iCo Therapeutics Announces Top-Line Primary Endpoint Data from iCo-007 Phase 2 iDEAL Study in Diabetic Macular Edema
VANCOUVER, June 9, 2014 /PRNewswire/ – iCo Therapeutics Inc. (“iCo” or “the
Company”) (TSX-V: ICO) (OTCQX: ICOTF) today announced top-line results
related to the eight month visual acuity (VA) primary endpoint for
subjects enrolled in the Phase 2 iDEAL Study, conducted in
collaboration with JDRF, evaluating the efficacy and safety after
repeated injections of iCo-007 in patients with Diabetic Macular Edema
Statistical methods employed included both Last Observation Carry
Forward (“LOCF”) and Multiple Imputation (“MI”) analyses given the
departure of patients from the study prior to their eight month visit.
Using both statistical methods, mean changes in visual acuity measures
in all four groups at both month four and month eight were negative.
Using the LOCF method, mean change in VA at eight months was
approximately minus 11 letters (350 µg monotherapy), minus 21 letters
(700 µg monotherapy), minus 14 letters (350 ug + laser arm) and minus
14 letters (350 µg + Lucentis).
Some patients in each cohort did show improvements in mean change in VA.
At eight months using the LOCF analysis, roughly 20% of patients in the
350 µg monotherapy arm gained five letters or greater of vision versus
13% in the 700 µg monotherapy arm, 12% in the 350 µg + laser arm and
11% in the 350 µg + Lucentis arm. At four months, patients gaining five
letters or more for the 350 µg, 700 µg, 350 µg + laser and 350 µg +
Lucentis arms were approximately 24%, 18%, 21% and 30%, respectively.
Using the LOCF method it was observed that at month eight there was an
inverse statistically significant difference in mean VA change from
baseline between 350 µg monotherapy and 700 µg monotherapy arms,
meaning there was greater loss of VA in the 700 µg monotherapy cohort.
There was no statistically significant difference in mean VA between
the 350 µg monotherapy and either 350 µg + laser or 350 µg + Lucentis
arms. When using MI analysis there was no statistically significant
difference observed between 350 µg monotherapy and each of the 700 µg
monotherapy, 350 µg + laser and 350 µg + Lucentis arms.
At eight months, in the 700 µg monotherapy arm, 64% of patients
experienced a 15 letter or greater loss of vision, compared to 33% in
the 350 µg monotherapy arm, 33% in the 350 µg + laser arm, and 41% in
the 350 µg + Lucentis arm. At four months the corresponding numbers
were 29%, 9%, 9%, and 14%, respectively.
“Quite simply, we don’t yet know enough about our patient groups and the
sub-group populations to determine what exactly this data means. To
this end, further data analysis at twelve months including secondary
endpoints will be necessary to better understand the viability of
iCo-007 in DME” said Andrew Rae, President & CEO of iCo Therapeutics.
“There were patients that responded to treatment and others that didn’t
respond. Central retinal thickness and sub group analyses represent
just a few examples of outstanding data sets that are required to give
clarity to the VA data we have generated at eight months. No clear
conclusions can be reached at this time though it appears the patient
population represents a difficult to treat population overall and
therefore analysis of factors such as patient resistance to drugs like
Lucentis and patient history of cataracts and progression in the study
need to be thoroughly analyzed”.
iDEAL Trial Design & Demographics
The iDEAL trial of 187 randomized patients 18 years and older (185
treated), explores whether varying combinations and concentrations of
iCo-007, alone or in combination, are effective in improving visual
acuity in persons with DME.
