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Atlas/Oligonucleotides/Tryngolza/Efficacy evidence

Tryngolza: animal efficacy model or human cells?

olezarsen · APOC3 (ASO)
Efficacy evidence
Human apoC-III transgenic mice, wild-type CD-1 mice (mouse surrogate) and cynomolgus monkeys; primary hepatocytes in vitro
“Olezarsen was evaluated in vitro in primary hepatocytes, transgenic mice expressing human apoC-III, wild-type (normal) CD-1 mice and cynomolgus monkeys.”
✓ VerifiedEMA assessment report, p. 22Source ↗
Why that model
Surrogate needed in wild-type mice due to mouse/human apoC-III mRNA sequence divergence
“due to the divergence in sequence between mouse and human apoC-III mRNA”
✓ VerifiedFDA integrated review, p. 44Source ↗
Reviewer's view of the efficacy data
FDA: animal models gave reasonable proof-of-concept supporting human trials
“Results from these animal models provide reasonable proof-of-concept that supported the initiation of human trials as assessed using a clinically translatable and monitorable pharmacological endpoint, plasma TG.”
✓ VerifiedFDA integrated review, p. 44Source ↗

Same question, other oligonucleotides

Amondys 45

casimersen · DMD exon 45 (PMO)
In vitro only: human rhabdomyosarcoma cells and normal primary myoblasts

Amvuttra

vutrisiran · TTR (siRNA)
hTTR V30M transgenic mice and cynomolgus monkeys: up to >=98% serum TTR reduction

Cyfendus

anthrax vaccine adsorbed, adjuvanted · TLR9 (CpG 7909 adjuvant)
Guinea pig and cynomolgus macaque lethal aerosolized B. anthracis spore challenge after two IM vaccinations

Dawnzera

donidalorsen · Prekallikrein / KLKB1 (ASO)
Mouse-specific surrogate ASO ISIS 482584 in five in vivo mouse vascular permeability studies

Defitelio

defibrotide · Fragmented DNA oligonucleotides
In vitro studies, primarily in a human microvascular endothelial cell line

Exondys 51

eteplirsen · DMD exon 51 (PMO)
Exon 51 skipping in human muscle cell cultures, DMD patient muscle explants, transgenic hDMD mice (IM) and cynomolgus monkey (IV)

Givlaari

givosiran · ALAS1 (siRNA)
Mouse and rat AIP disease models: givosiran prevented and reduced phenobarbital-induced ALA and PBG

Heplisav-B

hepatitis B vaccine (recombinant), adjuvanted · TLR9 (CpG 1018 adjuvant)
Anti-HBsAg immunogenicity of the adjuvanted vaccine in mice, rats and baboons

Izervay

avacincaptad pegol · C5 (aptamer)
In vitro and ex vivo complement functional assays plus in vivo complement inhibition in monkey

Kynamro

mipomersen · APOB (ASO)
Species-specific surrogate apoB ASOs in mouse, hamster, rabbit and monkey lipid models (mouse atherosclerosis models)

Leqvio

inclisiran · PCSK9 (siRNA)
PCSK9/LDL-C lowering in human PCSK9 transgenic mice and healthy NHPs

Macugen

pegaptanib · VEGF-165 (aptamer)
Mouse retinopathy of prematurity (hypoxia-induced retinal neovascularization), rat corneal pocket angiogenesis, guinea pig dermal permeability

Onpattro

patisiran · TTR (siRNA)
V30M/Hsf-1 KO mouse disease model (ALN-TTR01, same siRNA): 97-100% tissue TTR protein suppression

Oxlumo

lumasiran · HAO1 (siRNA)
Genetic PH1 mouse model (AGXT-/-): dose-dependent urinary oxalate reduction (~50% at 3 mg/kg)

Qalsody

tofersen · SOD1 (ASO)
Clinical molecule in transgenic human SOD1G93A mice and rats: SOD1 mRNA reduction; improved lifespan and rotarod in mouse

Qfitlia

fitusiran · Antithrombin / SERPINC1 (siRNA)
Hemophilia A and B knockout mice, genetic hemophilia A dog and antibody-induced hemophilia A monkey

Redemplo

plozasiran · APOC3 (siRNA)
Human ApoC-III transgenic (dyslipidemic) mouse, healthy cynomolgus monkey and dyslipidemic rhesus macaque

Rivfloza

nedosiran · LDHA (siRNA)
PH1 (Agxt knockout) and hydroxyproline-induced mouse models with mouse-active analog DCR-m355; LDHA knockdown in monkeys

Rytelo

imetelstat · Telomerase (oligo)
Xenograft mice with ovarian cancer and AML cell lines and paediatric AML patient-derived cells

Spinraza

nusinersen · SMN2 (ASO)
Transgenic SMA mouse models expressing human SMN2 (ICV and IT dosing)

Tegsedi

inotersen · TTR (ASO)
Transgenic mouse expressing human TTR Ile84Ser mutation and cynomolgus monkey (TTR mRNA/protein lowering)

Viltepso

viltolarsen · DMD exon 53 (PMO)
DMD patient fibroblasts differentiated into myotubes: exon 53 skipping (EC50 0.63-2.3 µM) and dystrophin production

Vitravene

fomivirsen · CMV IE2 mRNA (ASO)
In vitro HCMV inhibition in primary human retinal pigment epithelial (RPE) cells

Vyondys 53

golodirsen · DMD exon 53 (PMO)
Rhabdomyosarcoma cells and immortalized and primary myoblasts from DMD patients; no in vivo exon 53 skipping study with golodirsen

Wainua

eplontersen · TTR (ASO)
Human mutant TTR (I84S) transgenic mice: hepatic hTTR mRNA and plasma TTR reduction

Waylivra

volanesorsen · APOC3 (ASO)
Fructose-fed hypertriglyceridemic rhesus monkeys dosed with volanesorsen (binding site 100% homologous)

Zanvastro

zilganersen · GFAP (ASO)
Transgenic mice overexpressing human GFAP (AxD-like features reduced); species surrogate ASO in rat AxD model

Summary across all 28 oligonucleotides →