NEW YORK, July 19, 2017 /PRNewswire/ -- Neurotrope, Inc. (NASDAQ: NTRP) today presented clinical results from its recently completed Phase 2 trial demonstrating that moderate-to-severe Alzheimer’s disease (AD) patients treated with 20 µg bryostatin-1 showed preliminary evidence of sustained improvement in cognition compared to placebo. The data and comprehensive statistical analysis were presented in the Developing Topics: Clinical Trials oral session, “Effect of Bryostatin-1 on Cognition and Daily Living Tasks in Moderate to Severe Alzheimer’s disease Preliminary Report of a Phase 2 Study” at the Alzheimer’s Association International Conference 2017 in London.
“In this exploratory study evaluating a novel mechanism of action, we see an encouraging therapeutic signal in late stage AD patients with the 20 µg group, which was maintained across time points with relatively minimal toxicity and good tolerability,” said Martin R. Farlow, MD, Vice Chairman for Research in the Department of Neurology, Indiana University School of Medicine, Indiana Alzheimer Disease Center, who presented the data. “This study has shown a real and sustained increase in SIB over and above standard of care in a difficult to treat population. It is important now to determine if these effects can be maintained and enhanced over a longer period of time.”
The 13-week, randomized, double-blind, placebo-controlled study evaluated the safety, tolerability and efficacy of bryostatin-1 in 147 moderate-to-severe AD patients across three treatment arms (20 µg, 40 µg, placebo). This is the first placebo-controlled, AD trial of a protein kinase C epsilon (PKC) activator, which in preclinical studies induced the growth of new synapses and prevented neuronal death. This represents a new therapeutic strategy for AD that directly addresses the emerging consensus that synaptic loss has a major impact on cognitive deficits of AD.
The improvements in the primary cognitive endpoint, the Severe Impairment Battery (SIB), were observed in the study’s 20 µg treatment arm as early as week five, and were maintained throughout the 13-week study (Table1). The scores for the secondary functional endpoint, the ADCS-ADL-SIV (Alzheimer’s Disease Cooperative Study Activities of Daily Living Inventory Severe Impairment Version) for the 20 µg treatment arm showed improvement at week 13. Unlike the 20 µg dose, there was no therapeutic signal observed with the 40 µg dose. This contrast between the signal observed with the 20 µg dose versus the 40 µg dose was reinforced by the results of a Cohen’s D analysis, part of an in-depth statistical evaluation of the study data that found a consistent signal of benefit in SIB and ADCS-ADL-SIV for the 20 µg dose at the end of the trial.
“Although the study was not powered for statistical significance at a = 0.05, the clinical effects in the 20 µg group compared to placebo were consistent in magnitude for cognition and function, and hold up under multiple sensitivity analyses,” said Suzanne Hendrix, PhD of Pentara Corporation, a leading expert in statistical analysis of AD clinical trial results. “Standardized effect sizes were small for the sensitivity analyses for the 20 µg group. Using a standardized effect size such as Cohen’s D allows comparison of effects between different scales in a way that is independent of the sample size.”
Patients dosed with 20 µg had a dropout rate similar to placebo, while patients dosed at 40 µg experienced poorer safety and tolerability, and had a higher dropout rate. Treatment emergent adverse events (TEAEs) were mostly mild or moderate in severity. TEAEs, including serious adverse events, were more common in the 40 µg group, as compared to the 20 µg and placebo groups. These data reinforce the safety and tolerability of the 20 µg dose.
The lack of signal at the higher 40 µg dose is not entirely unexpected based on the in vitro dose response features of bryostatin-induced PKC activation. As seen with the 40 µg dose, the obligatory downregulation phase appears to override the initial activation phase, thereby mitigating the desired clinical effect.
“The persistent improvement seen in the 20 µg group versus the outcomes seen in the 40 µg treatment arm help define an optimal dosing range to potentially sustain clinical benefit with minimal side effects,” remarked Daniel Alkon, MD, President and Chief Scientific Officer at Neurotrope. “These findings are consistent with preclinical research on bryostatin-1 and affirm the viability of its mechanism of action. We are well positioned to move forward with our clinical development program.”
Table 1: SIB Results, MMRM Change from Baseline versus Placebo
SIB Change Score Difference Compared with Placebo | |||
Week 5 | Week 9 | Week 13 | |
20 µg mITT | 3.0 p=0.056 | 1.0 NS | 1.9 NS |
20 µg completer | 4.0 p=0.016 | 1.9 NS | 2.6 p=0.07 |
40 µg mITT | 0.6 NS | -0.6 NS | 0.8 NS |
40 µg completer | 2.1 NS | 0.1 NS | 1.5 NS |
NS = not statistically significant; pre-specified (per statistical analysis plan) p <0.1, 1-tailed
The prospective analysis defined two primary patient populations: the modified intent-to-treat (mITT) population (135 subjects received study drug and had at least one efficacy/safety evaluation), and the completer population (the 113 subjects in mITT that completed the 13-week assessment).
