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New gene therapy for Duchenne muscular dystrophy

Audentes Therapeutics, Inc., a leading Adeno-associated virus (AAV)* based genetic medicines company focused on developing and commercializing innovative products for serious rare neuromuscular diseases; announced it had expanded its scientific platform and pipeline to advance vectorized antisense treatments for the treatment of Duchenne muscular dystrophy (DMD) and myotonic dystrophy type 1 (DM1).

The Gene Therapy Market

Very promising and strong from its first successes, gene therapy benefits from active research and its development intensifies. Generating both hope and caution, it is about to prove its potential. The history of gene therapy is 30 years old. In 1999, the first clinical trials were carried out by the team of Professor Alain Fischer, at Necker Hospital for Sick Children, on young patients with severe immune deficiency (so-called “bubble children”).

The developments are long and require the creation of companies and industrial partnerships.

 

Gene therapy is now a real “promise” for patients and not just a “hope”.

 

In 2016, the U.S. Food and Drug Administration (FDA) approved the first drug to treat DMD, Sarepta’s Exondys 51. It was a long, dramatic and controversial approval journey involving numerous public hearings, internal FDA battles and letters from Congress and leading DMD physicians to the agency.

These deals mark the entry of gene therapy into mainstream drug development. Roche recently acquired Spark Therapeutics for $4.8 billion. Spark developed a gene therapy for rare eye disease and hemophilia. And in 2018, Novartis acquired AveXis for $8.7 billion. AveXis has a gene therapy for spinal muscular atrophy (SMA).

 

Audentes Therapeutics Partners with Nationwide Children’s Center

Published on April 8, 2019

Audentes Therapeutics, Inc., a leading Adeno-associated virus (AAV)* based genetic medicines company focused on developing and commercializing innovative products for serious rare neuromuscular diseases; today announced it had expanded its scientific platform and pipeline to advance vectorized antisense treatments for the treatment of Duchenne muscular dystrophy (DMD) and myotonic dystrophy type 1 (DM1).

To accelerate these promising new programs, Audentes has entered into a licensing agreement and will collaborate with Nationwide Children’s Hospital, utilizing the expertise of Kevin M. Flanigan, M.D. and Nicholas S. Wein, Ph.D., two recognized leaders in the field of genetic medicines for neuromuscular diseases.

 

Matthew R. Patterson, Chairman and Chief Executive Officer – «Today’s announcement represents a significant step forward in expanding our scientific platform and deepening our pipeline of product candidates for neuromuscular diseases with high unmet medical need.

We see tremendous potential in combining AAV with validated oligonucleotide-based approaches to treat diseases that are not amenable to traditional AAV-based gene replacement.

We believe this approach, combined with our in-house large-scale cGMP (current good manufacturing practice) manufacturing capability, can deliver best-in-class therapies for the treatment of Duchenne muscular dystrophy and myotonic dystrophy.»

 

Dr. Flanigan, Director of Nationwide Children’s Center for Gene Therapy – «We are excited to be collaborating with Audentes to advance these novel, highly differentiated approaches for DMD and DM1…»

 

Audentes and Nationwide Children’s are collaborating to develop AT702, an AAV-antisense candidate designed to induce exon two skipping for DMD with duplications of exon 2 and mutations in exons 1-5 of the dystrophin gene. Audentes is currently conducting additional preclinical work and expects to commence a Phase 1/2 study at Nationwide Children’s in the fourth quarter of 2019.

The Audentes approach

Separate from the Nationwide Children’s collaboration, Audentes is also conducting preclinical work to advance AT751 and AT753, additional vectorized exon skipping candidates, to treat DMD patients with genotypes amenable to exon 51 and exon 53 skipping. Both AT751 and AT753 utilize the same vector construct backbone as AT702, enabling a potentially accelerated path into clinical development. With these initial programs, Audentes is targeting more than 25% of patients with DMD and has plans to leverage its vectorized exon-skipping platform to develop further product candidates to address up to 80% of DMD patients over time.

This approach combines the delivery power of AAV with the precision tools of antisense oligonucleotides, or ASOs, to develop potential best-in-class therapeutic candidates for these devastating neuromuscular diseases.

Adeno-associated virus (AAV)*

Adeno-associated virus (AAV) is a small virus that infects humans and some other primate species. AAV is a very attractive candidate for creating viral vectors for gene therapy, and for the creation of isogenic human disease models.

Vectorized exon skipping uses an AAV vector

Vectorized exon skipping uses an AAV vector to deliver an antisense sequence designed to induce cells to skip over faulty or misaligned sections of genetic code, leading to the expression of a more complete, functional protein. For the treatment of DMD, this approach has the potential to provide significant advantages over microdystrophin gene replacement strategies that produce a substantially truncated protein, which may limit the degree and durability of disease correction, as well as existing ASO therapies, whose efficacy is limited by poor biodistribution to muscle tissue.

Antisense therapy (ASO)

Antisense therapy is a form of treatment for genetic disorders or infections. When the genetic sequence of a particular gene is known to cause a particular disease, it is possible to synthesize a strand of nucleic acid (DNA, RNA or a chemical analogue) that will bind to the messenger RNA (mRNA) produced by that gene and inactivate it, effectively turning that gene “off”. This is because mRNA has to be single-stranded for it to be translated. Alternatively, the strand might be targeted to bind a splicing site on pre-mRNA and modify the exon content of an mRNA.

About Audentes Therapeutics, Inc.

Audentes Therapeutics (Nasdaq: BOLD) is a leading AAV-based genetic medicines company focused on developing and commercializing innovative products for serious rare neuromuscular diseases. We are leveraging our AAV gene therapy technology platform and proprietary manufacturing expertise to develop programs across three modalities: gene replacement, vectorized exon skipping, and vectorized RNA knockdown. Our product candidates are showing promising therapeutic profiles in clinical and preclinical studies across a range of neuromuscular diseases. Audentes is a focused, experienced and passionate team driven by the goal of improving the lives of patients. For more information regarding Audentes, please visit www.audentestx.com.

 

About Nationwide Children’s Hospital

Named to the Top 10 Honor Roll on U.S. News & World Report’s 2018-19 list of “Best Children’s Hospitals,” Nationwide Children’s Hospital is one of America’s largest not-for-profit freestanding pediatric health care systems providing wellness, preventive, diagnostic, treatment and rehabilitative care for infants, children and adolescents, as well as adult patients with congenital disease. Nationwide Children’s has a staff of more than 13,000 providing state-of-the-art pediatric care during more than 1.4 million patient visits annually. As home to the Department of Pediatrics of The Ohio State University College of Medicine, Nationwide Children’s physicians train the next generation of pediatricians and pediatric specialists. The Research Institute at Nationwide Children’s Hospital is one of the top 10 National Institutes of Health-funded freestanding pediatric research facilities. More information is available at NationwideChildrens.org.

 

Myotonic dystrophy

Myotonic dystrophy is the most common form of adult-onset muscular dystrophy, with a worldwide prevalence of 14 per 100,000 population. More on muscle.ca

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