BioMarin Pharmaceutical Inc. (NASDAQ: BMRN) announced today an update to its previously reported interim results of an open-label Phase 1/2 study of BMN 270, an investigational gene therapy treatment for severe hemophilia A. The updated results will be presented by John Pasi, Ph.D. F.R.C.P, at Barts and the London School of Medicine and Dentistry and Haemophilia Clinical Director at Barts Health NHS Trust and primary investigator for the BMN 270 Phase 1/2 clinical trial, during an oral presentation at the International Society on Thrombosis and Haemostasis (ISTH) 2017 Congress being held July 8-13, 2017 in Berlin, Germany. Professor Pasi will present the data in a late breaking abstract on July 11, 2017, which will be the only clinical data in gene therapy for hemophilia A to be presented at the meeting.
In the open-label Phase 1/2 study, a total of 15 patients with severe hemophilia A1(defined by the World Federation of Hemophilia (WFH) as having Factor VIII activity levels less than 1%, expressed as a percentage of normal factor activity in blood) received a single dose of BMN 270, seven of whom were treated at a dose of 6e13 vg/kg and an additional six of whom were subsequently treated at a lower dose of 4e13 vg/kg. The other two patients in the study were treated at lower doses as part of dose escalation in the study and did not achieve therapeutic efficacy. According to the WFH rankings of severity of hemophilia A, the normal range of Factor VIII activity levels for people without disease is between 50% and 150%, expressed as a percentage of normal factor activity in blood, and the mild hemophilia A range of Factor VIII activity levels is between 5% and 40%. (See Table 6 for further information on severity levels)
As of the May 31, 2017 data cutoff, all patients at the 6e13 vg/kg dose had reached 52 weeks of post-treatment follow-up. Median and mean Factor VIII levels from week 20 through 52 for the 6e13 vg/kg dose cohort have been consistently within the normal levels post treatment as a percentage calculated based on the numbers of International Units per deciliter (IU/dL) of plasma. (See Table 1). At one year after dosing, the median and mean Factor VIII levels of the 6e13 vg/kg cohort continue to be above 50%. (See Table 6)
Table 1: Factor VIII Levels (%) of 6e13 vg/kg Dose Patients* by Visit (N=7)
Week**
20
24
28
32
36
40
44
48
52
6e13 vg/kg Dose
N***
7
7
7
6
7
7
7
7
7
Median
Factor VIII Level**** (%)
97
101
122
99
99
111
105
105
89
Mean
Factor VIII Level**** (%)
118
129
123
122
116
124
122
106
104
Range
(low, high)
(12, 254)
(12, 227)
(15, 257)
(26, 316)
(31, 273)
(17, 264)
(20,242)
(23,196)
(20, 218)
*All patients had severe hemophilia A, defined as less than 1% of Factor VIII activity levels, expressed as a percentage of normal factor activity in blood. **Weeks were windowed by +/- 2 weeks ***For week 32, one patient had no Factor VIII reading ****Bolded numbers are in the normal range of Factor VIII as defined by the World Federation of Hemophilia, http://www.wfh.org/en/page.aspx?pid=643 (link current as of June 30, 2017). Factor VIII levels are determined by one-stage assay.
The median and mean Factor VIII levels from week 8 to 24 for all patients observed at the 4e13 vg/kg dose are in the mild level. Three of these subjects who have been observed for 24 weeks are at the upper end of mild. (See Table 2 for Factor VIII levels and Table 6 for severity levels)
Table 2: Factor VIII Levels (%) of 4e13 vg/kg Dose Patients* by Visit (N=6)
Week**
4
8
12
16
20
24
4e13 vg/kg Dose
n
6
6
6
3
3
3
Median
Factor VIII Level*** (%)
4
15
21
35
37
33
Mean
Factor VIII Level*** (%)
5
13
19
33
38
33
Range
(low, high)
(2,10)
(3,21)
(6,32)
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