MoonLake Immunotherapeutics starts Phase 3 VELA program of the Nanobody(®)
sonelokimab in patients with moderate-to-severe hidradenitis suppurativa
* VELA is the first Phase 3 program in hidradenitis suppurativa to use the
higher clinical response level of HiSCR75 as the primary endpoint
* The topline primary endpoint readout at week 16, together with data on other
endpoints, is expected as of mid-2025
* Program will evaluate sonelokimab for a total of 52 weeks, across VELA-1 and
VELA-2, at sites in the United States and Europe, using a design informed by
the landmark Phase 2 MIRA trial
Zug, Switzerland, May 16, 2024 - MoonLake Immunotherapeutics (MoonLake; Nasdaq:
MLTX), a clinical-stage biotechnology company focused on creating next-level
therapies for inflammatory diseases, today announced that the first patients
have been screened at a U.S. trial site in its global Phase 3 clinical program,
VELA, evaluating sonelokimab, an investigational Nanobody(®) designed to treat
inflammatory disease, in patients with moderate-to-severe hidradenitis
suppurativa (HS).
HS is a severely debilitating chronic skin condition, affecting up to 4.1% of
the global population. Over time, uncontrolled and inadequately treated
inflammation can result in irreversible tissue destruction and scarring.
Sonelokimab is designed to directly target sites of inflammation by inhibiting
the IL-17A/A, IL-17A/F, and IL-17F/F dimers and to penetrate difficult-to-reach
inflamed tissues.
Following the positive results (https://ir.moonlaketx.com/news-releases/news-
release-details/moonlake-immunotherapeutics-announces-full-dataset-its-24-week)
from the landmark Phase 2 MIRA trial, the Phase 3 VELA program is expected to
enroll 800 patients across VELA-1 and VELA-2. Both trials are identical in
design comparing a single 120mg dose of sonelokimab to placebo with the higher
measure of clinical response, Hidradenitis Suppurativa Clinical Response (HiSCR)
75, as the primary endpoint reading out at week 16. From week 16, all patients
will receive the 120mg dose of sonelokimab through to 52 weeks, followed by an
open-label extension for up to two years. The Phase 3 program will use a
protocol design consistent with the Phase 2 MIRA trial, which identified the
optimal dose of sonelokimab for HS. The topline primary endpoint readout (week
16) from the VELA program is expected as of mid-2025.
Kristian Reich, Founder and Chief Scientific Officer at MoonLake commented:
"With real-world data indicating that at least two million Americans have been
diagnosed with and treated for HS, the launch of our Phase 3 VELA program with
our Nanobody(®) sonelokimab, using the higher clinical measure of HiSCR75 as the
primary endpoint and a straightforward, proven study design is a landmark moment
in our efforts to develop novel treatment options for patients suffering with
this under-diagnosed and under-treated condition. We are making significant
progress in establishing clinical trial sites to enroll 800 patients, and we
eagerly anticipate reporting the week 16 primary endpoint readout around mid-
2025."
Hadar Lev-Tov, MD, MAS, Associate Professor, Director Wound Healing Fellowship,
President Hidradenitis Suppurativa Foundation, Dr. Phillip Frost Department of
Dermatology and Cutaneous Surgery, University of Miami, Miller School of
Medicine, added: "HS is a chronic inflammatory skin condition with a range of
debilitating symptoms including pain, malodorous drainage, low mood and
depression. With only two FDA approved biologics, there is still an urgent need
for new treatment options that treat all patient types and lesions, with the
opportunity for inflammatory remission. The unique characteristics and mode of
action of MoonLake's Nanobody(®), sonelokimab to effectively inhibit IL-17F in
addition to IL-17A in deep tissue inflammation has to date shown promising
outcomes, highlighting the importance of this Phase 3 program, and placing HS at
the forefront of dermatological innovation."
Seth B Forman, MD, Principal Investigator at CenExel-FCR added: "It is with
great enthusiasm that I am participating as an investigator in the Phase 3 VELA
program investigating the Nanobody sonelokimab for HS, signifying a substantial
advancement in addressing the critical unmet need for more treatment options for
individuals living with HS. As a physician, I witness first-hand the immense
demand for novel treatment options for people living with HS, particularly those
that can achieve elevated response thresholds (e.g., HiSCR75 and beyond). The
findings from the Phase 2 MIRA trial offer valuable insights into what may be
possible as we work with our patients to establish more ambitious treatment
goals and alleviate the disease burden of this debilitating condition".
The initiation of this Phase 3 program follows the announcement
(https://ir.moonlaketx.com/news-releases/news-release-details/moonlake-
immunotherapeutics-announces-positive-feedback-both-fda) in February 2024 of the
successful outcome of MoonLake's end-of-Phase 2 interactions with the U.S. Food
and Drug Administration (FDA), as well as positive feedback from its
interactions with the European Medicines Agency (EMA), with both regulatory
bodies unanimously supporting MoonLake's proposed approach for advancing its
Phase 3 program in HS.
