– Treatment with the highly selective NaV1.8 pain signal inhibitor suzetrigine met the primary endpoint with a statistically significant and clinically meaningful 2.02 point within-group reduction from baseline in the Numeric Pain Rating Scale (NPRS) –
– Placebo arm showed similar within-group reduction in NPRS –
– Suzetrigine was generally well tolerated –
– Advancement to Phase 3 in painful lumbosacral radiculopathy planned, pending discussions with regulators –
– Vertex to host investor call on December 19 at 8:00 a.m. ET –
BOSTON--(BUSINESS WIRE)--Vertex Pharmaceuticals Incorporated (Nasdaq: VRTX) today announced results from its Phase 2 study of suzetrigine, an investigational, oral, highly selective NaV1.8 pain signal inhibitor in people with painful lumbosacral radiculopathy (LSR). The study met its primary endpoint with statistically significant and clinically meaningful reduction in pain on the numeric pain rating scale (NPRS).
Efficacy Results
The study's primary endpoint was a within-group change from baseline in the weekly average of daily leg pain intensity on the NPRS at Week 12. This 11-point scale ranges from 0 (no pain) to 10 (worst pain imaginable).
The suzetrigine arm showed a statistically significant and clinically meaningful within-group reduction from baseline in pain with a mean change in NPRS at Week 12 of -2.02.
The study also included a placebo reference arm which showed a similar within-group reduction from baseline in pain with a mean change in NPRS at Week 12 of -1.98. The study was not designed nor powered for statistical comparison between suzetrigine and placebo.
| Suzetrigine N = 102 | Placebo N = 100 |
Baseline NPRS | | |
Mean NPRS (SD) | 6.33 (1.22) | 6.05 (1.07) |
Change in NPRS from baseline at Week 12 | | |
LS mean | -2.02 | -1.98 |
95% CI | (-2.40, -1.64) | (-2.36, -1.60) |
P value | <0.0001 | <0.0001 |
Secondary and other endpoints were consistent with the study's primary endpoint.
Vertex also conducted post-hoc analyses to further evaluate the efficacy results. These showed that there was variability in the placebo response across study sites, a recognized issue in pain trials. In the ~40% of sites that had lower placebo responses, the suzetrigine arm within-group reduction in pain was similar to the overall study and had greater separation from the placebo arm. These analyses suggest that trial design innovation may better control the placebo response and separate the treatment effect of suzetrigine from placebo in future studies, which Vertex will incorporate as it designs the pivotal program.
Safety Results
Suzetrigine was generally well tolerated in the study. The incidence of adverse events (AEs) was 22.9% in the suzetrigine arm and 32.4% in the placebo arm. In both treatment arms, most AEs were mild to moderate. There were no serious adverse events (SAEs) related or possibly related to suzetrigine. There were no AEs leading to treatment discontinuation in patients treated with suzetrigine.
| Suzetrigine N = 109 n (%) | Placebo N = 108 n (%) |
Subjects with any AEs | 25 (22.9) | 35 (32.4) |
Subjects with AEs by strongest relationship |
Not related | 16 (14.7) | 20 (18.5) |
Unlikely related | 1 (0.9) | 6 (5.6) |
Possibly related | 6 (5.5) | 8 (7.4) |
Related | 2 (1.8) | 1 (0.9) |
Subjects with AEs by maximum severity |
Grade 1/Mild | 15 (13.8) | 17 (15.7) |
Grade 2/Moderate | 10 (9.2) | 17 (15.7) |
Grade 3/Severe | 0 | 1 (0.9) |
Grade 4/Life-threatening | 0 | 0 |
Grade 5/Death | 0 | 0 |
Subjects with serious AEs | 1 (0.9) | 2 (1.9) |
Subjects with AEs leading to treatment discontinuation | 0 | 1 (0.9) |
Subjects with AEs leading to death | 0 | 0 |
"Suzetrigine has again demonstrated its potential to fill an important unmet need in the treatment of pain. Today's LSR results are consistent with previous studies of this pain signal inhibitor in terms of showing a meaningful treatment effect across pain conditions and a favorable safety profile," said Carmen Bozic, M.D., Executive Vice President, Global Medicines Development and Medical Affairs, and Chief Medical Officer at Vertex. "We did not see separation between the suzetrigine and the placebo arms. Yet our post-hoc analyses suggest that this could be due to the high placebo response in this study. We remain committed to studying LSR and innovating our Phase 3 study design to control for the placebo effect as we advance suzetrigine into pivotal development for this condition."
