Phase 1/2 Study: Efficacy and Safety
The mean improvement in 6-minute walk distance was approximately 22 meters for the 16 patients treated in the 20 mg/kg cohort. In addition, there were three super-responders, or 19 percent of patients, who experienced greater than a 75 meter improvement in 6-minute walk distance from baseline to week 24. For pulmonary function, mean improvement in percent predicted forced vital capacity (FVC) was 1.2 percent in absolute terms, or a 2.0 percent relative improvement from pre-treatment baseline to week 24. Mean improvement in maximum voluntary ventilation (MVV) was 2.9 L/min in absolute terms, or a 4.3 percent relative improvement from pre-treatment baseline to week 24. Mean improvement in percent predicted maximal expiratory pressure (MEP) was 5.1 percent in absolute terms, or a 14.1 percent relative improvement from pre-treatment baseline to week 24. Mean improvement in percent predicted maximal inspiratory pressure (MIP) was 11.0 percent in absolute terms, or a 27.0 percent relative improvement from pre-treatment baseline to week 24. The company conducted a responder analysis in which each patient was assigned a score of plus one for improvement of more than 10 percent and minus one for a decline of 10 percent in the domains of 6-minute walk test, MEP and MIP. Each patient's scores were aggregated by summing the individual domain scores for that patient. Thirteen of the 16 patients scored a plus one or greater; two patients had a score of 0, consistent with stabilization, and one patient declined in one domain.
Side effects for BMN-701 were generally consistent with those seen for other enzyme replacement therapies. The principal clinical adverse event was infusion-associated reaction in two patients, resulting in temporary drug interruption in one patient and drug withdrawal in one patient. Infusion-associated hypoglycemia, an expected pharmacologic effect of BMN-701, occurred in 13 patients in the 20 mg/kg cohort. All hypoglycemia events occurred during or within one hour of infusion, were transient and readily manageable through diet and predominantly asymptomatic.
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