Larimar Therapeutics Presents Additional Data from Phase 1 Studies and Phase 2 Dose Exploration Study Supporting the Nomlabofusp Clinical Program at ICAR 2024
- Treatment with nomlabofusp modified gene expression and lipid profiles in addition to increasing frataxin (FXN) levels in study participants with Friedreich’s ataxia (FA)
- Modeling and simulation predict that, in most patients with FA, 50 mg of nomlabofusp administered daily is likely to achieve FXN levels that are ≥50% of levels observed in healthy controls and similar to mean FXN levels reported in asymptomatic heterozygous carriers
- Disease characteristics of adult participants in the nomlabofusp studies were representative of the broad population of adults with FA
- Relationships between tissue FXN levels and onset of disease and GAA repeat length observed at baseline in nomlabofusp clinical study participants were consistent with prior published studies
- Nomlabofusp program update expected
mid-December 2024
“As our nomlabofusp program advances towards potential registration, we are continuing to evaluate the characteristics and activity of nomlabofusp. Using modeling and simulation based on the data collected from our completed clinical studies, long-term daily administration of 50 mg nomlabofusp was predicted to achieve tissue FXN levels in most patients similar to the average FXN levels observed in asymptomatic heterozygous carriers,” said
Dr.
Disease characteristics and tissue FXN concentrations in nomlabofusp clinical studies
FA is an autosomal recessive neurodegenerative disorder caused by GAA repeats in the FXN gene that result in FXN deficiency. The variable number of GAA repeats leads to a diverse spectrum of disease characteristics. Tissue FXN levels are known to correlate with age of onset and inversely correlate with the number of GAA repeats and rate of disease progression. The data presented at ICAR described the characteristics of and tissue FXN levels in adult participants in the nomlabofusp clinical studies.
- Nomlabofusp study participants were representative of the broad population of adults with FA
- Lower tissue FXN levels were associated with younger age of onset and more severe and rapidly progressive disease
- Relationships between disease characteristics and baseline buccal cell FXN levels were consistent with previous published studies
- Baseline buccal cell FXN levels correlate with baseline skin cell FXN levels in adults with FA participating in nomlabofusp clinical studies
Prediction of skin FXN levels after nomlabofusp administration based on data from the Phase 1 studies and Phase 2 dose exploration studies
FXN deficiency is the root cause of FA, and based on the literature, on average patients with FA have 21%-35% of the mean tissue FXN levels observed in healthy controls, and asymptomatic heterozygous carriers on average have ~50% of the mean FXN levels in buccal cells observed in healthy controls. The modeling used the skin tissue FXN levels measured in the completed clinical studies evaluating short-term administration of nomlabofusp to predict the potential increase in skin FXN levels after long-term administration of nomlabofusp.
- Dose-dependent increases in nomlabofusp exposure and skin FXN levels were observed in adults with FA after short-term administration of 25, 50, 75 or 100 mg nomlabofusp
- Daily administration of 50 mg nomlabofusp is predicted to achieve skin FXN levels >50% of healthy controls in most patients, which is similar to mean tissue FXN levels observed in asymptomatic heterozygous carriers
- Prediction model will be further optimized with long-term administration data from the ongoing OLE and data from adolescents and children as it becomes available
Effect of nomlabofusp on plasma lipid profiles and tissue gene expression in adults with FA
Deficiency in the mitochondrial protein FXN results in metabolic dysfunction and abnormal gene expression and lipid profiles in patients with FA. This study evaluated the impact of short-term administration of nomlabofusp on gene and lipid profiles in patients with FA as part of an initial exploratory analysis.
- In subsets of identified genes and lipids, gene expression and triglyceride levels were altered in study participants with FA at baseline compared with values observed in healthy controls (gene expression measured from buccal cells and lipid profiling measured from plasma)
- Improvement in gene expression and lipid profiles was observed in study participants with FA as post-treatment values trended towards values observed in normal controls, suggesting that nomlabofusp administration affects downstream metabolic pathways
- Further evaluation of changes in gene expression and lipid profiles after treatment with nomlabofusp is ongoing, including following long-term administration in the OLE study
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Forward-Looking Statements
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Source: Larimar Therapeutics