| October
4, 2006
NEW ENGLAND JOURNAL OF MEDICINE Reports
Positive Results From Dynavax' Ragweed
Allergy Therapy Trial
BERKELEY, Calif., Oct. 4 /PRNewswire-FirstCall/
-- The NEW ENGLAND JOURNAL OF MEDICINE
(Vol. 355, October 5, 2006, No.14),
today reported that a new approach
to allergy therapy not only reduced
the acute allergic responses of individuals
with ragweed allergies but also sustained
that effect for over 12 months. The
novel treatment, called "AIC"
in the paper, is a TLR9 agonist linked
to ragweed allergen, developed by
Dynavax Technologies Corporation (Nasdaq:
DVAX).
Dr. Peter Creticos, principal investigator
and lead author of the paper, entitled,
"Immunotherapy with a Ragweed-Toll-like
Receptor 9 Agonist Vaccine for Allergic
Rhinitis," said that the pilot
study "appears to offer a means
of achieving long-term clinical efficacy
in ragweed allergic rhinitis as the
clinical effects suggest the induction
of long-lasting disease modification.
Furthermore, the demonstrated therapeutic
properties and safety pave the way
for a therapeutic intervention that
is qualitatively superior to standard
immunotherapy." Dr. Creticos
is Associate Professor of Medicine
and Clinical Director of the Division
of Clinical Immunology of The Johns
Hopkins University School of Medicine.
He serves as Medical Director of the
Johns Hopkins Asthma and Allergy Center
in Baltimore, Maryland.
In the paper, Dr. Creticos pointed
to statistically significant efficacy
results including peak Nasal Symptom
Complex Score (NSCS) reductions in
AIC-treated patients of 55% (p=0.03)
in 2001 which persisted through the
2002 ragweed season (53% reduction
in NSCS, p=0.02) with no additional
therapy. Additionally, the AIC-treated
group used no relief medication at
all during the second season, while
placebo patients used antihistamines
for 8 days (average) and decongestants
for 4 days (average) of the two-week
peak season. The intervention also
generated clinically significant quality
of life improvements for patients.
Dr. Creticos added that the intervention
was safely tolerated as no treatment-associated
serious adverse reactions were reported,
nor did any lab tests show abnormalities
in the patients tested.
With funding from the National Institute
of Allergy and Infectious Diseases
and the Immune Tolerance Network,
and the study drug provided by Dynavax,
Dr. Creticos conducted a blinded,
randomized, placebo-controlled, clinical
trial in 25 ragweed allergic patients
beginning in May 2001 and concluding
in October, 2002. Patients were treated
with either the drug or placebo, using
a 6-injection regimen, prior to the
first ragweed season, and were followed
for two years. Dynavax supplied the
study drug, now known as TOLAMBA(TM),
and contributed to trial design, but
did not participate in data accrual,
analysis, or funding of the trial.
TOLAMBA, consisting of a TLR9 agonist
linked to a specific ragweed allergen,
is currently being evaluated in late-stage
clinical trials for the treatment
of allergic rhinitis.
DYNAVAX Clinical Trials Update
In the paper, Dr. Creticos recommends
additional large-scale studies, which
are now underway at Dynavax. Since
the reported study's initiation in
2001, Dynavax has generated a substantial
amount of data in 14 clinical trials
in the U.S., France, and Canada. More
than 7,000 TOLAMBA injections have
been administered to over 1,100 patients.
In these trials, TOLAMBA was shown
to be safe and well tolerated, to
provide measurable improvements in
allergy symptoms, and to reduce medication
use.
TOLAMBA consists of 1018 ISS, a TLR9
agonist, linked to the purified major
allergen of ragweed, called Amb a
1. The linking of ISS to Amb a 1 ensures
that both ISS and ragweed allergen
are presented simultaneously to the
same immune cells, producing a highly
specific and potent effect suppressing
the Th2 cells responsible for inflammation
associated with ragweed allergy. Moreover,
this treatment reprograms the immune
response away from the Th2 response
and toward a Th1 memory response so
that, upon subsequent natural exposure
to the ragweed allergen, long-term
protection is achieved.
Other Clinical Results; Trial Background
A Dynavax-funded, 30-center, placebo-controlled
study in 738 ragweed allergic subjects,
aged 18 to 55 years, is expected to
produce interim data at one-year in
the first quarter of 2007. The study
known as "DARTT" (Dynavax
Allergic Rhinitis TOLAMBA Trial) randomized
subjects into three arms: the same
dosing regimen that was used in the
completed Phase 2/3 trial; a higher
total dose regimen; and placebo. Subjects
received six doses over six weeks
prior to the start of the 2006 ragweed
season. Ragweed symptoms were followed
over the 2006 ragweed season and will
also be followed through the 2007
season. The primary endpoint is reduction
in total nasal symptom scores (TNSS)
during the second (2007) peak ragweed
season. Dynavax anticipates that data
from the DARTT interim analysis, if
positive, combined with the safety
and efficacy data from the recently
completed two-year Phase 2/3 trial,
and from an ongoing trial in ragweed
allergic children, could provide sufficient
patient data for determining the potential
timeline to registration for the intervention.
Additionally, Dynavax is evaluating
TOLAMBA in a three-year, 19-center,
pediatric trial with over 300 patients,
ages six to 15 years. The primary
endpoint of the study is reduction
in TNSS during the 2006 peak ragweed
season; a key secondary endpoint is
the prevention of progression to asthma.
The study was initiated in early 2005.
Primary endpoint data for the study
is expected in early 2007.
In January 2006, Dynavax announced
that results from a two-year Phase
2/3 clinical trial of TOLAMBA showed
that patients treated with TOLAMBA
experienced a statistically significant
28.5% reduction in total nasal symptom
scores (TNSS) compared to placebo-treated
patients in the second year of the
trial (p=0.024). Results also showed
significant clinical benefit relative
to secondary endpoints, including
composite hay fever symptoms and ocular
effects, and a significant reduction
in antihistamine use (p=0.01). These
results were achieved after a single
short course of therapy prior to the
first ragweed season (2004), and demonstrated
that a booster dose prior to the second
season (2005) was not required to
achieve clinical benefit. The safety
profile of TOLAMBA was favorable;
systemic side effects were indistinguishable
from placebo and local injection site
tenderness was minor and transient.
TOLAMBA represents the foundation
of a comprehensive allergy franchise
for Dynavax, and has the potential
to be a novel entrant in the multibillion-
dollar global allergy market. In the
U.S. alone, approximately 40 million
people suffer from allergic rhinitis.
Ragweed is the single most common
seasonal allergen, affecting up to
75% of those with allergic rhinitis,
or 30 million Americans. Current therapeutic
options are mainly limited to symptomatic
therapies and conventional allergy
immunotherapy, which generally requires
60-90 shots over three to five years
and represents a significant treatment
burden for allergy sufferers. Dynavax
believes that TOLAMBA has the potential
to become the first of several new
and important disease-modifying therapeutic
options for patients and physicians.
|