Significant correlation shown between blood levels and symptom relief; TH104 was well tolerated with no unexpected treatment-emergent adverse events
Phase 2 preliminary data for chronic pruritus in primary biliary cholangitis expected in 2025
BRIDGEWATER, NJ / ACCESSWIRE / November 18, 2024 / Tharimmune, Inc. (Nasdaq:THAR) ("Tharimmune" or the "Company"), a clinical-stage biotechnology company developing a portfolio of therapeutic candidates in inflammation and immunology, presented new TH104 clinical data at the American Association for the Study of Liver Disease (AASLD) The Liver Meeting 2024, underway in San Diego from November 15-19. The Phase 1 trial was a single-dose, single-center, open-label, randomized study of TH104 transmucosal buccal film conducted in two cohorts of patients with chronic liver disease (CLD), with the primary outcome of safety and tolerability.
"This presentation at The Liver Meeting expands the audience for encouraging Phase 1 data with our lead candidate TH104," said Randy Milby, CEO of Tharimmune. "We look forward to initiating a Phase 2 multiple-ascending dose trial in the coming months to evaluate TH104 in chronic pruritus in primary biliary cholangitis (PBC) patients, with topline data expected in 2025. In the meantime, we continue to engage with both U.S. and EU regulatory authorities."
Data presented at The Liver Meeting include adverse events (AEs) as well as an assessment of patients' relief of pruritus symptom scores when correlated to pharmacokinetics (PK) of TH104. Patients with cholestatic liver disease and a known history of persistent generalized pruritus for at least 4 weeks prior to screening were included. After an overnight fast of 10 hours, subjects received a single low dose of TH104. Serial blood samples for PK analysis were taken, and patients were monitored for itch severity scores utilizing the Worst-Itch Numerical Rating Scale (WI-NRS), a relevant clinical outcome assessment for pruritus in chronic liver disease, and for itch intensity over a 24-hour period.
Pruritus is common in most liver diseases and the WI-NRS is a validated numerical rating scale displaying 11 numbers ranging from 0, representing "no itch," to 10, representing "worst imaginable itch," and patients are asked to pick the number corresponding to the intensity of their pruritus. Results from multiple large studies support the usefulness and validity of WI-NRS for evaluating change over time in clinical trials. Pearson's correlation coefficient (r) was used to assess the correlation between TH104 concentration (ng/ml) Area Under the Curve (AUC) and the change in WI-NRS score 48 hours after dosing.
This study screened 19 patients and 12 were enrolled with two types of CLD categorized as Child-Pugh A (cohort A) and Child-Pugh B (cohort B). The Child-Pugh score is a system for assessing the prognosis and necessity of transplant in CLD that provides a forecast of the increasing severity of a patient's liver disease and expected survival rate. The score is determined by scoring clinical measures of liver disease and the possibility of eventual liver failure, with Class A indicating mild liver disease and Class B indicating moderate liver disease with one-to-five-year survival rates of 95% and 75%, respectively. There were no patients enrolled in this study with the most severe Child-Pugh C classification.
The correlation coefficient between TH104 AUC and change in itch, r, was 0.7060, with a p-value of 0.0103 and a 95% confidence interval for r of 0.2220 to 0.9108.
Change in Itch Score vs. Pharmacokinetics of TH104
The mean baseline WI-NRS scores in Groups A and B were 4.33 and 6.17, respectively, translating to moderate-to-severe chronic pruritus at the start of the study. The mean baseline itch score for all 12 subjects was 5.25. At one-hour post-dosing with TH104, Group A and Group B had a mean decline in WI-NRS scores of 26.8% and 19.0%, respectively, and continued to decline two hours post-dose by 42.3% and 21.7%, respectively. Both cohorts continued to improve in mean itch scores at the four-hour and eight-hour time points, including the combined total subjects. At 24-hours post dosing, Group A and Group B achieved a mean decline of 30.7% and 35.2%, respectively, in pruritus scores. The mean reduction in itch scores for all 12 subjects 24 hours after a single dose of TH104 was 33.3%.
WI-NRS score over time
A total of two AEs (headache) were reported in two subjects over the course of the study. These AEs were mild and possibly related to study drug, with no serious adverse events reported. There were no deaths or other significant adverse events reported during the entire study. There were no new adverse events during the study, with events correlated with previous studies and a safety profile consistent with the literature for the active ingredient in TH104.
