Dapirolizumab Pegol Phase 3 Data Presented at the American College
of Rheumatology Shows Significant Reduction in Systemic Lupus
Erythematosus Disease Activity
- Dapirolizumab
pegol (DZP) met its primary endpoint, demonstrating statistically
and clinically significant improvement across all organ systems as
measured by BICLA, an endpoint measuring disease activity
- A greater
response was observed across multiple clinical endpoints among
participants treated with DZP including 50% less severe disease
flares compared to participants on standard of care alone
- Systemic Lupus
Erythematosus is a chronic, debilitating autoimmune disease
affecting multiple organ systems, primarily in women, for whom
there is a significant need for additional treatment
options
BRUSSELS, Belgium and CAMBRIDGE, Mass., Nov. 19,
2024 (GLOBE NEWSWIRE) -- UCB (Euronext Brussels: UCB) and Biogen
Inc. (NASDAQ: BIIB) today presented detailed results from the Phase
3 PHOENYCS GO study evaluating dapirolizumab pegol (DZP), a novel
Fc-free anti-CD40L drug candidate, demonstrating significant
clinical improvement in disease activity in people living with
moderate-to-severe systemic lupus erythematosus (SLE). The results
were shared during an oral, late-breaker presentation at ACR
Convergence 2024, the American College of Rheumatology’s annual
meeting, in Washington, DC.
“There remains a significant unmet need for
additional treatment options for people living with systemic lupus
erythematosus and the results we observed in PHOENYCS GO suggest
dapirolizumab pegol has the potential to be impactful for this
chronic and debilitating autoimmune disease. Across clinical
endpoints we observed a positive effect and a favorable safety
profile,” said Megan E.B. Clowse, M.D., principal investigator of
the study and Associate Professor of Medicine, Chief of the
Division of Rheumatology and Immunology at Duke University School
of Medicine. “Participants receiving dapirolizumab pegol
experienced reduced lupus activity while also tapering steroids,
changes important to people living with the disease.”
In the PHOENYCS GO study (n=321), dapirolizumab
pegol (DZP) was administered intravenously every four weeks. On the
primary endpoint measuring improvement of moderate-to-severe
disease activity as assessed by achievement of British Isles Lupus
Assessment Group (BILAG)-based Composite Lupus Assessment (BICLA)
after 48 weeks, study participants receiving DZP plus SOC had a
statistically significant 14.6% (95% confidence interval [CI]: 3.3,
25.8; p=0.0110) higher response rate (49.5%) than those receiving
SOC alone (34.6%). A higher BICLA response rate reflects a
treatment response across all affected organs at baseline and is
associated with meaningful clinical benefit.
On the first secondary endpoint of BICLA
response at Week 24, study participants receiving DZP plus SOC had
a 7.9% higher response rate (46.6%) than those receiving SOC alone
(38.3%). However, the difference did not reach statistical
significance (95% CI: -3.6, 19.4; p=0.1776). Given statistical
significance was not achieved for the first key secondary endpoint
in the hierarchical testing, analyses for all the subsequent
secondary endpoints are descriptive and nominal p-values are
included.
Subsequent analyses of additional secondary
endpoints showed clinical improvements in the DZP group, including
SLE Responder Index (SRI)-4 response, corticosteroid tapering, SLE
Disease Activity Index-2K (SLEDAI-2K), achievement of Lupus Low
Disease Activity State (LLDAS) and prevention of severe BILAG
flares:
- 17.1% more participants receiving
DZP were able to reduce their corticosteroid dose from >7.5
mg/day prednisone equivalent at baseline to ≤7.5 mg/day at Week 48
(72.4% vs. 52.9%; difference [95% CI]: 17.1% [0.7, 33.4]; nominal
p=0.0404).
- 18.8% higher SRI-4 response rate at
Week 48 (95% CI: 7.3, 30.3; nominal p=0.0014) among study
participants who received DZP plus SOC (60.1%) versus those who
received SOC alone (41.1%).
- A 1.8-fold greater decrease from
baseline in SLEDAI-2K in study participants receiving DZP plus SOC
compared to SOC alone at Week 48 (-6.1 vs –4.2; difference [95%
CI]: -1.8 [-2.7, -0.9]; nominal p=0.0001).
- A 20.9% greater proportion of
participants in the DZP group achieved LLDAS at Week 48 compared to
SOC alone (40.9% vs. 19.6%; difference [95% CI]: 20.9% [10.7,31.2];
nominal p<0.001).
- Participants receiving DZP plus SOC
had 50% fewer severe BILAG flares through Week 48 (95% CI: 1.4,
21.6; nominal p=0.0257) compared to SOC alone (11.6% vs.
23.4%).
“Due to the varied symptoms and severity by
patient, progress in the treatment of lupus has historically been
challenging. With dapirolizumab pegol, we believe that our
differentiated approach that targets the CD40L pathway results in
clinically meaningful improvements across multiple disease domains
and could substantially impact the burden of this disease in
particular for women, who are disproportionately affected by
lupus,” said Fiona du Monceau, Head of Patient Evidence at UCB. “We
are highly encouraged by the results we have seen in PHOENYCS GO
and are excited to continue the clinical development of
dapirolizumab pegol in the second Phase 3 study, PHOENYCS FLY.”
