Roche’s Phase IIb study of prasinezumab missed primary endpoint, but suggests possible benefit in early-stage Parkinson’s disease
19 December 2024 - 5:00PM
UK Regulatory
Roche’s Phase IIb study of prasinezumab missed primary endpoint,
but suggests possible benefit in early-stage Parkinson’s disease
- 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
Basel, 19 December 2024 - Roche (SIX: RO, ROG; OTCQX: RHHBY)
announced today results from the Phase IIb PADOVA study
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 efficacy in the primary endpoint of time to confirmed
motor progression with a HR=0.84 [0.69-1.01] and p=0.0657, missing
statistical significance. In a pre-specified analysis, the effect
of prasinezumab was more pronounced in the population treated with
levodopa (75% of participants), HR=0.79 [0.63-0.99]. 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.
“Parkinson’s is complex and devastating with no disease
modifying treatment options available for the millions of people
impacted,” said Levi Garraway, M.D., Ph.D., Roche’s Chief Medical
Officer and Head of Global Product Development. “We believe the
consistent efficacy trends from the Phase IIb study of prasinezumab
merit further exploration. We will continue our close collaboration
with the Parkinson’s community as we further evaluate the data to
determine next steps.”
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
Commercialisation agreement with Prothena in December 2013 to
develop and commercialise monoclonal antibodies targeting α-syn,
such as prasinezumab, for the treatment of Parkinson’s disease.
About the PADOVA study
PADOVA is a Phase IIb multicentre, randomised, double-blind trial
evaluating the efficacy and safety of prasinezumab compared with
placebo in 586 randomised 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 characterised 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. Today, PD affects over 10 million people
worldwide. The prevalence of Parkinson’s disease is increasing, and
it has become one of the fastest-growing neurological disorders.
Currently, symptomatic treatments that effectively alleviate motor
symptoms are available today, having a significant impact on
people’s quality of life; however, no available symptomatic
therapies slow down or stop the clinical progression of Parkinson’s
disease and the effects wear off over time as the disease
progresses.
Roche is evaluating multiple approaches to slow down disease
progression and potentially prevent Parkinson’s disease that
involve targeting underlying disease processes such as aggregated
α-syn production, lysosomal dysfunction and neuroinflammation.
About Roche in Neuroscience
Neuroscience is a major focus of research and development at Roche.
Our goal is to pursue groundbreaking science to develop new
treatments that help improve the lives of people with chronic and
potentially devastating diseases.
Roche is investigating more than a dozen medicines for
neurological disorders, including neuromuscular diseases: Duchenne
muscular dystrophy, facioscapulohumeral muscular dystrophy and
spinal muscular atrophy; neuro immune diseases: multiple sclerosis
and neuromyelitis optica spectrum disorder; and neurodegenerative
diseases: Alzheimer’s disease, Parkinson’s disease and Huntington’s
disease. Together with our partners, we are committed to pushing
the boundaries of scientific understanding to solve some of the
most difficult challenges in neuroscience today.
About Roche
Founded in 1896 in Basel, Switzerland, as one of the first
industrial manufacturers of branded medicines, Roche has grown into
the world’s largest biotechnology company and the global leader in
in-vitro diagnostics. The company pursues scientific excellence to
discover and develop medicines and diagnostics for improving and
saving the lives of people around the world. We are a pioneer in
personalised healthcare and want to further transform how
healthcare is delivered to have an even greater impact. To provide
the best care for each person we partner with many stakeholders and
combine our strengths in Diagnostics and Pharma with data insights
from the clinical practice.
For over 125 years, sustainability has been an integral part of
Roche’s business. As a science-driven company, our greatest
contribution to society is developing innovative medicines and
diagnostics that help people live healthier lives. Roche is
committed to the Science Based Targets initiative and the
Sustainable Markets Initiative to achieve net zero by 2045.
Genentech, in the United States, is a wholly owned member of the
Roche Group. Roche is the majority shareholder in Chugai
Pharmaceutical, Japan.
For more information, please visit www.roche.com.
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