Roche’s Phase IIb Study of Prasinezumab Missed Primary Endpoint, But Suggests Possible Clinical Benefit in Early-Stage Parkinson’s Disease
December 19 2024 - 1:05AM
Business Wire
- PADOVA study showed numerical delay in motor progression and
positive trends on multiple secondary and exploratory
endpoints
- Prasinezumab continues to be well tolerated and no new safety
signals were observed
- Roche is further evaluating the data and will work together
with health authorities to determine next steps
Prothena Corporation plc (NASDAQ:PRTA), today announced results
from the Phase IIb PADOVA study conducted by partner Roche
investigating prasinezumab in 586 people with early-stage
Parkinson’s disease, treated for a minimum of 18 months while on
stable symptomatic treatment. Prasinezumab showed potential
clinical effect in the primary endpoint of time to confirmed motor
progression with a HR=0.84 [0.69-1.01] and p=0.0657. The effect of
prasinezumab was more pronounced in a pre-specified analysis in the
population treated with levodopa (75% of participants), HR=0.79
[0.63-0.99] and nominal p=0.0431. Pre-specified supplementary
covariate-adjusted* analyses of these endpoints demonstrated
nominally significant effects on the primary endpoint (HR=0.81
[0.67-0.98]; nominal p=0.0334) and in the levodopa subgroup
(HR=0.76 [0.61-0.95]; nominal p=0.0175). Consistent positive trends
across multiple secondary and exploratory endpoints were also
observed. Prasinezumab continues to be well tolerated and no new
safety signals were observed in the study.
The Phase IIb PADOVA results along with prior clinical study
results will inform future clinical development, including study
design, statistical analysis, and appropriate evaluation of patient
sub-groups, of prasinezumab as a potential first-in-class
disease-modifying treatment for patients with Parkinson’s
disease.
“The results from the Phase 2b PADOVA study are a significant
step forward to potentially bring the first disease-modifying
treatment option to the millions of individuals living with
Parkinson’s disease and their families,” stated Gene Kinney, Ph.D.,
President and Chief Executive Officer, Prothena. “As pioneers in
developing the first anti-alpha synuclein targeting antibody, we
look forward to Roche presenting the results from the PADOVA study
at an upcoming medical conference and sharing with health
authorities to determine the most appropriate path forward.”
The Phase II PASADENA and Phase IIb PADOVA open-label extension
studies will continue in order to explore the observed effects in
both studies. Roche will continue to evaluate the data and work
together with health authorities to determine next steps.
Full results from the PADOVA study will be presented at an
upcoming medical meeting.
About prasinezumab
Prasinezumab is an investigational monoclonal antibody designed
to selectively bind aggregated α-syn and reduce neuronal toxicity.
By targeting the build-up of α-syn protein in the brain,
prasinezumab can potentially prevent further accumulation and
spreading between cells, thereby slowing down the progression of
the disease. The evidence supporting targeting α-syn aggregates as
a mechanism of action in Parkinson’s disease is based on a wide
range of scientific evidence in the field.
Prasinezumab is currently being assessed in ongoing open-label
extensions of the Phase II PASADENA and Phase IIb PADOVA studies.
Four-year data from the PASADENA study showed potential evidence of
sustained slowing of motor progression compared to a matched PPMI
natural history study cohort, published in the October 2024 edition
of Nature Medicine. The PASADENA delayed-start (n = 94) and
early-start (n = 177) groups showed a slower decline (a smaller
increase in score) in MDS–UPDRS Part III scores in the OFF state
(delayed start, −51%; early start, −65%) than did the PPMI external
comparator (n = 303). The safety database for prasinezumab consists
of data from more than 900 Parkinson’s disease study participants
that have been treated with the investigational medicine, including
more than 500 who were treated over 1.5-5 years.
Roche entered into a Licensing, Development, and
Commercialization agreement with Prothena in December 2013 to
develop and commercialize monoclonal antibodies targeting α-syn,
such as prasinezumab, for the potential treatment of Parkinson’s
disease.
