Novel Mechanistic Approach to Directly Modulating Muscle Contractility May Represent a Promising Strategy to Treat Serious Neuromuscular Disorders
SOUTH SAN FRANCISCO, CA, Mar 05, 2012 (MARKETWIRE via COMTEX) --Cytokinetics, Incorporated (NASDAQ: CYTK) announced today the
publication of preclinical research regarding the activation of the
troponin complex of fast skeletal muscle by its drug candidate
CK-2017357 and the potential therapeutic role that this novel
mechanism may play for patients with neuromuscular disorders. This
publication in the March 2012 issue of the journal Nature Medicine
reveals the mechanism of action for CK-2017357 and the scientific
rationale for directly modulating fast skeletal muscle contractility
as an innovative therapeutic strategy for improving physical activity
in diseases in which neuromuscular function is compromised.
"We are honored to have Cytokinetics' novel scientific research into
direct modulators of the skeletal muscle contractile apparatus
published in this prestigious journal," stated Fady I. Malik, MD,
PhD, FACC, Cytokinetics' Vice President of Biology and Therapeutics
and senior author of this report. "This publication summarizes
pioneering work performed by our dedicated research team that has
supported the progression of CK-2017357 into Phase II clinical
development for the potential treatment of patients with
neuromuscular diseases."
The publication, titled "Activation of Fast Skeletal Muscle Troponin
as a Potential Therapeutic Approach for Treating Neuromuscular
Diseases," discusses the potential clinical role for therapies that
directly activate troponin in fast skeletal muscle. The authors
sought to compensate for the limited neural input which results in
muscle weakness, a hallmark of many neuromuscular diseases.
CK-2017357, a small-molecule, direct activator of fast skeletal
muscle troponin, was developed as a potential pharmacologic treatment
intended to increase muscle strength by amplifying the response of
muscle when neural input is diminished secondary to neuromuscular
disease.
In this publication, the authors demonstrated that CK-2017357 binds
selectively to the troponin complex in fast-twitch skeletal muscle
and slows the rate of calcium release from Troponin C, thereby
sensitizing the muscle to calcium. As a consequence, the
force-calcium relationship of the muscle fibers shifted leftwards, as
did the force-frequency relationship of a nerve-muscle pair. In both
in vitro and in vivo experiments, CK-2017357 increased the production
of force at sub-maximal nerve stimulation rates. Notably, in an
animal model of myasthenia gravis, sensitization of the fast-twitch
skeletal muscle troponin complex to calcium improved muscle force and
grip strength immediately after administration of single doses of
CK-2017357. The authors concluded that troponin activation may
provide a new therapeutic approach to improve physical activity in
diseases where neuromuscular function is compromised.
"We believe this novel mechanism of action has the potential to
translate into clinically relevant improvements in muscle function
and may significantly contribute to enhancing the quality of life for
patients suffering from neuromuscular diseases," stated Robert I.
Blum, Cytokinetics' President and Chief Executive Officer.
"CK-2017357, our first-in-class skeletal troponin activator, has
arisen from our scientists' steadfast commitment to research directed
to the biology of muscle function and their focus to the discovery
and development of potential therapeutic options that may
meaningfully improve the lives of patients suffering from seriously
debilitating neuromuscular diseases like amyotrophic lateral
sclerosis or ALS."
Background on Cytokinetics Skeletal Muscle Contractility Program
Skeletal muscle contractility is driven by the sarcomere, the
fundamental unit of skeletal muscle contraction. The sarcomere is a
highly ordered cytoskeletal structure composed of skeletal muscle
myosin, the cytoskeletal motor that is directly responsible for
converting chemical energy into mechanical force, as well as actin,
and a set of regulatory proteins, troponins and tropomyosin, which
make the actin-myosin interaction dependent on changes in
intracellular calcium levels. Cytokinetics' skeletal muscle
contractility program is focused to the discovery and development of
small molecule skeletal sarcomere activators and leverages
Cytokinetics' expertise developed in its ongoing discovery and
development of cardiac sarcomere activators, including the cardiac
myosin activator omecamtiv mecarbil, now in Phase II clinical
development as a potential treatment for heart failure. CK-2017357, a
fast skeletal muscle troponin activator, is the lead drug candidate
from the company's skeletal muscle contractility program. CK-2017357
selectively activates the fast skeletal muscle troponin complex by
increasing its sensitivity to calcium, leading to an increase in
skeletal muscle force. This mechanism of action has demonstrated
encouraging pharmacological activity in preclinical models that may
relate to the potential treatment of diseases associated with aging,
muscle wasting or neuromuscular dysfunction. In addition, CK-2017357
has shown pharmacological activity in healthy volunteers, in patients
with amyotrophic lateral sclerosis ("ALS"), and in patients with
peripheral artery disease and claudication. The clinical effects of
muscle wasting, fatigue and loss of mobility can range from decreased
quality of life to, in some instances, life-threatening
complications. By directly improving skeletal muscle function, a
small molecule activator of the skeletal sarcomere may potentially
enhance physical performance and quality of life in patients
suffering from diseases or medical conditions characterized or
complicated by muscle weakness or wasting.