For more information regarding baseline patient demographics please
refer to the following ARVO 2014 poster related to iCo-007: http://www.arvo.org/webs/am2014/abstract/sessions/238.pdf
The Phase 2 clinical trial is a multi-center study chaired by Quan Dong
Nguyen, MD, MSc, Professor and Chair of Ophthalmology and Director of
the Stanley M. Truhlsen Eye Institute at University of Nebraska Medical
Center (“UNMC”). Recruitment took place at 28 clinical sites across the
United States. In addition, the Retinal Imaging Research and Reading
Center (RIRRC) based at the UNMC serves as the Reading Center for the
The study follows patients for a 12 month period. During the trial,
patients were randomized into one of the following four groups:
-- Cohort 1: Mono-therapy using repeated intravitreal dosing of iCo-007 at 350 µg at day 0, month 4 and if required at month 8 -- Cohort 2: Mono-therapy using repeated intravitreal dosing of iCo-007 at 700 µg at day 0, month 4 and if required at month 8 -- Cohort 3: Combination therapy using repeated intravitreal dosing of iCo-007 at 350 µg with laser photocoagulation at day 0, month 4 and if required at month 8 (laser at month 4 if required) -- Cohort 4: Combination therapy using repeated intravitreal dosing of iCo-007 at 350µg with ranibizumab (Lucentis®) at 0.5 mg (Lucentis® at day 0 followed by iCo-007 at week 2, Lucentis® at month 4 followed iCo-007 two weeks later and again if required at month 8)
To be eligible for the trial, participants must have type 1 or type 2
diabetes, baseline best corrected visual acuity (BCVA) between 20/32
and 20/320 and DME with central retinal thickness equal to or greater
than 250 microns measured by optical coherence tomography (OCT).
For information related to study design, please visit www.clinicaltrials.gov.
All patients in the study have received their final iCo-007 injections
and the last patient 12 month follow-up visit is expected in June 2014.
A Drug Safety Monitoring Committee (“DSMC”) has periodically reviewed
relevant safety data from the clinical trial and iCo currently expects
to report overall safety, and other secondary endpoints, in Q4 2014.
Secondary endpoints of the iDEAL Study will be announced in Q42014.
-- Change in visual acuity from baseline to 12 months -- Change in central retinal thickness from baseline to month 8 and month 12 -- Duration of effect during 12 month follow up period -- Safety of repeated injections -- Pharmacokinetic assessments (PK)
The company expects that the full data set will be presented at a
medical conference later this year.
About Diabetic Macular Edema
Diabetic macular edema (DME) occurs when blood vessels in the retina of
patients with diabetes begin to leak into the macula, the part of the
eye responsible for detailed central vision. These leaks cause the
macula to thicken and swell, progressively distorting acute vision.
While the swelling may not lead to blindness, the effect can cause a
severe loss in central vision. DME is the major cause of vision loss in
people with diabetic retinopathy. People with diabetes have a 10
percent risk of developing the condition during their lifetime. It is
estimated that close to 1,000,000 people in the United States have DME.
A second-generation antisense inhibitor targeting C-raf (ribonucleic
acid – mRNA) and preventing the signaling of multiple growth factors
(not just VEGF), which in turn prevents the production of new and
permeable blood vessels in the back of the eye. Recent results have
shown that the pathways activated by Ras/Raf play a crucial role in
diabetes-associated complications including diabetic retinopathy. Due
to its mechanism of action iCo-007 may eventually be applicable to
neovascular form of age-related macular degeneration (AMD) and other
ocular indications, as well as DME.
JDRF is the leading global organization funding type 1 diabetes (T1D)
research. JDRF’s goal is to progressively remove the impact of T1D
from people’s lives until we achieve a world without T1D. JDRF
collaborates with a wide spectrum of partners and is the only
organization with the scientific resources, regulatory influence, and a
working plan to better treat, prevent, and eventually cure T1D. As the
largest charitable supporter of T1D research, JDRF is currently
sponsoring $568 million in scientific research in 17 countries. For
more information, please visit www.jdrf.org.
About iCo Therapeutics
iCo Therapeutics in-licenses and redefines existing drug candidates or
generics by employing reformulation and delivery technologies for new
or expanded use indications. The Company has exclusive worldwide rights
to two drug candidates – iCo-007 for Diabetic Macular Edema (DME) and
iCo-008 for other sight-threatening diseases. iCo-007 is in Phase 2
clinical studies for DME. With Phase 2 clinical history, iCo-008 is
targeted for the treatment of keratoconjunctivitis and wet age-related
macular degeneration. In addition, iCo holds worldwide rights to an
oral drug delivery platform. The first platform candidate is the Oral
Amp B Delivery system, utilizing a known anti-fungal drug to treat
life-threatening infectious diseases. iCo trades on the TSX Venture
Exchange under the symbol “ICO” and the OTCQX under the symbol “ICOTF”.
For more information, visit the Company website at: www.icotherapeutics.com.
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SOURCE iCo Therapeutics Inc.