Mitapivat Clinical Development
Agios has two ongoing global, pivotal trials in adults with PK deficiency that are on track to complete enrollment byyear-end 2019. Learn more at activatetrials.com.
| • | | ACTIVATE: A placebo-controlled trial with a 1:1 randomization, expected to enroll approximately 80 patients who do not receive regular transfusions. The primary endpoint of the trial is the proportion of patients who achieve a sustained hemoglobin increase of³1.5 g/dL. |
| • | | ACTIVATE-T: A single arm trial of up to 40 regularly transfused patients with a primary endpoint of reduction in transfusion burden over six months compared to individual historical transfusion burden over prior 12 months. |
In addition, Agios is conducting a Phase 2 study evaluating the efficacy, safety, pharmacokinetics and pharmacodynamics of treatment with mitapivat in adults withnon-transfusion-dependent ß- and α-thalassemia (NTDT). The primary endpoint is hemoglobin response, and approximately 17 participants with NTDT will be enrolled. Mitapivat is also being studied in sickle cell disease under a Cooperative Research and Development Agreement (CRADA) with the U.S. National Institutes of Health.
Mitapivat is not approved for use by any regulatory authority.
About Pyruvate Kinase Deficiency and Genetic Background
Pyruvate kinase (PK) deficiency is a rare, inherited disease that presents as chronic hemolytic anemia, which is the accelerated destruction of red blood cells. The inherited mutations in PKR genes cause a deficit in cellular energy within the red blood cell, as evidenced by lower PK enzyme activity, a decline in adenosine triphosphate levels and abuild-up of upstream metabolites, including2,3-DPG(2,3-diphosphoglycerate).
PK deficiency is associated with chronic hemolysis leading to complications including gallstones, pulmonary hypertension, extramedullary hematopoiesis, cirrhosis, osteoporosis, and iron overload and its sequelae, which occur regardless of transfusion burden. Current management strategies for PK deficiency, including blood transfusion and splenectomy, are associated with both short- and long-term risks.
More than 300 different mutations have been identified to date. The mutations observed in PK deficiency patients are classified in two main categories. A missense mutation causes a single amino acid change in the protein, generally resulting in some functional protein. Anon-missense mutation is any mutation other than a missense mutation, generally resulting in little functional protein. It is estimated that 58 percent of patients with PK deficiency have two missense mutations, 27 percent have one missense and onenon-missense mutation, and 15 percent have twonon-missense mutations1. For more information about PK deficiency, including the signs and symptoms, how to test for it (including a free testing option), and how it is currently managed, visit knowpkdeficiency.com.