Iveric Bio's Zimura®, a Novel Complement C5 Inhibitor, Met its Primary Endpoint and Reached Statistical Significance in a Phase 2b Randomized, Controlled Clinical Trial in Geographic Atrophy Secondary to Dry Age-Related Macular Degeneration
- Overall Data Suggest a Dose Response Relationship Across Treatment Groups -
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Zimura was generally well tolerated after 12 months of administration. There was no Zimura-related inflammation and there were no Zimura-related discontinuations from the trial. Further, there have been no ocular serious adverse events and no cases of endophthalmitis reported in the study eye in this ongoing clinical trial. During the first 12 months of the trial, the incidence of choroidal neovascularization (CNV) in the untreated fellow eye was 10 patients (3.5%), and in the study eye was 3 patients (2.7%) in the sham control group, 6 patients (9.0%) in the Zimura 2 mg group, and 8 patients (9.6%) in the Zimura 4 mg group. The most frequently reported ocular adverse events were related to the injection procedure.
“IVERIC bio’s unwavering commitment to science has resulted in compelling Phase 2b data in GA secondary to dry AMD, a major public health problem that has devastating effects on our patients,” stated
“This is a major milestone for IVERIC bio and a potentially significant advancement for patients with GA secondary to dry AMD who currently have no treatment options,” stated
“Zimura’s efficacy data in this clinical trial supports the potential role of C5 inhibition in GA secondary to dry AMD,” stated
Phase 2b GA Clinical Trial Design and Results
In this international, randomized, double masked, sham-controlled, multi-center clinical trial, the safety and efficacy of various doses of Zimura were assessed in patients with geographic atrophy secondary to dry AMD. A total of 286 patients were enrolled across two parts of the trial as follows:
- In Part 1 of the trial: 26 patients were randomized to receive monthly intravitreal injections of Zimura 1 mg; 25 patients were randomized to receive monthly intravitreal injections of Zimura 2 mg; and 26 patients were randomized to receive monthly sham injections.
- This trial was modified to add a 4 mg dose group. In Part 2 of the trial: 83 patients were randomized to receive monthly intravitreal injections of Zimura 4 mg, administered as two injections of Zimura 2 mg; 42 patients were randomized to receive monthly intravitreal injections of Zimura 2 mg plus a sham injection; and 84 patients were randomized to receive monthly sham injections, administered as two separate sham injections.
The prespecified statistical analysis plan for the primary and secondary endpoints used a model of repeated measures (MRM) to compare data for the Zimura 2 mg and Zimura 4 mg groups to the corresponding sham groups. The statistical analysis for the Zimura 2 mg group as compared to sham includes stratified data for patients from both Part 1 and Part 2 of the trial. Data from patients receiving Zimura 1 mg in Part 1 of the trial was not part of the prespecified statistical analysis for the efficacy endpoints.
Primary Efficacy Endpoint
The prespecified primary endpoint, mean rate of change in GA growth over 12 months, was measured by fundus autofluorescence (FAF) based on readings at three time points (baseline, month 6, and month 12) and was calculated using the square root transformation of the GA area. The FAF images were assessed by an independent masked reading center. Detailed data for the primary endpoint is shown below:
Mean Rate of Change in Geographic Atrophy (GA) Area from Baseline to Month 12
(Square Root Transformation)
Cohort |
Zimura 2 mg (N = 67) |
Sham (N = 110) |
Difference |
p-value |
% Difference |
Mean Change in GAa (mm) |
0.292 |
0.402 |
0.11 |
0.0072b |
27.38% |
|
|
|
|
|
|
Cohort |
Zimura 4 mg (N = 83) |
Sham (N = 84) |
Difference |
p-value |
% Difference |
Mean Change in GAa (mm) |
0.321 |
0.444 |
0.124 |
0.0051b |
27.81% |
a Based on least squared means from MRM model b Reflects statistically significant p-value |
Secondary Efficacy Endpoints
The prespecified secondary endpoints in this trial were the mean change in best corrected visual acuity (Early Treatment of Diabetic Retinopathy Study (ETDRS) letters) from baseline to month 12 and the mean change in low luminance best corrected visual acuity (ETDRS letters) from baseline to month 12. Detailed data for the secondary endpoints are shown below:
