− Echocardiographic and Cardiac Biomarker Data
From the HELIOS-B Study Presented Today Support the Potential of
Vutrisiran in ATTR-CM –
− Vutrisiran Significantly Improved
Echocardiographic Assessments of Cardiac Structure, Systolic
Function and Diastolic Function Relative to Placebo Over 30 Months
–
− Vutrisiran Demonstrated Relative Stability of
Cardiac Biomarkers NT-proBNP and Troponin-I Relative to Placebo
Over 30 Months –
Alnylam Pharmaceuticals, Inc. (Nasdaq: ALNY), the leading RNAi
therapeutics company, today announced that two new data sets from
the HELIOS-B Phase 3 study of vutrisiran, an investigational RNAi
therapeutic in development for the treatment of ATTR amyloidosis
with cardiomyopathy (ATTR-CM), were presented in the Late Breaking
Clinical Research Session 1 at the Heart Failure Society of America
(HFSA) Annual Scientific Meeting 2024, which was held virtually. An
open access recording of Alnylam presentations will be available on
the HFSA website following the session.
Progression in ATTR-CM is associated with cardiac wall
thickening, deterioration in systolic and diastolic function and
increases in biomarkers of cardiac stress and injury, NT-pro-BNP
and Troponin I.
“Consistent with demonstrated improvements in outcomes and
health status, these new data show that vutrisiran attenuated
measures of disease progression across multiple domains of cardiac
structure and function, NT-proBNP and troponin I, in a contemporary
ATTR-CM patient population,” said Pushkal Garg, M.D., Chief Medical
Officer, Alnylam. “These data demonstrate that rapid knockdown of
TTR leads to an early impact on cardiac biomarkers and
echocardiographic parameters, indicative of a potential
disease-modifying effect, and underscores the benefit of treating
patients with an RNAi therapeutic earlier in the course of disease.
We remain confident that, with approval, vutrisiran has the
potential to become a first-line therapy for ATTR amyloidosis with
cardiomyopathy and are on track to complete multiple global
regulatory submissions before the end of the year.”
Analysis results
New echocardiographic data demonstrated that treatment with
vutrisiran slowed disease progression in a contemporary population
of patients with ATTR-CM across multiple domains of cardiac
structure and diastolic and systolic function at Month 30 as
compared to placebo. The magnitude of the treatment effects with
vutrisiran compared to placebo were similar or greater in the
monotherapy population. Significant improvements in both diastolic
and systolic function were observed as early as 12 months and 18
months, respectively, in the overall population. The Month 30
results in the overall population are detailed in the table
below.*
Overall population
N=654
Cardiac Wall Structure
Mean Left Ventricular Wall Thickness
Change from Baseline, cm LS Mean difference (Vutrisiran –
Placebo)
-0.04 cm p=0.03
Left Ventricular Mass Index Change from
Baseline, g/m2 LS Mean difference (Vutrisiran – Placebo)
-10.6 g/m2 p=0.0047
Left Ventricular Diastolic
Function
E/A Ratio Change from Baseline LS Mean
difference (Vutrisiran – Placebo)
-0.29 p=0.0434
E/e’ Ratio Change from Baseline LS Mean
difference (Vutrisiran – Placebo)
-1.82 p=0.00003
TDI Lateral e’ Change from Baseline, cm/s
LS Mean ± SEM
0.55 cm/s p=0.0005
Left Ventricular Systolic
Function
Left Ventricular Ejection Fraction Change
from Baseline, % LS Mean difference (Vutrisiran – Placebo)
2.03% p=0.02
Absolute Global Longitudinal Strain Change
from Baseline, % LS Mean difference (Vutrisiran – Placebo)
1.23% p=0.000002
Left Ventricular Stroke Volume Change from
Baseline, mL LS Mean difference (Vutrisiran – Placebo)
4.05 mL p=0.0007
*All p-values included within the table are nominal
p-values.
In addition, analyses of cardiac biomarkers NT-proBNP and
troponin I were also presented. At Month 30, the relative reduction
in the fold change in NT-proBNP in patients treated with vutrisiran
compared to placebo was 32% in the overall population and 43% in
the monotherapy population (adjusted geometric mean fold change
ratio [vutrisiran/placebo]: 0.68; nominal p-value 3.440E-12 and
0.57; nominal p-value 4.339E-12, respectively). At Month 30,
relative reduction in the fold change of troponin I was 32% in the
overall population and 45% in the monotherapy population (adjusted
geometric mean fold change ratio [vutrisiran/placebo]: 0.68;
nominal p-value 1.566E-14 and 0.55; nominal p-value 9.684E-17,
respectively).
