On August 15, 2022, Viridian Therapeutics, Inc. (the “Company”) announced positive initial clinical data from the 10mg/kg cohort in its ongoing Phase 1/2 clinical trial of VRDN-001, an anti-IGF-1R antibody, in patients with active thyroid eye disease (“TED”). TED is a rare autoimmune disease in which the body’s own immune system attacks the tissues around and behind the eyes causing inflammation, swelling, and damage, which develops into signs and symptoms of double vision, bulging eyes, and ocular pain. The double-blind, placebo-controlled Phase 1/2 trial is evaluating two infusions of VRDN-001 administered intravenously. The inclusion and exclusion criteria and the baseline patient characteristics for this trial are similar to prior TED clinical trials. Efficacy measurements include proptosis (bulging eyes), Clinical Activity Score (“CAS”), and diplopia (double vision), which are the same endpoints as measured in the clinical development of Tepezza®, the only approved therapy targeting IGF-1R in patients with TED.
Data from Ongoing VRDN-001 Phase 1/2 Proof-of-concept Trial
This ongoing trial is evaluating two infusions of VRDN-001, three weeks apart, with efficacy measured 6 weeks after the first dose. Each dose is evaluated in a cohort of 8 patients, randomized so that 6 patients receive VRDN-001 and 2 patients receive placebo. The first cohort evaluated a dose of 10mg/kg, with initial clinical data reported on August 15, 2022. The second cohort is evaluating a dose of 20mg/kg and enrollment is nearly complete, and the Company plans to report results at an upcoming medical meeting in the fourth quarter of 2022. A third cohort will evaluate a dose of 3mg/kg, with data anticipated in the fourth quarter of 2022.
Initial VRDN-001 Safety Data
VRDN-001 was well-tolerated by all patients treated at the 10mg/kg dose. There were no reported serious adverse events (“SAEs”), no patient discontinuations, and no hyperglycemia or infusion reactions as of August 9, 2022, the cutoff date for follow up observation. Two cases of mild muscle spasm were reported and did not require intervention. There was one report of “ringing in the ears” which resolved within two weeks without intervention.
In the ongoing second TED cohort, which is evaluating two infusions of 20mg/kg of VRDN-001, no adverse events of hyperglycemia, muscle spasm, hearing impairment, infusion reactions, or any serious adverse events were reported as of the cutoff date of August 9, 2022.
Initial VRDN-001 Clinical Activity Data
All patients in the 10mg/kg cohort were treated for two full cycles and were evaluated for proptosis, CAS, and diplopia.
The following clinical activity was observed at week 6:
Proptosis
| • | | 83% proptosis responder rate, defined as a ≥2mm reduction in proptosis from baseline |
| • | | Rapid reduction with a median time to proptosis response of 3 weeks |
| • | | 2.4mm mean reduction in proptosis from baseline |
Clinical Activity Score (CAS)
| • | | 83% of patients achieved maximal or near-maximal therapeutic effect on CAS, defined as reaching a CAS of 0 or 1 on a 7-point composite measure of signs and symptoms of TED |
| • | | 4.3 point mean reduction in CAS from baseline |