Development Status of CK-2017357 in ALS
Cytokinetics is developing CK-2017357, a skeletal muscle activator,
as a potential treatment for diseases and conditions associated with
aging, muscle wasting or neuromuscular dysfunction. CK-2017357 is
currently the subject of a Phase II clinical development program and
has been granted orphan-drug designation by the U.S. Food and Drug
Administration for the potential treatment of ALS, a debilitating
disease of neuromuscular impairment.
CK-2017357 demonstrated potentially clinically relevant
pharmacodynamic effects in a Phase IIa Evidence of Effect clinical
trial in ALS patients. In that trial, the single doses of CK-2017357
evaluated appeared generally well-tolerated. In addition, both
patients and investigators perceived a dose-dependent positive change
in the patients' overall status at 6 hours after dosing with
CK-2017357, based on a Global Assessment in which the patient and the
investigator each independently assessed the patient's status
compared to prior to dosing. Furthermore, there was a clear
relationship between improvements in Global Assessments and plasma
concentrations of CK-2017357 Also at this 6-hour time point, there
was a trend towards decreased muscle fatigability, as evidenced by
data from a test of sub-maximal hand-grip endurance. Data from that
clinical trial also demonstrated a statistically significant increase
in the maximum volume of air patients could inhale and exhale
(Maximum Voluntary Ventilation) at both 6 and 24 hours after 500 mg
of CK-2017357, as well as small but statistically significant
increases in maximum strength of certain muscle groups tested.
In December 2011, the company reported data from Part A of its
ongoing Phase II clinical trial (CY 4024), in which 24 ALS patients
who were not concurrently taking riluzole were randomized to one of
four different treatment groups to receive daily oral doses of
placebo or 125 mg, 250 mg, or 375 mg of CK-2017357, respectively, for
two weeks. CK-2017357 was well-tolerated by these patients at all
dose levels studied. The incidence of dizziness, the most common
adverse event, appeared dose-related but was mild in severity in all
patients who completed study drug treatment. Most reports of
dizziness began early after initiating treatment and resolved
spontaneously within the first week of treatment in all but one
patient who nevertheless completed the trial No serious adverse
events were reported. The second cohort of this clinical trial, or
Part B, is ongoing, and is intended to enroll approximately 24 ALS
patients who are concurrently taking riluzole; otherwise, Part B is
identical in design to Part A. An additional Phase II clinical trial
(CY 4025) designed to evaluate the safety and tolerability of an
ascending dose-titration regimen of CK-2017357 is also ongoing.
Cytokinetics anticipates that results from each of these two clinical
trials will be presented at the American Academy of Neurology 64th
Annual Meeting in New Orleans, LA on April 25, 2012.
Cytokinetics has met with the U.S. Food and Drug Administration's
Center for Drug Evaluation and Research's Division of Neurology
Products and with the European Medicines Agency to discuss its
progress in the development of CK-2017357 as a potential treatment
for patients with ALS and the company's plans for its further
development, including potential registration strategies.
Cytokinetics is assessing options that may enable the initiation of a
registration program for CK-2017357. Cytokinetics anticipates having
additional meetings with U.S. and European regulatory authorities
during 2012 to discuss the development of CK-2017357 as a potential
treatment for patients with ALS, including potential registration
strategies.
In July 2010, Cytokinetics was awarded a grant of approximately $2.8
million from the National Institute of Neurological Disorders and
Stroke to support research and development of CK-2017357 in
myasthenia gravis. The grant was awarded under the American Recovery
and Reinvestment Act of 2009. Cytokinetics continues to enroll and
dose patients in a Phase IIa Evidence of Effect clinical trial of
CK-2107357 in patients with generalized myasthenia gravis.
Cytokinetics anticipates that data will be available from this trial
in the first half of 2012.