"The suzetrigine Phase 2 results clearly show reduced pain intensity from baseline in the active drug arm, and the potential for suzetrigine to fill an unmet need in relieving LSR pain, a heterogeneous condition that is notoriously difficult to treat," said Christine Sang, M.D., M.P.H., FASA, Director, Translational Pain Research, Brigham and Women's Hospital, Associate Professor of Anesthesia, Harvard Medical School, co-chair of Vertex's Peripheral Neuropathic Pain steering committee, and lead principal investigator on the study. "Managing the placebo response in pain trials is a complex challenge. We look forward to innovating in clinical trial design, including for the pivotal study, with the aim of bringing a potentially safe and effective treatment to patients suffering from LSR."
Next Steps for the Pain Portfolio
Neuropathic Pain
Vertex plans to advance suzetrigine into pivotal development for painful LSR following discussions with regulators on the study design and regulatory package. The company will apply learnings from analysis of the full Phase 2 data set and post-hoc analyses to inform the Phase 3 study design.
Earlier this year, Vertex initiated its suzetrigine pivotal program in painful diabetic peripheral neuropathy (DPN), another type of peripheral neuropathic pain (PNP). That study is ongoing.
Acute Pain
Additionally, as previously announced, suzetrigine is under FDA review for the treatment of moderate-to-severe acute pain. The agency granted priority review and assigned a Prescription Drug User Fee Act (PDUFA) target action date of January 30, 2025.
In line with its portfolio strategy, Vertex continues to advance preclinical and clinical development of additional NaV1.8 and NaV1.7 inhibitors, for use alone or in combination, in acute and neuropathic pain.
Conference Call and Webcast
The company will host a conference call and webcast at 8:00 a.m. ET on Thursday, December 19, 2024. To access the call, please dial (833) 630-2124 (U.S.) or +1 (412) 317-0651 (International) and reference the "Vertex Pharmaceuticals Conference Call."
The conference call will be webcast live and a link to the webcast can be accessed through Vertex's website at in the "Investors" section. To ensure a timely connection, it is recommended that participants register at least 15 minutes prior to the scheduled webcast. An archived webcast will be available on the company's website.
About the Phase 2 Suzetrigine Lumbosacral Radiculopathy (LSR) Study
This phase 2, 12-week, randomized, double-blind, placebo-controlled study evaluated the efficacy and safety of suzetrigine in treating patients with painful LSR. A total of 218 patients were enrolled in the study and randomized 1:1 with suzetrigine or placebo. The primary endpoint was the within-group change from baseline in the weekly average of daily leg pain intensity on a numeric pain rating scale (NPRS) at Week 12. The study also included a placebo reference arm; however, the study was not designed nor powered for comparison between suzetrigine and placebo.
Secondary endpoints assessed the within-group change from baseline in the weekly average of the daily sleep interference scale at Week 12 and safety and tolerability. By blocking the pain signal from the peripheral sensory neurons, Vertex believes that suzetrigine may alleviate the suffering for millions of patients with painful LSR.
About Painful Lumbosacral Radiculopathy (LSR)
Painful lumbosacral radiculopathy, or LSR, is one of the most common causes of peripheral neuropathic pain. It is pain caused by impairment of nerve roots in the area of the lumbar spine. It often results in radiating pain along the distribution of the impacted nerve in the body, and patients can experience back and leg pain, sensory issues or motor dysfunction. Common causes of LSR include nerve compression from a herniated disk, or arthritic or degenerative changes in the area of the lower spine. LSR is a neuropathic pain condition because the impacted nerve roots are part of the peripheral nervous system and not part of the spinal cord. Millions of patients suffer from pain due to LSR every year.
