The Phase 1b MAD study is a double-blind, placebo-controlled trial evaluating the safety, tolerability, pharmacokinetics and pharmacodynamics (PK/PD) of RGLS8429 in adult patients with ADPKD. The study is evaluating RGLS8429 treatment across three different weight-based dose levels, including measuring changes in urinary polycystins 1 and 2 (PC1 and PC2), htTKV, cyst architecture, and overall kidney function.
In November 2023, Regulus announced it had dosed the first patient in the third cohort of the Phase 1b MAD study. This cohort is receiving 3 mg/kg of RGLS8429 or placebo every other week for three months. In January, the Company announced that it had completed enrollment in cohort 3 with top-line data expected in mid-2024.
In late 2023, Regulus amended the protocol for the Phase 1b MAD study to include a fourth cohort that will receive an open label fixed dose of 300 mg of RGLS8429 that will provide higher exposure in a larger number of patients based on anticipated body weight in order to compare biomarker and safety data to the weight-based dosing, with initiation of screening planned for Q2 2024. Based on the results from the second cohort, the Company plans to amend the protocol to increase the sample size to up to 30 patients in cohort 4.
In December 2023, the Company held a successful Type D meeting with the U.S. Food and Drug Administration (FDA) to discuss the accelerated approval pathway. The meeting was constructive and confirmed the potential for an accelerated approval pathway based on a single pivotal Phase 2 study of RGLS8429 for the treatment of ADPKD. The FDA has adopted an accelerated approval pathway for ADPKD based on a single pivotal trial demonstrating statistically significant reduction in TKV growth compared to placebo, with completion of a post approval Phase 3 trial as a post-marketing requirement, demonstrating a statistically significant improvement in estimated glomerular filtration rate (eGFR) compared to placebo.
Corporate Highlights
Closed Oversubscribed $100 Million Private Placement: On March 12, 2024, the Company announced that it entered into a definitive securities purchase agreement in connection with a private placement to certain institutional and other accredited investors. The financing included participation from new and existing institutional investors, including Adage Capital Partners L.P., Deep Track Capital, the Federated Hermes Kaufmann Funds, New Enterprise Associates (NEA), Octagon Capital, RA Capital Management, and Vivo Capital.
Financial Results
Cash and Cash Equivalents: As of December 31, 2023, Regulus had $23.8 million in cash and cash equivalents. Combined with the $100 million private placement equity financing in March, the Company expects its cash runway to extend into H1 2026.
Research and Development (R&D) Expenses: Research and development expenses were $5.8 million and $21.2 million for the fourth quarter and year ended December 31, 2023, respectively, compared to $4.7 million and $18.4 million for the same periods in 2022, respectively.
General and Administrative (G&A) Expenses: General and administrative expenses were $2.5 million and $10.0 million for the fourth quarter and year ended December 31, 2023, respectively, compared to $2.2 million and $9.8 million for the same periods in 2022, respectively.
Net Loss: Net loss was $8.1 million, or $0.40 per share (basic and diluted), and $30.0 million, or $1.58 per share (basic and diluted), for the fourth quarter and year ended December 31, 2023, compared to $6.8 million, or $0.40 per share (basic and diluted), and $28.3 million, or $1.86 per share (basic and diluted), for the same periods in 2022.