REGENXBIO Announces Positive Topline Results from Pivotal Phase III AFFINITY DUCHENNE® Study of RGX-202
- Achieved primary endpoint with high statistical significance; 93% of patients achieved microdystrophin expression above 10% (p<0.0001)
- Statistically significant correlation between RGX-202 microdystrophin expression and functional improvement (NSAA n=9), supporting validity of surrogate endpoint
- Well-tolerated, differentiated safety profile
- Company preparing for potential accelerated approval in 2027
- Webcast to be held at
8:00 a.m. ET today
"These topline results are exciting for the Duchenne community," said
"Duchenne muscular dystrophy is a rare, progressive neuromuscular disease characterized by worsening muscle weakness and loss of function, and there continues to be a critical unmet need for therapies that can reliably alter the course of the disease", said AFFINITY DUCHENNE principal investigator Aravindhan Veerapandiyan, M.D.,
"RGX-202 is the first gene therapy in development for Duchenne to demonstrate strong, statistically significant correlation between microdystrophin expression and functional improvement, a landmark distinction in the field," said
AFFINITY DUCHENNE Topline Pivotal Interim Data
As of
The pivotal portion of the Phase I/II/III AFFINITY DUCHENNE trial evaluated RGX-202 at 2x1014 GC/kg in 31 ambulatory boys aged 1 year of age and older. Key topline interim results include safety (n=31), biomarker (n=30), and functional data (n=9 aged >4 years, 12 months post-treatment).1
More than 20 additional participants have been enrolled in the confirmatory trial of RGX-202 (n=30), and the Company expects to have completed dosing in all 60 patients across the pivotal and confirmatory trials by mid-year.
Primary Endpoint and Biomarker Data
93% of participants achieved >10% RGX-202 microdystrophin expression at Week 12 (p<0.0001). Microdystrophin expression averaged 71.1% across all participants, and 41.6% in older boys, aged >8 years. Additionally, 80% of participants achieved >40% microdystrophin expression.
RGX-202 was appropriately localized to the sarcolemma, demonstrating that the differentiated construct with the inclusion of the C-Terminal (CT) domain is appropriately targeting the muscle. Additionally, robust vector copies per nucleus and percent positive fibers observed support the potential for sustained microdystrophin expression.
Interim Safety and Tolerability Data
RGX-202 was well tolerated and demonstrated a favorable safety profile as of last data cut. A proactive, short-course immune suppression regimen in combination with a differentiated construct and industry-leading product purity levels of more than 80% full capsids may contribute to a favorable safety profile for RGX-202. Mean gamma-glutamyl transferase (GGT) and total bilirubin, recognized markers of liver inflammation in Duchenne, did not exceed the upper limit of normal up to one year post-treatment (n=9).
Two serious adverse events were reported; both were easily managed and resolved within weeks without sequelae. One case of subacute myocarditis was reported in an 8-year-old participant. The participant's most recent cardiac MRI confirmed no heart muscle fibrosis and no change in ejection fraction. One case of asymptomatic liver injury was reported in a 10-year-old participant. This patient's GGT peak elevation was 123 U/L, and his abdominal ultrasound and bilirubin levels were normal. Common drug-related adverse events included vomiting, fatigue, and nausea, all considered mild or moderate, and resolved without sequelae.
Interim One Year Functional Data
In interim functional results from nine participants aged approximately 5 to 12 years at dosing, RGX-202 demonstrated functional improvement and evidence of positively impacting disease trajectory at one year post-treatment, as measured by North Star Ambulatory Assessment (NSAA) and timed function tests (Time to Stand, 10 Meter Walk-run, Time to Climb).
Participants demonstrated statistically significant improved performance across NSAA and all timed function tests when compared to external control using propensity score weighting, which is the primary analysis method specified in the SAP for the pivotal trial. [Figure 1]
RGX-202 microdystrophin expression at Week 12 demonstrated a statistically significant correlation with functional improvement at one year as measured by NSAA change from baseline (correlation= .094, p = 0.0002) and NSAA change from baseline compared to the cTAP predictive model (correlation= .092, p = 0.0005). [Figure 2]
Primary Endpoint and Interim Data Support Potential Accelerated Approval
In recent discussions with FDA, the agency shared that the use of RGX-202 microdystrophin expression as a surrogate endpoint will be based on the correlation analysis with clinical outcomes, which has been clearly demonstrated in the interim data. While the FDA has recommended a randomized controlled trial, it has guided that externally controlled trials may be adequate for demonstrating substantial evidence of effectiveness, especially when the treatment effect is sufficiently large enough to overcome limitations of externally controlled trials. FDA offered to review the RGX-202 data and alternative proposals.
Given the positive topline pivotal data, continued favorable safety profile, and statistically significant correlation between microdystrophin and functional improvement,
Webcast Details
The live webcast can be accessed HERE and in the Investors section of
About RGX-202 RGX-202 is designed to address the underlying cause of Duchenne by enabling targeted expression of a novel microdystrophin that is closest to naturally occurring dystrophin. It is the only microdystrophin that includes the C-Terminal domain, which has been shown to protect and preserve muscle function. The differentiated therapeutic approach behind RGX-202 includes a novel construct, a proactive immune suppression regimen, and a suspension-based manufacturing process that delivers industry-leading product purity levels. RGX-202 is designed for improved muscle function, durability and safety outcomes for patients.
About Duchenne Muscular Dystrophy
Duchenne is a severe, progressive, degenerative muscle disease, affecting 1 in 3,500 to 5,000 boys born each year worldwide. Duchenne is caused by mutations in the Duchenne gene which encodes for dystrophin, a protein involved in muscle cell structure and signaling pathways. Without dystrophin, muscles throughout the body degenerate and become weak, eventually leading to loss of movement and independence, required support for breathing, cardiomyopathy and premature death.
About
FORWARD-LOOKING STATEMENTS
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Contacts:
Dana Cormack
Corporate Communications
dcormack@regenxbio.com
Investors:
George E. MacDougall
Investor Relations
IR@regenxbio.com
1 30 of 31 total participants have Week 12 biopsy available for evaluation; one participant refused muscle biopsy.
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