About Suzetrigine
Suzetrigine is an investigational oral, highly selective pain signal inhibitor that is selective for NaV1.8 relative to other NaV channels. NaV1.8 is a voltage-gated sodium channel that is selectively expressed in peripheral pain-sensing neurons (nociceptors), where its role is to transmit pain signals (action potentials). Vertex's approach is to selectively inhibit NaV1.8 using small molecules with the objective of creating a new class of pain signal inhibitors that have the potential to provide effective relief of pain without the limitations of currently available therapies, including the addictive potential of opioids. Suzetrigine has demonstrated a favorable benefit/risk profile in multiple Phase 2 and Phase 3 studies in patients with moderate-to-severe acute pain and has been granted FDA Fast Track and Breakthrough Therapy designations in moderate-to-severe acute pain in the U.S. It is currently under priority review by the FDA for the treatment of moderate-to-severe acute pain with a Prescription Drug User Fee Act (PDUFA) target action date of January 30, 2025. The Phase 3 pivotal program for suzetrigine in patients with painful diabetic peripheral neuropathy is ongoing, and the company plans to advance its pivotal program evaluating suzetrigine in patients with painful lumbosacral radiculopathy pending discussions with regulators. Suzetrigine is investigational and has not been approved by any health authority.
About Vertex
Vertex is a global biotechnology company that invests in scientific innovation to create transformative medicines for people with serious diseases. The company has approved medicines that treat the underlying causes of multiple chronic, life-shortening genetic diseases — cystic fibrosis, sickle cell disease and transfusion-dependent beta thalassemia — and continues to advance clinical and research programs in these diseases. Vertex also has a robust clinical pipeline of investigational therapies across a range of modalities in other serious diseases where it has deep insight into causal human biology, including acute and neuropathic pain, APOL1-mediated kidney disease, IgA nephropathy, primary membranous nephropathy, autosomal dominant polycystic kidney disease, type 1 diabetes and myotonic dystrophy type 1.
Vertex was founded in 1989 and has its global headquarters in Boston, with international headquarters in London. Additionally, the company has research and development sites and commercial offices in North America, Europe, Australia, Latin America and the Middle East. Vertex is consistently recognized as one of the industry's top places to work, including 15 consecutive years on Science magazine's Top Employers list and one of Fortune's 100 Best Companies to Work For.
– 使用高度选择性的NaV1.8疼痛信号抑制剂suzetrigine的治疗达到了主要终点,在数字疼痛评分表(NPRS)中与基线相比,组内减少了2.02分,具有统计学意义和临床意义 –
– 安慰剂组在NPRS中显示出相似的组内减少 –
