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Tegsedi: which tox species, and why?

inotersen · TTR (ASO)
Species
Mouse, rat and cynomolgus monkey; monkey the only pharmacologically relevant species
“Inotersen is pharmacologically active in cynomolgus monkey but not rodent or rabbit.”
✓ VerifiedFDA pharmacology/toxicology review, p. 4Source ↗
Why that species
Target sequence conserved in monkey; 8 mismatches in rodents and 4 in rabbit
“The target sequence of inotersen is conserved between monkeys and humans, but contains 8 mismatches in rodents and 4 mismatches in rabbits.”
✓ VerifiedEMA assessment report, p. 28Source ↗
Surrogate molecule
Yes: mouse (ISIS 401724) and rat (ISIS 594799) TTR-specific surrogate ASOs in tox, repro and carcinogenicity studies
“For this reason, mouse- and rat-specific analogues of inotersen were included in the toxicology evaluations in order to distinguish toxicity associated with reduction of the target (TTR) from toxicities related to the chemistry of the oligonucleotide”
✓ VerifiedEMA assessment report, p. 20Source ↗

Same question, other oligonucleotides

Amondys 45

casimersen · DMD exon 45 (PMO)
Adult male mouse and cynomolgus monkey; juvenile male rat

Amvuttra

vutrisiran · TTR (siRNA)
Rat and cynomolgus monkey (monkey only pharmacologically active; rat for off-target/class tox); rabbit EFD

Dawnzera

donidalorsen · Prekallikrein / KLKB1 (ASO)
Mouse (CD-1) and cynomolgus monkey

Exondys 51

eteplirsen · DMD exon 51 (PMO)
Cynomolgus monkey and juvenile rat (eteplirsen); mdx/C57BL mouse incl. mouse surrogate

Givlaari

givosiran · ALAS1 (siRNA)
Rat and cynomolgus monkey (both pharmacologically active); rabbit inactive (EFD only)

Izervay

avacincaptad pegol · C5 (aptamer)
Rabbit and dog (IVT ocular studies); rat and cynomolgus monkey (7-day IV); monkey the only pharmacologically relevant species

Kynamro

mipomersen · APOB (ASO)
Mouse, rat and cynomolgus monkey (clinical ASO plus rodent surrogates)

Leqvio

inclisiran · PCSK9 (siRNA)
Rat and cynomolgus monkey (both pharmacologically active); rabbit for EFD

Macugen

pegaptanib · VEGF-165 (aptamer)
Rabbit and dog (pivotal IVT); rat IV for systemic; supportive monkey, mouse

Onpattro

patisiran · TTR (siRNA)
Rat and cynomolgus monkey (monkey pharmacologically active; rat off-target/LNP)

Oxlumo

lumasiran · HAO1 (siRNA)
Rat and cynomolgus monkey (both pharmacologically relevant); rabbit for EFD

Qalsody

tofersen · SOD1 (ASO)
Cynomolgus monkey (IT, relevant species), CD-1 mouse (SC) and rat single-dose IT

Qfitlia

fitusiran · Antithrombin / SERPINC1 (siRNA)
Healthy rat and cynomolgus monkey (GLP); hemophilia A mouse, hemophilia A dog and induced-HA monkey models

Redemplo

plozasiran · APOC3 (siRNA)
Rat (off-target toxicity) and cynomolgus monkey (pharmacologically relevant)

Rivfloza

nedosiran · LDHA (siRNA)
Cynomolgus monkey (relevant) plus mouse (nedosiran inactive; off-target assessment)

Rytelo

imetelstat · Telomerase (oligo)
Mouse and cynomolgus monkey (general tox); mouse and rabbit (EFD)

Spinraza

nusinersen · SMN2 (ASO)
Juvenile cynomolgus monkey (IT) and CD-1 mouse (SC, systemic effects)

Tryngolza

olezarsen · APOC3 (ASO)
Mouse (with surrogate) and cynomolgus monkey

Viltepso

viltolarsen · DMD exon 53 (PMO)
Male CD-1 mouse and male cynomolgus monkey (plus juvenile male mouse)

Vyondys 53

golodirsen · DMD exon 53 (PMO)
Mouse, cynomolgus monkey (adult males) and juvenile rat

Wainua

eplontersen · TTR (ASO)
Mouse and cynomolgus monkey (monkey the pharmacologically relevant species)

Waylivra

volanesorsen · APOC3 (ASO)
Mouse, rat and cynomolgus monkey (rabbit for embryo-fetal); monkey most relevant

Zanvastro

zilganersen · GFAP (ASO)
Mouse (SC and ICV, juvenile) and juvenile monkey (intrathecal); mouse surrogate ASO arm

Summary across all 24 oligonucleotides →