About Cytokinetics
Cytokinetics is a clinical-stage biopharmaceutical company focused on
the discovery and development of novel small molecule therapeutics
that modulate muscle function for the potential treatment of serious
diseases and medical conditions. Cytokinetics' lead drug candidate
from its cardiac muscle contractility program, omecamtiv mecarbil, is
in Phase II clinical development for the potential treatment of heart
failure. Amgen Inc. holds an exclusive license worldwide (excluding
Japan) to develop and commercialize omecamtiv mecarbil and related
compounds, subject to Cytokinetics' specified development and
commercialization participation rights. Cytokinetics is independently
developing CK-2017357, a skeletal muscle activator, as a potential
treatment for diseases and conditions associated with aging, muscle
wasting or neuromuscular dysfunction. CK-2017357 is currently the
subject of a Phase II clinical trials program and has been granted
orphan-drug designation by the U.S. Food and Drug Administration for
the potential treatment of amyotrophic lateral sclerosis, a
debilitating disease of neuromuscular impairment in which CK-2017357
demonstrated potentially clinically relevant pharmacodynamic effects
in a Phase IIa trial. Cytokinetics is also conducting research of
compounds that inhibit smooth muscle contractility and which may be
useful as potential treatments for diseases and conditions associated
with excessive smooth muscle contraction, such as bronchoconstriction
associated with asthma and chronic obstructive pulmonary disorder
(COPD). All of these drug candidates and potential drug candidates
have arisen from Cytokinetics' research activities and are directed
towards the cytoskeleton. The cytoskeleton is a complex biological
infrastructure that plays a fundamental role within every human cell.
Additional information about Cytokinetics can be obtained at
www.cytokinetics.com.
This press release contains forward-looking statements for purposes
of the Private Securities Litigation Reform Act of 1995 (the "Act").
Cytokinetics disclaims any intent or obligation to update these
forward-looking statements, and claims the protection of the Act's
Safe Harbor for forward-looking statements. Examples of such
statements include, but are not limited to, statements relating to
Cytokinetics' and its partners' research and development activities,
including plans for and the initiation, conduct, design and results
of clinical trials for CK-2017357, the significance and utility of
such results, the anticipated timing for the availability of such
results and planned presentations of such results, anticipated
meetings with regulatory authorities and potential initiation of a
registration program for CK-2017357; and the properties and potential
benefits of CK-2017357 and Cytokinetics' other drug candidates and
potential drug candidates, including CK-2017357's potential utility
in the treatment of patients with ALS and myasthenia gravis. Such
statements are based on management's current expectations, but actual
results may differ materially due to various risks and uncertainties,
including, but not limited to, potential difficulties or delays in
the development, testing, regulatory approvals for trial
commencement, progression or product sale or manufacturing, or
production of Cytokinetics' drug candidates that could slow or
prevent clinical development or product approval, including risks
that current and past results of clinical trials or preclinical
studies may not be indicative of future clinical trials results,
patient enrollment for or conduct of clinical trials may be difficult
or delayed, Cytokinetics' drug candidates may have adverse side
effects or inadequate therapeutic efficacy, the U.S. Food and Drug
Administration (FDA) or foreign regulatory agencies may delay or
limit Cytokinetics' or its partners' ability to conduct clinical
trials, the FDA may not grant CK-2017357 orphan drug exclusivity in
ALS even if it is approved for marketing, and Cytokinetics may be
unable to obtain or maintain patent or trade secret protection for
its intellectual property; Amgen's decisions with respect to the
design, initiation, conduct, timing and continuation of development
activities for omecamtiv mecarbil; Cytokinetics may incur
unanticipated research and development and other costs or be unable
to obtain additional financing necessary to conduct development of
its products on acceptable terms, if at all; funding from the
National Institute of Neurological Disorders and Stroke may not be
available in future periods; Cytokinetics may be unable to enter into
future collaboration agreements for its drug candidates and programs
on acceptable terms, if at all; standards of care may change,
rendering Cytokinetics' drug candidates obsolete; competitive
products or alternative therapies may be developed by others for the
treatment of indications Cytokinetics' drug candidates and potential
drug candidates may target; and risks and uncertainties relating to
the timing and receipt of payments from its partners, including
milestones and royalties on future potential product sales under
Cytokinetics' collaboration agreements with such partners. For
further information regarding these and other risks related to
Cytokinetics' business, investors should consult Cytokinetics'
filings with the Securities and Exchange Commission
Contact:
Jodi Goldstein
Manager, Marketing & Corporate Communications
(650) 624-3000
SOURCE: Cytokinetics, Inc.