Last Monday the results from the phase 2 study of Interferon Gamma for the treatment of Friedreich’s Ataxia was presented. There was also a presentation held by the pharmaceutical company Horizon Pharma that owns the right to Actimmune/Imukin.
This event was recorded and is available HERE. You can both listen to the webcast and see the slides they used.
I thought I would try to make a short version of the main points of this presentation. This is a mix of the info that was shared from the different speakers.
Just note that I am not part of the studies in any way. I am not a researcher or a doctor. What I write in my blog is based on my own individual experience and how I understand the facts.
SUMMARY
Actimmune (interferon gamma-1b) has been on the market for many years and is already FDA approved for two other orphan diseases (orphan diseases = rare diseases). The first approval came in 1999 for Chronic Granulomatous Disease (CGD).
There have been about 200 clinical trials done on Actimmune. The research is done on a variety of diseases so the safety and tolerability of the drug is well documented.
The good news for us is that since it already is on the market it is usually easier to get it approved for another indication than if it was a whole new molecule. This can speed things up. Speed is a good thing, right?
Not much of the research on FA going on today is done on children. This is because the majority of substances tested are new molecules. Using children as subjects in research is therefore often restricted, but not on Actimmune. Since this medication already is used on children (with other conditions) they were able to do this phase 2 study on children with FA.
STUDY DESIGN
- 12 people, ages 5- 17
- Doses: from 10 micrograms, gradually increased to the maximum dose at 50 mcg
- 12 weeks duration
- Measurements: Frataxin levels, Neurological tests (including FARS). See the other tests below;
RESULTS
Side-effects:
Almost everyone experienced some kind of reaction, but they were minor and typical for IFG. These are the flu-like symptoms.
Frataxin:
The way that frataxin is measured is through blood cells and buccal cells. Buccal cells are the cells you can sample from a swab of the inside of a person’s cheek. You have probably seen this on CSI 😉
The problem with this measurement is that these cells are not affected in FA. The best thing would be to investigate the neurons affected, but this is not possible at the moment. We cannot go to the lab and deliver samples of our spinal cord every other week, right! Some interesting problems we would get then… 😛
Back to the results;
“While there was statistically significant change in frataxin levels it was not at a level or magnitude that could be clinically meaningful.” You can see every individuals change in frataxin below. Every line shows one person. Injections stopped at v5.
Even though the increase is not high enough to make any conclusions at this point, the researchers find this amount of “noise” on the charts unusual and very interesting for further research.
FARS
FARS can be a bit confusing since 0 is good and high numbers are bad. If you have a lower score it means you have improved. A higher score means that you are getting worse.
After 12 weeks the FARS score decreased by 5 points!
Five points might seem very little, but check this out; They say that 6 point increase is the normal progression rate over two years. The results indicate that these children improved about 18 months in neurological function!
This is a significant neurologic improvement.
The improvements did not last when they stopped the injections as the trial ended.
NEXT STEP
As you can see below the phase 3 study is already in planning. Horizon Pharma and FARA will do what they can to speed up this process. Scheduled start of phase 3 is during the second quarter (April – May) of 2015.
Finally a comment about my own FARS score. I started taking Imukin the 27th of August 2013. My FARS at baseline was 47,5. When I re-tested the 10th of December it was 44. That means 3,5 points improvement. I was told that this change was very low, but what I learned from hearing JenNifer Farmers speech last week is that 3,5 points improvement equals over 1 year improvement! That is huge! This was after 15 weeks on Imukin.
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