About the PADOVA study
PADOVA is a Phase IIb multicenter, randomized, double-blind
trial evaluating the efficacy and safety of prasinezumab compared
with placebo in 586 randomized patients with early-stage
Parkinson’s disease who were on stable symptomatic treatment
(stable doses of levodopa or monoamine oxidase-B inhibitor as
monotherapy for more than three months at baseline). Patients
receive monthly intravenous doses of prasinezumab 1500 mg or
placebo every four weeks for at least 76 weeks. This is followed by
a two-year open-label extension phase in which all participants
receive active treatment, which is currently ongoing.
The primary endpoint of PADOVA is the time to confirmed motor
progression of Parkinson’s disease (≥5-point increase in Movement
Disorder Society-Unified Parkinson’s Disease Rating Scale
[MDS-UPDRS] Part III score assessed in OFF medication state). A
5-point increase in MDS-UPDRS Part III represents a clinically
meaningful motor progression event (Trundell et al., in press).
About Parkinson’s disease
Parkinson's disease is a chronic, progressive and debilitating
neurodegenerative disease that has a devastating impact on patients
and families. Parkinson's disease is characterized by the gradual
loss of neurons that make dopamine and other nerve cells, and the
development of motor and non-motor symptoms that may appear years
before diagnosis. Symptoms can vary widely between individuals and
disease progression is not predictable, in which symptoms can
develop gradually over time or suddenly. Clinical diagnosis of
Parkinson’s disease is late in the disease course and currently
based only on motor symptoms, with non-motor symptoms often
preceding diagnosis by up to 20 years.
About Prothena
Prothena Corporation plc is a late-stage clinical biotechnology
company with expertise in protein dysregulation and a pipeline of
investigational therapeutics with the potential to change the
course of devastating neurodegenerative and rare peripheral amyloid
diseases. Fueled by its deep scientific expertise built over
decades of research, Prothena is advancing a pipeline of
therapeutic candidates for a number of indications and novel
targets for which its ability to integrate scientific insights
around neurological dysfunction and the biology of misfolded
proteins can be leveraged. Prothena’s pipeline includes both
wholly-owned and partnered programs being developed for the
potential treatment of diseases including AL amyloidosis, ATTR
amyloidosis with cardiomyopathy, Alzheimer’s disease, Parkinson’s
disease and a number of other neurodegenerative diseases. For more
information, please visit the Company’s website at www.prothena.com
and follow the Company on Twitter @ProthenaCorp.
Forward-Looking Statements
This press release contains forward-looking statements. These
statements relate to, among other things, the treatment potential,
design, and proposed mechanism of action prasinezumab; plans for
ongoing and future clinical trials of prasinezumab; plans to work
with health authorities to determine next steps for prasinezumab;
and the expected reporting data from the PADOVA clinical trials.
These statements are based on estimates, projections and
assumptions that may prove not to be accurate, and actual results
could differ materially from those anticipated due to known and
unknown risks, uncertainties and other factors, including but not
limited to those described in the “Risk Factors” sections of our
Quarterly Report on Form 10-Q filed with the Securities and
Exchange Commission (SEC) on November 12, 2024, and discussions of
potential risks, uncertainties, and other important factors in our
subsequent filings with the SEC. We undertake no obligation to
update publicly any forward-looking statements contained in this
press release as a result of new information, future events, or
changes in our expectations.
*Covariates used for adjustment: Medication at baseline, H&Y
stage, DaT-SPECT, Age, Sex, Baseline dependent parameter
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version on businesswire.com: https://www.businesswire.com/news/home/20241218381145/en/
Media Michael Bachner, Senior Director, Corporate Communications
609-664-7308, michael.bachner@prothena.com
Investors Mark Johnson, CFA, Vice President, Investor Relations
650-417-1974, mark.johnson@prothena.com
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