The safety profile of dapirolizumab pegol was
generally favorable. The safety results were consistent with
previous DZP studies and with that in study participants with SLE
receiving an immunomodulator. In the PHOENYCS GO study, a higher
proportion of patients receiving DZP plus SOC had
treatment-emergent adverse events (TEAEs) compared to SOC alone
(82.6% vs. 75.0%). The proportion of participants with serious
TEAEs was 9.9% in those participants receiving DZP plus SOC
compared to 14.8% in those receiving SOC alone. Opportunistic
infections were reported in 2.8% of participants receiving DZP plus
SOC compared to 0.9% of those receiving SOC alone. Discontinuation
of treatment or study participation due to TEAEs occurred in 4.7%
(10) of participants receiving DZP plus SOC and 3.7% (4) of
participants receiving SOC alone.
“At Biogen, we understand that lupus affects
everyone differently and are committed to developing treatments as
diverse as the patients we serve,” said Diana Gallagher, MD, Head
of AD, MS and Immunology Development Units at Biogen. “These
results reinforce our belief that dapirolizumab pegol has the
potential to change the approach to care of SLE and we are
dedicated to advancing this program with our partner UCB.”
Participants from the PHOENYCS GO study will
continue to be followed in a long-term open-label study. In 2024,
UCB and Biogen will initiate a second Phase 3 trial of
dapirolizumab pegol, PHOENYCS FLY (NCT06617325).
The safety and efficacy of dapirolizumab pegol
in systemic lupus erythematosus have not been established, and it
is not approved for use in systemic lupus erythematosus by any
regulatory authority worldwide.
About Systemic Lupus Erythematosus
(SLE)
SLE is a chronic, multifactorial autoimmune disease that is caused
by the activation of autoreactive T, B and antigen-presenting
cells, resulting in manifestations across multiple organ systems
with periods of illness or flares alternating with periods of
inactivity.1 SLE can present itself in several ways
including rash, arthritis, anemia, thrombocytopenia, serositis,
nephritis, seizures or psychosis.2 SLE is associated
with a greater risk of death from causes such as infection and
cardiovascular disease.
An estimated 90% of people living with lupus are
women; most begin to see symptoms between the ages of
15-55.3,4,5 Individuals from populations of African,
Hispanic, Asian and Native American descent are at a greater risk
of earlier onset and more aggressive disease.6,7
Pregnancy in women with SLE is high risk, with higher maternal and
fetal mortality and morbidity than the general
population.8,9
About Dapirolizumab Pegol
Dapirolizumab pegol is a novel investigational humanized Fc-free
polyethylene glycol (PEG)-conjugated antigen-binding (Fab’)
fragment. Dapirolizumab pegol inhibits CD40L signaling which has
been shown to reduce B cell activation and autoantibody production,
mitigate type 1 interferon (IFN) secretion, and attenuate T cell
and antigen-presenting cell (APC) activation.10
Dapirolizumab pegol is presently in Phase 3 clinical development
for the treatment of systemic lupus erythematosus (SLE) under a
collaboration between UCB and Biogen.11
About UCB
UCB, Brussels, Belgium (www.ucb.com) is a global biopharmaceutical
company focused on the discovery and development of innovative
medicines and solutions to transform the lives of people living
with severe diseases of the immune system or of the central nervous
system. UCB is listed on Euronext Brussels (symbol: UCB).
About Biogen
Founded in 1978, Biogen is a leading biotechnology company that
pioneers innovative science to deliver new medicines to transform
patient’s lives and to create value for shareholders and our
communities. We apply deep understanding of human biology and
leverage different modalities to advance first-in-class treatments
or therapies that deliver superior outcomes. Our approach is to
take bold risks, balanced with return on investment to deliver
long-term growth.
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References:
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Gladman DD, Touma Z, et al. Disease course patterns in systemic
lupus erythematosus. Lupus. 2019;28(1):114-122.
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management of systemic lupus erythematosus. Ann Rheum Dis.
2021;80(1):14-25. doi:10.1136/annrheumdis-2020-218272
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Epidemiology of systemic lupus erythematosus. Best Pract Res Clin
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Ann Rheum Dis. 2016;75(1):136-41. Epub 2014/10/01. doi:
10.1136/annrheumdis-2014-206334. PubMed PMID: 25265938; PubMed
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Ugarte-Gil MF, Alarcón GS. Epidemiology of systemic lupus
erythematosus. Expert Rev Clin Immunol. 2017;13(8):799-814.
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SG, Clarke AE. The global burden of SLE: prevalence, health
disparities and socioeconomic impact. Nat Rev Rheumatol.
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PubMed PMID: 27558659.
- Kheir JM,
Guthridge CJ, Johnston JR, Adams LJ, Rasmussen A, Gross TF, et al.
Unique clinical characteristics, autoantibodies and medication use
in Native American patients with systemic lupus erythematosus.
Lupus Sci Med. 2018;5(1):e000247. Epub 2018/03/14. doi:
10.1136/lupus-2017-000247. PubMed PMID: 29531773; PubMed Central
PMCID: PMCPMC5844376.
- Mehta B, Luo Y,
Xu J, Sammaritano L, Salmon J, Lockshin M, et al. Trends in
Maternal and Fetal Outcomes Among Pregnant Women With Systemic
Lupus Erythematosus in the United States: A Cross-sectional
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Systemic Lupus Erythematosus During Conception, Pregnancy and
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-
Clinicaltrials.gov (NCT04294667). A Study to Evaluate the Efficacy
and Safety of Dapirolizumab Pegol in Study Participants With
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(PHOENYCS GO) 2023 [cited August 2024] Available at:
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2024.
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