About TH104
TH104 is embedded with nalmefene onto a proprietary transdermal buccal film that easily adheres to the inside of the mouth. This endows TH104 with key features making it an ideal product candidate for multiple liver-related and other pruritogenic inflammatory conditions. The molecule has a dual mechanism of action affecting both the μ-opioid receptor and the kappa-opioid receptor, as well as potentially inhibiting IL-17 inflammatory cytokine expression. These opioid receptors when stimulated and/or inhibited by the body's natural ligands have been known to be involved in the body's itch circuitry.
About Pruritus and Primary Biliary Cholangitis
According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health, PBC is a chronic disease where the bile ducts in the liver eventually become dysfunctional and cause the buildup of bile, resulting in liver damage. The disease, believed to be an autoimmune condition, affects an estimated 58 out of every 100,000 U.S. women and about 15 out of every 100,000 U.S. men. Pruritus is one of the most common conditions associated with PBC, affecting up to 75% of individuals at some point during their disease course. It has a negative impact on health-related quality of life with limited treatment options.Published survey data of PBC respondents suffering from pruritus described their itch as "bugs crawling under the skin." More than 65% of patients reported that the itch was worse at night, known as nocturnal pruritus, a high unmet need.
About Tharimmune
Tharimmune, Inc. is a clinical-stage biotechnology company developing a diverse portfolio of therapeutic candidates in immunology, inflammation and oncology. Its lead clinical asset, TH104, aims to suppress chronic pruritus associated with primary biliary cholangitis (PBC), a rare autoimmune liver disease with no known cure. The expanded pipeline includes TH023, an oral TNF-alpha inhibitor, offering a new approach to treating autoimmune diseases. Tharimmune is also advancing early-stage multi-specific biologics targeting unique epitopes against multiple solid tumors. The company has a license agreement with OmniAb, Inc. to access their antibody discovery technology for targeting specified disease markers.
Related Images
Change in Itch Score vs. Pharmacokinetics of TH104 WI-NRS score over time |
SOURCE: Tharimmune, Inc.