In the subgroup of patients receiving tafamidis at baseline, a
relative reduction in the fold change of 18% was observed in
NT-proBNP and 10% in troponin I (adjusted geometric mean fold
change ratio [vutrisiran/placebo]: 0.82; nominal p-value 0.0045 and
0.90; nominal p-value 0.0849, respectively) at Month 30. For both
NTproBNP and troponin I, patients treated with vutrisiran
demonstrated nominally significant reductions relative to placebo
at 6 months. These results were consistent across all pre-specified
subgroups, with a larger treatment effect observed in the
monotherapy population.
Detailed results from the HELIOS-B study were presented at the
European Society of Cardiology annual congress on August 30, 2024,
and simultaneously published in The New England Journal of
Medicine.
Alnylam plans to include a discussion of these data at its
upcoming TTR Investor Day on Wednesday, October 9, 2024, at 8:30 am
ET in New York City. The event will be webcast on the Investors
section of the Company’s website, www.alnylam.com. A replay will be
available on the Alnylam website within 48 hours after the
event.
HELIOS-B Study Design
HELIOS-B (NCT: NCT04153149) was a Phase 3, randomized,
double-blind, placebo-controlled multicenter global study designed
and powered to evaluate the efficacy and safety of vutrisiran on
the reduction of all-cause mortality and recurrent cardiovascular
events as a primary composite endpoint in patients with ATTR
amyloidosis with cardiomyopathy. The study randomized 655 adult
patients with ATTR amyloidosis (hereditary or wild-type) with
cardiomyopathy. Patients were randomized 1:1 to receive vutrisiran
25mg or placebo subcutaneously once every three months during a
double-blind treatment period of up to 36 months. After the
double-blind period, all eligible patients remaining on the study
to were able receive vutrisiran in an open-label extension period
of HELIOS-B.
IMPORTANT SAFETY INFORMATION
Reduced Serum Vitamin A Levels and Recommended
Supplementation
AMVUTTRA® (vutrisiran) treatment leads to a decrease in serum
vitamin A levels.
Supplementation at the recommended daily allowance (RDA) of
vitamin A is advised for patients taking AMVUTTRA. Higher doses
than the RDA should not be given to try to achieve normal serum
vitamin A levels during treatment with AMVUTTRA, as serum vitamin A
levels do not reflect the total vitamin A in the body.
Patients should be referred to an ophthalmologist if they
develop ocular symptoms suggestive of vitamin A deficiency (e.g.,
night blindness).
Adverse Reactions
The most common adverse reactions that occurred in patients
treated with AMVUTTRA for polyneuropathy of hereditary
transthyretin-mediated amyloidosis (hATTR-PN) were arthralgia
(11%), dyspnea (7%), and vitamin A decreased (7%).
For additional information about AMVUTTRA, please see the
full Prescribing Information.
About AMVUTTRA® (vutrisiran)
AMVUTTRA® (vutrisiran) is an RNAi therapeutic that delivers
rapid knockdown of mutant and wild‑type transthyretin (TTR),
addressing the underlying cause of transthyretin (ATTR)
amyloidosis. Administered quarterly via subcutaneous injection,
AMVUTTRA is approved and marketed in more than 15 countries for the
treatment of the polyneuropathy of hereditary
transthyretin-mediated amyloidosis (hATTR-PN) in adults. Vutrisiran
is also in development for the treatment of ATTR amyloidosis with
cardiomyopathy (ATTR-CM), which encompasses both wild-type and
hereditary forms of the disease. For more information about
AMVUTTRA, including the full U.S. Prescribing Information,
visit AMVUTTRA.com.
About ATTR
Transthyretin amyloidosis (ATTR) is an underdiagnosed, rapidly
progressive, debilitating and fatal disease caused by misfolded
transthyretin (TTR) proteins, which accumulate as amyloid deposits
in various parts of the body, including the nerves, heart and
gastrointestinal tract. Patients may present with polyneuropathy,
cardiomyopathy or both manifestations of disease. There are two
different forms of ATTR – hereditary ATTR (hATTR), which is caused
by a TTR gene variant and affects approximately 50,000 people
worldwide, and wild-type ATTR (wtATTR), which occurs without a TTR
gene variant and impacts an estimated 200,000-300,000 people
worldwide.1-4
About RNAi
RNAi (RNA interference) is a natural cellular process of gene
silencing that represents one of the most promising and rapidly
advancing frontiers in biology and drug development today.5 Its
discovery has been heralded as “a major scientific breakthrough
that happens once every decade or so,” and was recognized with the
award of the 2006 Nobel Prize for Physiology or Medicine.6 By
harnessing the natural biological process of RNAi occurring in our
cells, a new class of medicines known as RNAi therapeutics is now a
reality. Small interfering RNA (siRNA), the molecules that mediate
RNAi and comprise Alnylam’s RNAi therapeutic platform, function
upstream of today’s medicines by potently silencing messenger RNA
(mRNA) – the genetic precursors that encode for disease-causing or
disease pathway proteins – thus preventing them from being made.5
This is a revolutionary approach with the potential to transform
the care of patients with genetic and other diseases.
