08 June 2023 | Thursday | News
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- Coya reports new data illustrating that administration of COYA 301 (low dose Interleukin-2 (IL-2)) in an open- label study in 8 patients with mild to moderate AD (COYA 301 Trial) resulted in a statistically significant reduction in the expression of three well characterized proinflammatory cytokines -- Tumor Necrosis Factor alpha (TNF-α), Interleukin 6 (IL-6), and Interleukin 1- Beta (IL-1β) -- which correlated with lack of cognitive decline of the patients over the course of the study.
- TNF-α is one of the main inflammatory cytokines involved in initiating and propagating an inflammatory response and its role in the pathophysiology of AD has been documented. The proinflammatory cytokines IL-6 and IL-1β have also been documented to play a central role in AD and in the development of neuroinflammation and induction of neuronal damage.
- Furthermore, Coya reports a case study of a patient in the COYA 301 trial who had pre-treatment and post-treatment Positron Emission Tomography (PET) brain scans to evaluate neuroinflammation. Meaningful reductions in neuroinflammation were observed throughout the cerebral cortex including hippocampal regions following treatment with COYA 301, which correlated with improvement in cognitive function in this patient.
- Coya previously reported that patients in the COYA 301 trial achieved a statistically significant improvement in cognitive function, as measured by the Mini-Mental State Examination test (MMSE) and no cognitive decline when measured by the Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog), and the Clinical Dementia Rating-Sum of Boxes scale (CDR-SB).
- Coya also previously reported that treatment with COYA 301 restored peripheral Treg function and numbers, significantly lowered the levels of systemic chemokines CCL11, CCL2, and cytokine IL-15, and was well tolerated.
- An ongoing academic phase 2 double blind randomized trial (supported by the Gates Foundation and Alzheimer's Association) for use of low dose IL-2 in up to 46 mild to moderate AD patients that is underway at Houston Methodist (led by Alireza Faridar M.D. and the Chair of Coya's SAB, Stanley Appel, M.D.), should report top line data in Q2 2024, and inform Coya on its strategy.
The open-label study enrolled 8 patients with confirmed presence of brain amyloid pathology and baseline MMSE scores between 12 and 25. The patients were treated with five day-courses of COYA 301 for four monthly cycles and were followed for two months post-treatment. Treg function and numbers, serum biomarkers of inflammation, and cognitive functioning as measured by the ADAS-Cog, CDR-SB and MMSE assessment tools were evaluated.
Clinically, evaluation of cognitive function showed that administration of COYA 301 resulted in a statistically significant improvement in mean MMSE scores during the treatment phase, compared to mean MMSE score at baseline (p=0.015). Consistent with the positive trend in MMSE score, mean scores in ADAS-Cog and CDR-SB scales did not significantly change at the end of treatment with COYA 301, compared to pre-treatment baseline scores, indicating no cognitive decline as measured by these validated instruments.
In addition to COYA 301 administration resulting in a statistically significant reduction of blood biomarkers CCL11, CCL2, and IL-15. Today, we report statistically significant reductions in the peripheral expression of the pro-inflammatory cytokines TNF-α, IL-6, and IL-1β. These biomarkers are well characterized in playing a central role in AD pathophysiology, propagation of neuroinflammation, and contribution to neuronal damage. The consistent reduction of these cytokines correlated with lack of cognitive decline of the patients over the course of the study. Further, the significant reduction of proinflammatory cytokine expression and the lack of clinical decline also correlated with significant increase of regulatory T cell function following the administration of COYA 301.
One of the patients in the study underwent a pre- and post-treatment PET brain scan using a radioligand for imaging 18 kDa translocator protein (TSPO), a biomarker for neuroinflammation. Increased binding of TSPO to activated microglia in brain regions is indicative of heightened inflammation and be observed with a color code with red, orange, and yellow. In contrast, images in green and blue indicate lower levels of neuroinflammation. In this patient, the pre-treatment PET scan showed high levels of TSPO binding indicative of inflammation throughout the cerebral cortex in both sagittal and coronal views, including in hippocampal regions. The PET scan after the last cycle of COYA 301 showed marked reduction in TSPO binding across the brain representing lowered inflammation. This reduction in inflammation corresponded to improvement in cognitive function as measured by MMSE scores in this patient with AD.
"We believe these additional data further support our Treg-focused approach to develop safe and effective treatments for neurodegenerative diseases of high unmet need. We remain excited about the outcome of our studies with COYA 301 in AD and COYA 302 in ALS, and look forward to the next steps in progressing these programs," Howard H Berman, Ph.D., founder and Chief Executive Officer of Coya commented.