血液水平与症状缓解之间显示明显的相关性;TH104耐受性良好,未出现意外的治疗相关不良事件
2025年预计公布原发性胆汁性胆汁淤积慢性瘙痒相2初步数据
美国生物技术公司Tharimmune在纳斯达克上市,开发治疗炎症和免疫学的一系列候选药物,于2024年11月18日在新泽西布里奇沃特通过ACCESSWIRE发布了新的TH104临床数据。该公司在圣地亚哥举行的2024年美国肝病研究协会肝病年会上展示了这些数据。第1阶段试验是关于TH104口腔膜贴剂的单剂、单中心、开放标签、随机化研究,针对患有慢性肝病(CLD)的两组患者,以安全性和耐受性为主要结局指标。
"这次在肝病会议上的报告扩大了对我们领先候选药物TH104令人鼓舞的第1阶段数据的听众观众,"Tharimmune的CEO Randy Milby表示。"我们期待在未来几个月启动第2阶段多次升剂试验,评估TH104在原发性胆汁性胆汁淤积慢性瘙痒(PBC)患者中的效果,预计在2025年公布头号数据。与此同时,我们将继续与美国和欧盟监管机构保持联系。"
在肝病会议上呈现的数据包括不良事件(AEs)以及将瘙痒症状评分与TH104的药代动力学(PK)相关联时患者的缓解评估。包括患有胆汁淤积性肝病且在筛查前至少4周有持续性全身性瘙痒症状的患者。经过10小时的隔夜禁食后,受试者接受了一次低剂量TH104。进行药代动力学分析的连续血样采集,并监测患者的痒痒程度评分,利用最痒数值评定量表(WI-NRS),这是慢性肝脏疾病瘙痒的相关临床结局评估,以及在整个24小时内的痒感强度。
瘙痒在大多数肝脏疾病中很常见,WI-NRS是一个经过验证的数值评分量表,显示从0到10的11个数字,0代表"没有痒",10代表"想象中最严重的痒",患者被要求选择与他们瘙痒程度对应的数字。来自多项大型研究的结果支持WI-NRS在临床试验中评估随时间变化的有效性和有效性。使用Pearson相关系数(r)评估了TH104浓度(ng/ml)曲线下面积(AUC)与用药后48小时WI-NRS评分变化之间的相关性。
本研究筛选了19名患者,12名患者被分为两种类型的CLD,分为Child-Pugh A(组A)和Child-Pugh b(组B)。Child-Pugh评分是评估CLD预后和移植必要性的系统,提供了对患者肝脏疾病严重程度逐渐增加和预期生存率的预测。评分是通过评分肝脏疾病的临床措施和可能发生的肝功能衰竭来确定的,A级表示轻度肝脏疾病,b级表示中度肝脏疾病,分别对应95%和75%的一至五年生存率。在本研究中没有患者被纳入最严重的Child-Pugh C分级。
TH104 AUC与瘙痒变化之间的相关系数r为0.7060,p值为0.0103,r的95%置信区间为0.2220至0.9108。
瘙痒评分变化与TH104药代动力学之间的关系
A和B组的平均基线WI-NRS评分分别为4.33和6.17,表示研究开始时中度至重度慢性瘙痒。所有12名受试者的平均基线瘙痒评分为5.25。用TH104后一小时,A组和B组的WI-NRS平均评分分别下降了26.8%和19.0%,用药后两小时持续下降42.3%和21.7%。在四小时和八小时时间点,包括总体受试者在内的两个队列的平均瘙痒评分继续改善。用药后24小时,A组和B组的瘙痒评分平均下降了30.7%和35.2%,所有12名受试者在一次TH104剂量后24小时的平均瘙痒评分减少了33.3%。
WI-NRS得分随时间变化
在研究过程中,共有两例不良事件(头痛)报告,这些不良事件轻度且可能与研究药物有关,未报告严重不良事件。在整个研究过程中报告没有死亡或其他重大不良事件。研究过程中没有新的不良事件,事件与前期研究相关,并且对于TH104药物的活性成分具有与文献一致的安全性描述。
关于TH104
TH104内嵌纳美非林,附着在专有的经皮颊膜贴片上,易于附着于口腔内侧。这使TH104具备关键特征,使其成为多种与肝脏相关及其他致瘙痒性炎症条件的理想候选产品。该分子具有影响μ-阿片受体和κ-阿片受体的双重作用机制,还可能抑制IL-17炎症细胞因子的表达。这些阿片受体在被体内天然配体刺激和/或抑制时,被认为参与了身体的瘙痒信号传导。
关于瘙痒症和原发性胆管炎
根据美国国立卫生研究院的国家糖尿病消化肾脏疾病研究所(NIDDK)的数据,PBC是一种慢性疾病,肝内的胆管最终功能失常,导致胆汁积聚,进而损害肝脏。这种被认为是一种自身免疫性疾病的疾病,约每10万美国女性中有58人患病,每10万美国男性中约有15人患病。瘙痒症是与PBC相关的最常见症状之一,影响高达75%的患者在疾病过程中的某个时段。它对健康相关生活质量产生负面影响,治疗选择有限。对患有瘙痒症的PBC受访者进行的调查数据显示,他们描述瘙痒感为“昆虫在皮肤下爬行”。多达65%以上的患者报告称夜间瘙痒更加严重,即所谓的夜间瘙痒,这是一个未被满足的高需求。
关于Tharimmune
Tharimmune, Inc.是一家临床阶段的生物技术公司,致力于开发免疫学、炎症和肿瘤学领域的治疗候选药物组合。其主要临床资产TH104旨在抑制与原发性胆汁性肝炎(PBC)相关的慢性瘙痒,这是一种罕见的自身免疫性肝病,目前没有已知治愈方法。扩展的产品线包括TH023,一种口服TNF-α抑制剂,提供了治疗自身免疫疾病的新方法。Tharimmune还在推进早期多特异性生物制品的开发,针对多种实体肿瘤的独特抗原表位。该公司与OmniAb, Inc.签订了许可协议,以获取其抗体发现技术,用于针对特定疾病标记物。
相关图像
瘙痒评分变化与TH104的药代动力学 WI-NRS评分随时间变化 |
来源:Tharimmune, Inc.