Akari Therapeutics Announces Completion of Phase II Trial

Akari Therapeutics, Plc recently announced additional data for its Phase II COBALT clinical trial and provides an update on other clinical trials with Coversin. The final three patients enrolled in the eight patient 90-day open-label Phase II single-arm COBALT clinical trial for patients with PNH who have never received a complement blocking therapy, have now completed the trial. They had a median LDH (lactate dehydrogenase; an indicator of hemolysis) of <1.5 times the ULN (upper limit of normal) at day 28, day 60 and day 90. As previously disclosed, these three patients utilized the higher 45 mg per day subcutaneous dose of Coversin. The 45 mg dosing regimen is the intended dose for the Phase III PNH trials of Coversin discussed with the US FDA in September 2017.

The trial achieved its primary endpoint, defined as a reduction in LDH to ≤1.8 times the ULN at day 28. Seven of the eight enrolled patients completed the 90-day trial.

Of the seven patients who completed the COBALT trial, six were transfusion-dependent prior to the trial. Of those six patients, three have not required transfusions while on Coversin during the COBALT trial. All seven patients that completed the study had a CH50 level below the limit of quantification (<8 CH50 U Eq/mL) after the ablating dose phase indicating total blockade of the terminal complement pathway.

All of the seven patients who completed the COBALT trial have entered the long-term safety study, CONSERVE, and have been receiving Coversin subcutaneously for between 4 to 13 months. The CONSERVE safety database is intended to contribute to the approval package after completion of Phase III trials and the primary objective of CONSERVE is to determine the safety profile of long-term Coversin treatment. To date there have been no drug-related serious adverse events reported.

The three long-term (more than six months in CONSERVE) patients in CONSERVE, who were transfusion dependent on entry into COBALT, have remained transfusion dependent throughout COBALT and CONSERVE and have seen relatively stable LDH levels with mean values between 1.8 and 2.2 times the ULN. One additional long term patient has experienced intermittent rises in LDH, while one of the patients recently enrolled in CONSERVE experienced a rise in LDH believed to be associated with a febrile illness – their LDH levels have ranged between 1.8 to 3.1 times the ULN. The last two patients to complete COBALT have just entered CONSERVE with LDH levels of 1.5 and 1.2 times the ULN.

A Phase III trial of Coversin in PNH patients who have not previously been treated with a complement inhibitor (CAPSTONE) is anticipated to begin at the end of the first quarter of 2018.

The Company also announces the following developments:

-A Phase II clinical trial for Coversin in atypical Hemolytic Uremic Syndrome (aHUS) has been initiated.

-The Company continues to develop Coversin in indications that take advantage of the dual-acting properties of the drug to inhibit both C5 and LTB4. To that end, two Phase II clinical trials, in the inflammatory-mediated eye disorder Atopic Keratoconjunctivitis (AKC) and in the skin inflammatory disease Bullous Pemphigoid (BP), are anticipated to begin in the first half of 2018.

“We are pleased to announce the completion of our Phase II program in PNH, with the last three patients achieving a low LDH level at day 28 on patient-administered 45mg per day – the dose we intend to use in our upcoming Phase III CAPSTONE trial,” commented Dr. David Horn Solomon, Chief Executive Officer of Akari Therapeutics. “We anticipate progressing into a Phase III clinical trial in PNH by the end of the first quarter of 2018 and remain focused on advancing Coversin into Phase II trials this year in AKC and BP, both orphan indications with significant unmet need. This is an exciting time for Akari, patients, and caregivers as we continue to build on the momentum in the business and work towards commercializing treatments for orphan autoimmune and inflammatory diseases.”

For the seven patients that completed the study, LDH as a multiple of ULN (xULN) was 1.4, 2.2, 2.3, 1.4, 1.3, 1.6 and 1.3 at day 28; 1.5, 2.1, 1.8, 1.5, 1.3, 1.4 and 2.2 at day 60; and 1.6, 2.4, 2.0, 1.9, 1.2, 1.5 and 2.5 at day 90. Data from CONSERVE not yet source data verified.

Akari is a biopharmaceutical company focused on developing inhibitors of acute and chronic inflammation, specifically the complement system, the eicosanoid system and the bioamine system for the treatment of rare and orphan diseases, in particular those where the complement system or leukotrienes or both complement and leukotrienes together play a primary role in disease progression. Akari’s lead drug candidate Coversin is a C5 complement inhibitor currently being evaluated in paroxysmal nocturnal hemoglobinuria (PNH) and atypical hemolytic uremic syndrome (aHUS). In addition to its C5 inhibitory activity, Coversin independently and specifically inhibits leukotriene B4 (LTB4) activity. Akari intends to evaluate Coversin in two conditions, the skin and eye diseases bullous pemphigoid and atopic keratoconjunctivitis, where the dual action of Coversin on both C5 and LTB4 may be beneficial. Akari is also developing other tick derived proteins, including long acting versions.