Sonelokimab is not yet approved for use in any indication.
- Ends -
About the VELA program
The Phase 3 VELA program is expected to enroll 800 patients across VELA-1 and
VELA-2. Both global, randomized, double-blind, placebo-controlled trials are
identical in design evaluating the efficacy and safety of the
Nanobody(®) sonelokimab, administered subcutaneously, in adult patients with
active moderate-to-severe hidradenitis suppurativa. Similar to the design of the
landmark Phase 2 MIRA trial, the primary endpoint is the percentage of
participants achieving Hidradenitis Suppurativa Clinical Response 75 (HiSCR75),
defined as a >=75% reduction in total abscess and inflammatory nodule (AN) count
with no increase in abscess or draining tunnel count relative to baseline. The
trials will also evaluate a number of secondary endpoints, including the
proportion of patients achieving HiSCR50, the change from baseline in
International Hidradenitis Suppurativa Severity Score System (IHS4), the
proportion of patients achieving a Dermatology Life Quality Index (DLQI) total
reduction of >=4, the proportion of patients achieving at least 50% reduction
from baseline in Numerical Rating Scale (NRS50) in the Patient's Global
Assessment of Skin Pain (PGA Skin Pain) and complete resolution of Draining
Tunnels (DT100). Further details are available under NCT06411379 and NCT06411899
at ClinicalTrials.gov. (https://www.clinicaltrials.gov/)
About Sonelokimab
Sonelokimab (M1095) is an investigational -40 kDa humanized Nanobody® consisting
of three VHH domains covalently linked by flexible glycine-serine spacers. With
two domains, sonelokimab selectively binds with high affinity to IL-17A and IL-
17F, thereby inhibiting the IL-17A/A, IL-17A/F, and IL-17F/F dimers. A third
central domain binds to human albumin, facilitating further enrichment of
sonelokimab at sites of inflammatory edema.
Sonelokimab is being assessed in two lead indications, HS and psoriatic
arthritis (PSA), and the Company is pursuing other indications in dermatology
and rheumatology.
For HS, sonelokimab is being assessed in the Phase 3 trials, VELA-1 and VELA-2,
following the successful outcome of MoonLake's end-of-Phase 2 interactions with
the FDA and as well as positive feedback from its interactions with the EMA
announced in February 2024. In June 2023, topline results of the MIRA trial
(NCT05322473) at 12 weeks showed that the trial met its primary endpoint, the
Hidradenitis Suppurativa Clinical Response (HiSCR)75, which is a higher measure
of clinical response versus the HiSCR50 measure used in other clinical trials,
setting a landmark milestone. In October 2023, the full dataset from the MIRA
trial at 24 weeks showed that maintenance treatment with sonelokimab led to
further improvements in HiSCR75 response rates and other high threshold clinical
and patient relevant outcomes. The safety profile of sonelokimab in the MIRA
trial was consistent with previous trials with no new safety signals detected.
For PsA, Phase 3 initiation is anticipated in Q4 2024 following the announcement
in March 2024 of the full dataset from the global Phase 2 ARGO trial (M1095-PSA-
201) evaluating the efficacy and safety of the Nanobody® sonelokimab over 24
weeks in patients with active PsA. Significant improvements were observed across
all key outcomes, including approximately 60% of patients treated with
sonelokimab achieving an American College of Rheumatology (ACR) 50 response and
Minimal Disease Activity (MDA) at week 24. This followed the positive top-line
results in November 2023, where the trial met its primary endpoint with a
statistically significant greater proportion of patients treated with either
sonelokimab 60mg or 120mg (with induction) achieving ACR50 response compared to
those on placebo at week 12. All key secondary endpoints in the trial were met
for the 60mg and 120mg doses with induction. The safety profile of sonelokimab
in the ARGO trial was consistent with previous trials with no new safety signals
detected.
A Phase 2 trial is expected to be initiated in 2024 for palmo-plantar pustulosis
(PPP), a debilitating inflammatory skin condition affecting a significant number
of patients. In addition, a Phase 3 trial is expected to initiate in juvenile
HS, a condition that typically manifests at this early stage of a patient's
life, and the period in which irreversible damage and inflammatory remission is
most critical.
Sonelokimab will also be assessed in seronegative spondyloarthritis with Phase
2 trials in radiographic and non-radiographic axial spondyloarthritis (axSpA)
and PsA expected to start in 2024. The trials are set to incorporate innovative
designs that enhance traditional clinical outcomes with contemporary tissue and
cellular imaging techniques.
Sonelokimab has also been assessed in a randomized, placebo-controlled Phase 2b
trial (NCT03384745) in 313 patients with moderate-to-severe plaque-type
psoriasis. High threshold clinical responses (Investigator's Global Assessment
Score 0 or 1, and Psoriasis Area and Severity Index 90/100) were observed in
patients with moderate-to-severe plaque-type psoriasis. Sonelokimab was
generally well tolerated, with a safety profile similar to the active control,
secukinumab (Papp KA, et al. Lancet. 2021; 397:1564-1575).