The full presentation from the oral session is available at: http://www.neurotropebioscience.com/Welcome_to_Neurotrope_BioScience/HomePage-Forms/AAICF.pdf
About Bryostatin
Bryostatin-1 is a protein kinase C epsilon (PKC) activator that works through synaptic growth factors, as well as anti-amyloid and anti-tangle signaling pathways in the brain. It has been shown in preclinical efficacy studies to induce the growth of mature synapses in the brain and prevent neuronal death. Thus, Bryostatin-1 introduces a fundamentally different biological mechanism of action with the potential for longer lasting effects than the other currently available therapies. Bryostatin-1 is the first PKC modulator to be tested in a phase 2 clinical study for patients suffering from moderate to severe AD a difficult to treat population.
The rationale for researching this novel mechanism in AD results from in vitro and in vivo models of AD demonstrating that modulation of PKC by Bryostatin-1 enhances synaptogenesis and prevents neuronal death. As synaptic loss is tightly correlated with cognitive impairment in AD, this attribute of the molecule made bryostatin an intriguing candidate for additional investigation in dementia. Furthermore, preclinical studies also demonstrated bryostatin reduces toxic Aß levels, prevents plaque formation, inhibits tau phosphorylation, and enhances cognition. Thus, the multimodal effects of this first PKC modulator offer a potential new mechanism to study in AD with the ultimate goal to slow or prevent the progression of disease.
The maximum dose chosen for this study, if normalized to a standard body surface area (BSA) of 1.73 m2, is similar to the 25 µg/m2 dose studied in oncology patients and shown to be relatively safe.
About Neurotrope
Neurotrope is at the forefront of developing a new approach to combatting AD and other neurodegenerative diseases. The Company’s world-class science offers the potential to realize a paradigm shift to overcome one of today’s most challenging clinical problems finding a way to slow or even prevent the progression of AD.
In addition to the Company’s Phase 2 trial of bryostatin-1 in moderate to severe AD, Neurotrope has also conducted preclinical studies of bryostatin as a potential treatment for Fragile X Syndrome, Niemann-Pick Type C disease and Rett Syndromethree rare genetic diseases for which only symptomatic treatments are currently available. The FDA has granted Orphan Drug Designation to Neurotrope for Bryostatin-1 as a treatment for Fragile X Syndrome. Bryostatin-1 has already undergone testing in more than 1,500 people in cancer studies, thus creating a large safety data base that will further inform clinical trial designs in AD.
Forward-Looking Statements
Any statements contained in this press release that do not describe historical facts may constitute forward-looking statements. These forward-looking statements include statements regarding the Phase 2 study and further studies, and continued development of use of Bryostatin-1 for Alzheimer’s dementia and other cognitive diseases. Such forward-looking statements are subject to risks and uncertainties and other influences, many of which the Company has no control over. These statements are subject to the risk that further analyses of the Phase 2 data may lead to different interpretations of the data than the analyses conducted to date and/or may identify important implications of the Phase 2 data that are not reflected in these statements. Clinical trial data are subject to differing interpretations, and regulatory agencies, medical and scientific experts and others may not share the Company’s views of the Phase 2 data. There can be no assurance that the clinical program for Bryostatin-1 will be successful in demonstrating safety and/or efficacy that we will not encounter problems or delays in clinical development, or that Bryostatin-1 will ever receive regulatory approval or be successfully commercialized. Actual results and the timing of certain events and circumstances may differ materially from those described by the forward-looking statements as a result of these risks and uncertainties. Additional factors that may influence or cause actual results to differ materially from expected or desired results may include, without limitation, the Company’s inability to obtain adequate financing, the significant length of time associated with drug development and related insufficient cash flows and resulting illiquidity, the Company’s patent portfolio, the Company’s inability to expand the Company’s business, significant government regulation of pharmaceuticals and the healthcare industry, lack of product diversification, availability of the Company’s raw materials, existing or increased competition, stock volatility and illiquidity, and the Company’s failure to implement the Company’s business plans or strategies. These and other factors are identified and described in more detail in the Company’s filings with the SEC, including the Company’s Annual Report on Form 10-K for the year ended December 31, 2016 and on Form 10-Q for the quarter ending March 31, 2017. The Company does not undertake to update these forward-looking statements.
Please visit www.neurotropebioscience.com for further information.
Contact information:
Investors
Jeffrey Benison, Director of Corporate Communications
Neurotrope Bioscience, Inc.
973.242.0005 Ext. 101
jbenison@neurotropebioscience.com
Media
James Heins
Senior Vice President
ICR Healthcare
203.856.2121
james.heins@icrinc.com
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SOURCE Neurotrope, Inc.
