Allergan and Molecular Partners announced the release of two positive clinical trials, SEQUOIA and CEDAR, for abicipar, demonstrating that both the 8-week and 12-week treatment regimens met the prespecified primary endpoint of noninferiority to ranibizumab.
SEQUOIA and CEDAR are identical global phase 3 studies designed to assess the efficacy and safety of abicipar compared with ranibizumab in treatment-naïve patients with neovascular age-related macular degeneration (AMD). The primary endpoint measured the proportion of treated patients with stable vision at week 52.
In both studies, abicipar demonstrated similar efficacy after 6 or 8 injections, compared to 13 ranibizumab injections in the first year of this study. The overall adverse events were similar among the three treatment arms. The incidence of intraocular inflammation was higher in the abicipar arms compared to ranibizumab-treated patients in both trials. We are further analyzing these results. SEQUOIA and CEDAR clinical trials continue on a masked basis for a second year.
The filing for abicipar is planned for the first half of 2019. Allergan will be requesting a meeting with the FDA to discuss our BLA submission.
In the SEQUOIA study, the proportion of patients with stable vision in abicipar dosed Q8 was 94.8 percent, in Q12 was 91.3 percent compared to ranibizumab dosed Q4 96.0 percent.
In CEDAR, the proportion of patients with stable vision in the abicipar dosed Q8 was 91.7 percent, in Q12 was 91.2 percent compared to ranibizumbab dosed Q4 95.5 percent.
“In both studies abicipar demonstrated remarkable efficacy in the 8-week and 12-week regimens,” David Nicholson, Chief Research and Development Officer, Allergan, said in a company news release. “We are pleased with the outcome of these trials. We believe the SEQUOIA and CEDAR studies demonstrated what we set out to achieve, strong efficacy and duration of effect which shows the potential of abicipar as a treatment for AMD patients. We have generated important findings in these trials to address a serious unmet need. We will continue to review these data including inflammation findings and are working on further optimizing the abicipar formulation.”
“Abicipar could transform the way physicians manage AMD with anti-VEGF therapy. Today’s anti-VEGFs were designed for monthly or bimonthly dosing. In the real world, patients have difficulty adhering to the schedule, which places their vision at risk. The adopted treat-and extend approach, while practical, is supported by limited data and in certain cases shows sub-optimal visual outcomes. Treat-and-extend amounts to a compromise for most patients who are unable or unwilling to comply with frequent injections. Abicipar could be the first and only 12- week anti-VEGF treatment that improves visual outcomes in a real world setting for a large number of AMD patients,” said Raj Maturi, MD, Midwest Eye Institute & Associate Professor Ophthalmology, Indiana University School of Medicine.
“We are very excited to see that the most advanced DARPin molecule, abicipar, reaches its primary endpoint in phase 3. This is a very important milestone for Molecular Partners and the DARPin technology in general,” Patrick Amstutz, PhD, CEO of Molecular Partners, said in the news release.
“We are very pleased to see that abicipar can indeed help patients in need with less frequent dosing which was the key point when we generated abicipar in the first place,” added Michael T. Stumpp, PhD, COO of Molecular Partners.
In the SEQUOIA study, overall treatment-emergent adverse events were similar among the 3 treatment arms, reported in 78.3 percent, 78.0 percent and 74.0 percent of patients receiving abicipar Q8, abicipar Q12 and ranibizumab Q4, respectively.
Incidence of intraocular inflammation events was similar among the two abicipar treatment groups but higher than the ranibizumab arm and reported at 15.7 percent and 15.3 percent of patients in the abicipar Q8 and Q12 arms compared to 0.6 percent in the ranibizumab Q4 arm.
In the CEDAR study, overall treatment-emergent adverse events were similar among the 3 treatment arms reported in 73.7 percent, 81.1 percent and 73.2 percent of patients receiving abicipar Q8, abicipar Q12 and ranibizumab Q4, respectively.
Incidence of intraocular inflammation events was similar among the two abicipar treatment groups but higher than ranibizumab arm and reported at 15.1 percent and 15.4 percent of patients in the abicipar Q8 and Q12 arms compared to 0 percent in the ranibizumab Q4.
Allergan is continuing to review these data. The full data details of the primary endpoints and the secondary endpoints will be presented at an upcoming scientific conference.