In an earlier Phase 1 trial in patients with moderate-to-severe plaque-type
psoriasis, sonelokimab has been shown to decrease (to normal skin levels) the
cutaneous gene expression of pro-inflammatory cytokines and chemokines (Svecova
D. J Am Acad Dermatol. 2019;81:196-203).
About Nanobodies(®)
Nanobodies(®) represent a new generation of antibody-derived targeted therapies.
They consist of one or more domains based on the small antigen-binding variable
regions of heavy-chain-only antibodies (VHH). Nanobodies(®) have a number of
potential advantages over traditional antibodies, including their small size,
enhanced tissue penetration, resistance to temperature changes, ease of
manufacturing, and their ability to be designed into multivalent therapeutic
molecules with bespoke target combinations.
The terms Nanobody(®) and Nanobodies(®) are trademarks of Ablynx, a Sanofi
company.
About Hidradenitis Suppurativa
Hidradenitis suppurativa is a severely debilitating chronic skin condition
resulting in irreversible tissue destruction. HS manifests as painful
inflammatory skin lesions, typically around the armpits, groin, and buttocks.
Over time, uncontrolled and inadequately treated inflammation can result in
irreversible tissue destruction and scarring. The disease affects 0.05-4.1% of
the global population, with three times more females affected than males. Real-
world data in the US indicates that at least 2 million unique patients have been
diagnosed with and treated for HS between 2016 and 2023 alone, highlighting a
significant unmet need and impact on healthcare systems, and a market
opportunity exceeding $10bn by 2035. Onset typically occurs in early adulthood
and HS has a profound negative impact on quality of life, with a higher
morbidity than other dermatologic conditions. There is increasing scientific
evidence to support IL-17A- and IL-17F-mediated inflammation as a key driver of
the pathogenesis of HS, with other identified risk factors including genetics,
cigarette smoking, and obesity.
About MoonLake Immunotherapeutics
MoonLake Immunotherapeutics is a clinical-stage biopharmaceutical company
unlocking the potential of sonelokimab, a novel investigational Nanobody® for
the treatment of inflammatory disease, to revolutionize outcomes for patients.
Sonelokimab inhibits IL-17A and IL-17F by inhibiting the IL-17A/A, IL-17A/F, and
IL-17F/F dimers that drive inflammation. The company's focus is on inflammatory
diseases with a major unmet need, including hidradenitis suppurativa and
psoriatic arthritis - conditions affecting millions of people worldwide with a
large need for improved treatment options. MoonLake was founded in 2021 and is
headquartered in Zug, Switzerland. Further information is available at
www.moonlaketx.com (http://www.moonlaketx.com).
Cautionary Statement Regarding Forward Looking Statements
This press release contains certain "forward-looking statements" within the
meaning of the U.S. Private Securities Litigation Reform Act of 1995. Forward-
looking statements include, but are not limited to, statements regarding
MoonLake's expectations, hopes, beliefs, intentions or strategies regarding the
future including, without limitation, statements regarding: plans for and timing
of clinical trials, including the topline primary endpoint readout for the Phase
3 VELA program, the trial design and patient enrollment across the VELA-1 and
VELA-2 trials, the initiation of the Phase 3 program in PsA, commencement of
clinical trials of sonelokimab in PPP, juvenile HS and seronegative
spondyloarthritis, the efficacy and safety of sonelokimab for the treatment of
HS and PsA, including in comparison to existing standards or care or other
competing therapies, clinical trials and research and development programs and
the anticipated timing of the results from those studies and trials. In
addition, any statements that refer to projections, forecasts, or other
characterizations of future events or circumstances, including any underlying
assumptions, are forward- looking statements. The words "anticipate," "believe,"
"continue," "could," "estimate," "expect," "intend," "may," "might," "plan,"
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expressions may identify forward-looking statements, but the absence of these
words does not mean that statement is not forward looking.
Forward-looking statements are based on current expectations and assumptions
that, while considered reasonable by MoonLake and its management, as the case
may be, are inherently uncertain. New risks and uncertainties may emerge from
time to time, and it is not possible to predict all risks and uncertainties.
Actual results could differ materially from those anticipated in such forward-
looking statements as a result of various risks and uncertainties, which
include, without limitation, risks and uncertainties associated with MoonLake's
business in general and limited operating history, difficulty enrolling patients
in clinical trials, state and federal healthcare reform measures that could
result in reduced demand for MoonLake's product candidates and reliance on third
parties to conduct and support its preclinical studies and clinical trials and
the other risks described in or incorporated by reference into MoonLake's Annual
Report on Form 10-K for the year ended December 31, 2023 and subsequent filings
with the Securities and Exchange Commission.
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person that the forward-looking statements set forth herein will be achieved or
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