Mean Change in Best Corrected Visual Acuity (VA) from Baseline to Month 12
Cohort |
Zimura 2 mg (N = 67) |
Sham (N = 110) |
Difference |
Mean Change in VAa (ETDRS letters) |
-7.90 |
-9.29 |
1.39 |
|
|
|
|
Cohort |
Zimura 4 mg (N = 83) |
Sham (N = 84) |
Difference |
Mean Change in VAa (ETDRS letters) |
-3.79 |
-3.51 |
-0.28 |
a Based on least squared means from MRM model |
Mean Change in Low Luminance Best Corrected Visual Acuity (VA) from Baseline to Month 12
Cohort |
Zimura 2 mg (N = 67) |
Sham (N = 110) |
Difference |
Mean Change in VAa (ETDRS letters) |
-1.03 |
-1.41 |
0.38 |
|
|
|
|
Cohort |
Zimura 4 mg (N = 83) |
Sham (N = 84) |
Difference |
Mean Change in VAa (ETDRS letters) |
1.53 |
2.97 |
-1.44 |
a Based on least squared means from MRM model |
As per the clinical trial protocol, patients will continue to be treated and followed through month 18 in order to collect additional data regarding Zimura in GA.
About Dry AMD / Geographic Atrophy
Dry AMD is a significant cause of moderate and severe loss of central vision in older adults, affecting both eyes in the majority of patients. Although dry AMD is the most common form of AMD, there are no
About Zimura
Complement factor C5 is a central component of the complement cascade and is believed to be involved in the development and progression of dry AMD. Zimura is designed to target and inhibit complement factor C5. Zimura binds to C5 and inhibits its cleavage into the terminal fragments, C5a and C5b. By inhibiting the formation of complement system terminal fragments, Zimura may decrease the activation of inflammasomes and the formation of membrane attack complex (MAC), which occur at the end of the complement cascade. This mechanism of action could potentially prevent or slow down the degeneration of RPE cells providing the potential therapeutic rationale for GA secondary to dry AMD.
Conference Call/Web Cast Information
IVERIC bio’s management team will host a conference call/webcast today at
About IVERIC bio
IVERIC bio is a biopharmaceutical company focused on the discovery and development of novel treatment options for retinal diseases with significant unmet medical needs. Vision is Our Mission. For more information on the Company please visit www.ivericbio.com.
IVERIC bio Forward-looking Statements
Any statements in this press release about the Company’s future expectations, plans and prospects constitute forward-looking statements for purposes of the safe harbor provisions under the Private Securities Litigation Reform Act of 1995. Forward-looking statements include any statements about the Company’s strategy, future operations and future expectations and plans and prospects for the Company, and any other statements containing the words “anticipate,” “believe,” “estimate,” “expect,” “intend”, “goal,” “may”, “might,” “plan,” “predict,” “project,” “target,” “potential,” “will,” “would,” “could,” “should,” “continue,” and similar expressions. In this press release, the Company’s forward-looking statements include statements about the impact of results from the Company’s Phase 2b clinical trial of Zimura for GA, including on the Company’s development plan for Zimura, the timing, progress and results of clinical trials and other research and development activities, the potential utility and development potential of its product candidates and the potential for its business development strategy. Such forward-looking statements involve substantial risks and uncertainties that could cause the Company’s development programs, future results, performance or achievements to differ significantly from those expressed or implied by the forward-looking statements. Such risks and uncertainties include, among others, those related to the initiation and the conduct and design of research and development programs and clinical trials, establishment of manufacturing capabilities, availability of data from these programs, reliance on university collaborators and other third parties, expectations for regulatory matters, need for additional financing and negotiation and consummation of business development transactions and other factors discussed in the “Risk Factors” section contained in the quarterly and annual reports that the Company files with the
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Source:
Investor:
IVERIC bio
Kathy Galante, 212-845-8231
Vice President, Investor Relations and Corporate Communications
kathy.galante@ivericbio.com
or
Media:
SmithSolve
Alex Van Rees, 973-442-1555 ext. 111
alex.vanrees@smithsolve.com