About Alnylam Pharmaceuticals
Alnylam (Nasdaq: ALNY) has led the translation of RNA
interference (RNAi) into a whole new class of innovative medicines
with the potential to transform the lives of people afflicted with
rare and prevalent diseases with unmet need. Based on Nobel
Prize-winning science, RNAi therapeutics represent a powerful,
clinically validated approach yielding transformative medicines.
Since its founding in 2002, Alnylam has led the RNAi Revolution and
continues to deliver on a bold vision to turn scientific
possibility into reality. Alnylam has a deep pipeline of
investigational medicines, including multiple product candidates
that are in late-stage development. Alnylam is executing on its
“Alnylam P5x25” strategy to deliver transformative medicines in
both rare and common diseases benefiting patients around the world
through sustainable innovation and exceptional financial
performance, resulting in a leading biotech profile. Alnylam is
headquartered in Cambridge, MA. For more information about our
people, science and pipeline, please visit www.alnylam.com
and engage with us on X (formerly Twitter) at @Alnylam, or
on LinkedIn, Facebook, or Instagram.
Alnylam Forward-Looking Statements
This press release contains forward-looking statements within
the meaning of Section 27A of the Securities Act of 1933 and
Section 21E of the Securities Exchange Act of 1934. All statements
other than historical statements of fact regarding Alnylam’s
expectations, beliefs, goals, plans or prospects including, without
limitation, Alnylam’s expectations regarding the safety and
efficacy of vutrisiran for the treatment of ATTR amyloidosis with
cardiomyopathy, including its potential to become a first-line
therapy for patients with ATTR amyloidosis with cardiomyopathy, and
the timing of Alnylam’s global regulatory submissions for
vutrisiran should be considered forward-looking statements. Actual
results and future plans may differ materially from those indicated
by these forward-looking statements as a result of various
important risks, uncertainties and other factors, including,
without limitation, risks and uncertainties relating to: Alnylam’s
ability to successfully execute on its “Alnylam P5x25” strategy;
Alnylam’s ability to successfully demonstrate the efficacy and
safety of its product candidates; the pre-clinical and clinical
results for Alnylam’s product candidates, including vutrisiran;
actions or advice of regulatory agencies and Alnylam’s ability to
obtain regulatory approval for its product candidates, including
vutrisiran, as well as favorable pricing and reimbursement;
successfully launching, marketing and selling Alnylam’s approved
products globally; and any delays, interruptions or failures in the
manufacture and supply of Alnylam’s product candidates or its
marketed products; as well as those risks more fully discussed in
the “Risk Factors” filed with Alnylam’s 2023 Annual Report on Form
10-K filed with the Securities and Exchange Commission (SEC), as
may be updated from time to time in Alnylam’s subsequent Quarterly
Reports on Form 10-Q and in its other SEC filings. In addition, any
forward-looking statements represent Alnylam’s views only as of
today and should not be relied upon as representing its views as of
any subsequent date. Alnylam explicitly disclaims any obligation,
except to the extent required by law, to update any forward-looking
statements.
1 Hawkins PN, Ando Y, Dispenzeri A, et al. Ann Med.
2015;47(8):625-638. 2 Gertz MA. Am J Manag Care.
2017;23(7):S107-S112. 3 Conceicao I, Gonzalez-Duarte A, Obici L, et
al. J Peripher Nerv Syst. 2016;21:5-9. 4 Ando Y, Coelho T, Berk JL,
et al. Orphanet J Rare Dis. 2013;8:31. 5 Elbashir SM, Harborth J,
Lendeckel W, et al. Nature. 2001;411(6836):494-498. 6 Zamore P.
Cell. 2006;127(5):1083-1086.
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Alnylam Pharmaceuticals, Inc. Christine Regan Lindenboom
(Investors and Media) +1-617-682-4340
Josh Brodsky (Investors) +1-617-551-8276
Alnylam Pharmaceuticals (NASDAQ:ALNY)
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