?

imetelstat · Telomerase (oligo)
Genotoxicity
Conducted; negative (Ames, in vitro micronucleus, in vivo mouse micronucleus)
“In genetic toxicity studies, imetelstat was not mutagenic in the in vitro bacterial reverse mutation assay.”
✓ VerifiedFDA multi-discipline review, p. 43Source ↗
Carcinogenicity
Not conducted pre-approval; mouse and rat carcinogenicity studies required as PMRs
“To address the carcinogenicity risk assessment of imetelstat, there will be separate Post Marketing Requirements (PMRs) for carcinogenicity assessments in the mouse and rat species.”
✓ VerifiedFDA multi-discipline review, p. 43Source ↗
Reproductive & developmental
EFD in mice and rabbits: post-implantation loss/resorptions; no fertility or PPND studies
“Increased rates of post-implantation loss and early resorptions that resulted in a decreased number of viable fetuses and litter size per animal, and decreased uterine weight were observed at”
✓ VerifiedFDA multi-discipline review, p. 42Source ↗
Safety pharmacology
Stand-alone telemetered monkey CV/CNS/respiratory study plus ECG in 9-month monkey study; no effects
“There were no test article-related changes observed in the cardiovascular, central nervous or respiratory systems.”
✓ VerifiedFDA multi-discipline review, p. 41Source ↗

Same question, other oligonucleotides

Amondys 45

casimersen · DMD exon 45 (PMO)
Conducted; negative (Ames, CHO chromosomal aberration, mouse micronucleus)

Amvuttra

vutrisiran · TTR (siRNA)
Conducted: Ames, human lymphocyte chromosome aberration, rat micronucleus; all negative

Dawnzera

donidalorsen · Prekallikrein / KLKB1 (ASO)
Conducted: in vitro Ames, CHL chromosomal aberration and in vivo mouse bone marrow micronucleus; no genotoxicity

Exondys 51

eteplirsen · DMD exon 51 (PMO)
Conducted; negative (Ames, CHO chromosomal aberration, mouse micronucleus)

Givlaari

givosiran · ALAS1 (siRNA)
Conducted: Ames, human lymphocyte chromosome aberration, rat micronucleus; all negative

Izervay

avacincaptad pegol · C5 (aptamer)
Conducted: Ames, chromosomal aberration in mammalian cells, mouse micronucleus; all negative

Kynamro

mipomersen · APOB (ASO)
Conducted; negative (Ames, mouse lymphoma, mouse micronucleus)

Leqvio

inclisiran · PCSK9 (siRNA)
Conducted: standard panel, negative

Macugen

pegaptanib · VEGF-165 (aptamer)
Conducted (GLP); pegaptanib and 2'-FU/2'-FC nucleosides negative overall

Onpattro

patisiran · TTR (siRNA)
Conducted: Ames, human lymphocyte chromosome aberration, mouse micronucleus; all negative

Oxlumo

lumasiran · HAO1 (siRNA)
Conducted: Ames, human lymphocyte chromosome aberration, rat micronucleus; all negative

Qalsody

tofersen · SOD1 (ASO)
Conducted; negative (Ames, CHL chromosomal aberration, mouse micronucleus)

Qfitlia

fitusiran · Antithrombin / SERPINC1 (siRNA)
Conducted: bacterial reverse mutation, in vitro chromosomal aberration (human lymphocytes), rat bone-marrow micronucleus; all negative

Redemplo

plozasiran · APOC3 (siRNA)
Conducted: Ames, in vitro chromosomal aberration (TK6), in vivo mouse micronucleus; not genotoxic

Rivfloza

nedosiran · LDHA (siRNA)
Conducted; negative (Ames, in vitro micronucleus, in vivo mouse micronucleus)

Spinraza

nusinersen · SMN2 (ASO)
Conducted; negative (Ames, CHO chromosomal aberration, mouse micronucleus)

Tegsedi

inotersen · TTR (ASO)
Conducted; negative (Ames, CHL chromosomal aberration, mouse micronucleus)

Tryngolza

olezarsen · APOC3 (ASO)
Conducted; negative (Ames, chromosomal aberration, mouse micronucleus)

Viltepso

viltolarsen · DMD exon 53 (PMO)
Conducted; negative (Ames, CHL chromosomal aberration, mouse micronucleus)

Vyondys 53

golodirsen · DMD exon 53 (PMO)
Conducted; negative (Ames, CHO chromosomal aberration, mouse micronucleus)

Wainua

eplontersen · TTR (ASO)
Conducted; negative (Ames, chromosomal aberration, mouse micronucleus)

Waylivra

volanesorsen · APOC3 (ASO)
Conducted: bacterial reverse mutation, mouse lymphoma TK, mouse bone-marrow micronucleus; all negative

Zanvastro

zilganersen · GFAP (ASO)
Conducted: Ames, in vitro chromosomal aberration, mouse micronucleus; all negative

Summary across all 24 oligonucleotides →