– Suzetrigine通常耐受良好 –
– 计划推进到第三阶段,针对疼痛性腰骶神经根病的讨论,待与监管机构讨论后进行 –
– Vertex将在12月19日上午8:00举办投资者电话会议 –
波士顿–(商业新闻)–福泰制药公司(纳斯达克:VRTX)今日宣布了其针对susetrigine的第二阶段研究结果,susetrigine是一种针对疼痛性腰骶神经根病(LSR)的临床研究口服高度选择性的NaV1.8疼痛信号抑制剂。该研究达到了主要终点,在数字疼痛评分表(NPRS)中表现出统计学显著性与临床意义的疼痛减少。
疗效结果
本研究的主要终点是在第12周时,基线以上的每日腿部疼痛强度的周平均变化,采用NPRS来评估。该评分表的评分范围为0(无疼痛)到10(想象中的最严重疼痛)。
suzetrigine组在统计学上显著并且临床意义上实现了从基线到第12周的疼痛组内减少,NPRS的平均变化为-2.02。
该研究还包含一个安慰剂对照组,该组在疼痛上也显示了一定的组内减少,NPRS的平均变化在第12周为-1.98。该研究并未设计或具有统计比较suzetrigine和安慰剂的能力。
| Suzetrigine N = 102 | 安慰剂 N = 100 |
基线NPRS | | |
平均NPRS (SD) | 6.33 (1.22) | 6.05 (1.07) |
第12周与基线的NPRS变化 | | |
LS意味着 | -2.02 | -1.98 |
95%置信区间 | (-2.40, -1.64) | (-2.36, -1.60) |
P值 | <0.0001 | <0.0001 |
次要和其他指标与研究的主要指标一致。
福泰制药还进行了事后分析,以进一步评估疗效结果。这些结果显示,在研究地点中,安慰剂反应存在变异,这是疼痛试验中一个被认可的问题。在约40%的安慰剂反应较低的地点,suzetrigine组内部减轻疼痛的幅度与整体研究相似,并且与安慰剂组的分离效果更大。这些分析表明,试验设计创新可能更好地控制安慰剂反应,并在未来的研究中将suzetrigine的治疗效果与安慰剂分开,福泰制药在设计关键项目时将纳入此项。
安全结果
在研究中,suzetrigine的耐受性通常良好。在suzetrigine组不良事件(AEs)发生率为22.9%,而安慰剂组为32.4%。在两个治疗组中,大多数不良事件为轻度到中度。没有与suzetrigine相关或可能相关的严重不良事件(SAEs)。在接受suzetrigine治疗的患者中,没有导致治疗中断的不良事件。
| Suzetrigine N = 109 n (%) | 安慰剂 N = 108 n (%) |
有任何不良事件的受试者 | 25 (22.9) | 35 (32.4) |
按最强关系划分的有不良事件的受试者 |
无关 | 16 (14.7) | 20 (18.5) |
不太相关 | 1 (0.9) | 6 (5.6) |
可能相关 | 6 (5.5) | 8 (7.4) |
相关 | 2 (1.8) | 1 (0.9) |
按最大严重程度分组的受试者不良事件 |
等级1/轻度 | 15 (13.8) | 17 (15.7) |
二级/中度 | 10 (9.2) | 17 (15.7) |
三级/严重 | 0 | 1 (0.9) |
4级/危及生命 | 0 | 0 |
5级/死亡 | 0 | 0 |
有严重不良事件的受试者 | 1 (0.9) | 2 (1.9) |
因不良事件导致停止治疗的受试者 | 0 | 1 (0.9) |
因不良事件导致死亡的受试者 | 0 | 0 |
“苏泽曲汀再次展示了其在疼痛治疗中填补一个重要未被满足的需求的潜力。今天的LSR结果与之前关于此疼痛信号抑制剂的研究一致,显示出在各种疼痛状况下具有显著的治疗效果和良好的安全性,”福泰制药全球药物开发和医疗事务执行副总裁兼首席医疗官克莉丝汀·万·博齐克说。“我们没有看到苏泽曲汀和安慰剂组之间的分离。然而,我们的事后分析表明,这可能是由于本研究中高水平的安慰剂反应。我们依然致力于研究LSR,并创新我们的三期研究设计,以控制安慰剂效应,同时推进苏泽曲汀的关键开发。”
“苏泽曲丁第二阶段的结果清楚地显示了在主动药物组中,从基线开始疼痛强度有所降低,并且苏泽曲丁有可能满足缓解LSR疼痛的未满足需求,这是一种难以治疗的异质性疾病,”克莉丝汀·桑万·D·万·P.H.,FASA,布莱根和妇女医院转化疼痛研究主任,哈佛医学院麻醉学副教授,Vertex外周神经病理性疼痛指导委员会共同主席及该研究的首席主要研究员表示。“在疼痛试验中管理安慰剂反应是一项复杂的挑战。我们期待创新临床试验设计,包括为关键研究,以期为遭受LSR困扰的患者带来一种可能安全有效的治疗。”
疼痛组合的下一步
神经性疼痛
Vertex计划在与监管机构讨论研究设计和监管方案后,推动苏泽曲丁进入有痛LSR的关键开发。该公司将利用对完整第二阶段数据集和事后分析的分析结果,来指导第三阶段的研究设计。
今年早些时候,Vertex启动了其针对有痛糖尿病周围神经病(DPN)苏泽曲丁的关键项目,这是另一种类型的周围神经病理性疼痛(PNP)。该研究正在进行中。
急性疼痛
此外,正如之前所宣布的,苏泽曲丁正在接受FDA对中度至重度急性疼痛的治疗审查。该机构已授予优先审查,并分配了2025年1月30日的处方药用户收费法案(PDUFA)目标行动日期。
在其组合策略的一致性下,Vertex继续推进额外NaV1.8和NaV1.7抑制剂的临床前及临床开发,以单独或组合的方式在急性和神经性疼痛中使用。
电话会议和网络直播
公司将在2024年12月19日(星期四)美国东部时间上午8:00举行电话会议和网络广播。要拨打电话,请拨打(833)630-2124(美国)或+1(412)317-0651(国际),并引用 "福泰制药电话会议"。
此次电话会议将进行现场直播,参与者可以通过福泰制药的网站在 "投资者 "部分访问网络广播链接。为了确保及时连接,建议参与者在预定网络广播的前至少15分钟注册。会议录音将在公司网站上提供。
关于第二阶段Suzetrigine腰骶神经根病(LSR)研究
这项为期12周的第二阶段随机双盲安慰剂对照研究评估了suzetrigine在治疗有疼痛的LSR患者中的有效性和安全性。共有218名患者参加了该研究,并以1:1的比例随机分配到suzetrigine或安慰剂组。主要终点是第12周基线到治疗组内每天腿部疼痛强度的周平均值在数字疼痛评分标准(NPRS)上的变化。该研究还包括一个安慰剂参考组;然而,该研究并未设计或有能力比较suzetrigine与安慰剂之间的差异。
次要终点评估了第12周基线到治疗组内每天睡眠干扰量表周平均值的变化以及安全性和耐受性。福泰制药相信,通过阻断外周感觉神经元的疼痛信号,suzetrigine可能为数百万患有疼痛LSR的患者减轻痛苦。
关于疼痛性腰骶神经根病(LSR)
疼痛性腰骶神经根病(LSR)是外周神经病疼痛最常见的原因之一。这是一种由于腰椎区域神经根受损而导致的疼痛。它通常导致沿着受影响神经在体内的分布放射性疼痛,患者可能会经历背部和腿部疼痛、感觉问题或运动功能障碍。LSR的常见原因包括椎间盘突出引起的神经压迫,或下脊柱区域的关节炎或退行性变化。LSR是一种神经病性疼痛病症,因为受影响的神经根是外周神经系统的一部分,而不属于脊髓。每年有数百万患者因LSR而遭受疼痛。
About Suzetrigine
Suzetrigine is an investigational oral, highly selective pain signal inhibitor that is selective for NaV1.8 relative to other NaV channels. NaV1.8 is a voltage-gated sodium channel that is selectively expressed in peripheral pain-sensing neurons (nociceptors), where its role is to transmit pain signals (action potentials). Vertex's approach is to selectively inhibit NaV1.8 using small molecules with the objective of creating a new class of pain signal inhibitors that have the potential to provide effective relief of pain without the limitations of currently available therapies, including the addictive potential of opioids. Suzetrigine has demonstrated a favorable benefit/risk profile in multiple Phase 2 and Phase 3 studies in patients with moderate-to-severe acute pain and has been granted FDA Fast Track and Breakthrough Therapy designations in moderate-to-severe acute pain in the U.S. It is currently under priority review by the FDA for the treatment of moderate-to-severe acute pain with a Prescription Drug User Fee Act (PDUFA) target action date of January 30, 2025. The Phase 3 pivotal program for suzetrigine in patients with painful diabetic peripheral neuropathy is ongoing, and the company plans to advance its pivotal program evaluating suzetrigine in patients with painful lumbosacral radiculopathy pending discussions with regulators. Suzetrigine is investigational and has not been approved by any health authority.
Vertex是一家全球性的生物技术公司,致力于通过科学创新为患有严重疾病的人创造变革性药物。该公司已经获批准的药物治疗多种慢性、缩短寿命的遗传病的基本原因,包括囊性纤维化、镰状细胞病和输血依赖性β地中海贫血,并在这些疾病中不断推进临床和研究计划。Vertex在其他严重疾病领域也有一系列调查治疗法的丰富临床流水线,包括急性和神经性疼痛、APOL1介导的肾脏疾病、常染色体显性多囊肾病、1型糖尿病、肌强直性营养不良型1和α-1抗胰蛋白酶缺乏症。
Vertex is a global biotechnology company that invests in scientific innovation to create transformative medicines for people with serious diseases. The company has approved medicines that treat the underlying causes of multiple chronic, life-shortening genetic diseases — cystic fibrosis, sickle cell disease and transfusion-dependent beta thalassemia — and continues to advance clinical and research programs in these diseases. Vertex also has a robust clinical pipeline of investigational therapies across a range of modalities in other serious diseases where it has deep insight into causal human biology, including acute and neuropathic pain, APOL1-mediated kidney disease, IgA nephropathy, primary membranous nephropathy, autosomal dominant polycystic kidney disease, type 1 diabetes and myotonic dystrophy type 1.
福泰制药成立于1989年,全球总部位于波士顿,国际总部位于伦敦。此外,公司在北美、欧洲、澳洲、拉丁美洲和中东设有研发中心和商务办公室。福泰制药始终被认可为行业板块中最佳工作场所之一,包括在《科学》杂志的Top Employers名单上连续15年,以及被《财富》评选为100家最佳工作公司之一。