Prof. Juerg Nussberger, MD, University Hospital of the Canton of Vaud
(CHUV), in Lausanne, Switzerland, presents today detailed results of a
placebo-controlled, double-blind phase IIa clinical trial with CYT006-AngQb
in 72 patients with mild to moderate hypertension. In addition, the
American Heart Association publishes today at the time of presentation an
independent News Release about the vaccine CYT006-AngQb. For more
information on this report please visit scientificsessions.
The study was designed to evaluate safety, tolerability, and
exploratory efficacy of two dose levels of the vaccine (100 micrograms and
300 micrograms).For efficacy evaluation, the change in blood pressure from
baseline to post-treatment was assessed in individual subjects by 24-hour
ambulatory blood pressure monitoring.
Both dose levels of CYT006-AngQb tested were safe and well tolerated.
The majority of side effects observed were transient and mostly mild local
injection site reactions. During the entire safety follow-up period from
month 4 to 12 after the first injection, no vaccine-related adverse events
were reported. This confirms the excellent safety and tolerability profile
of the vaccine and underscores its potential for long-term disease
management.
All patients who received the vaccine mounted a strong antibody
response against angiotensin II, which was dose-dependent and long-lived
but reversible with a half-life of about 4 months. Also efficacy was
dose-dependent and a significant reduction of the mean ambulatory day-time
blood pressure was observed in the group who received the 300 mg dose of
the vaccine. Systolic blood pressure (SBP) was reduced by 5.6 mmHg and
diastolic blood pressure (DBP) by 2.8 mmHg from baseline.
Furthermore, strong efficacy of the vaccine was observed in the early
morning hours, a critical time period when serious cardiovascular events
occur frequently. The early morning rise of blood pressure starting at 5 am
was significantly reduced by the vaccine, leading at 8 am to a blood
pressure difference from baseline of (SBP / DBP) - 25 / - 13 mmHg compared
to placebo.
Prof. Juerg Nussberger comments: "Despite the fact that effective drugs
are available to treat hypertension, only about one out of four
hypertensive patients has the blood pressure successfully controlled. Once
people are aware of the often symptomless hypertension, they have to take
their medications daily, and many are apparently unable or unwilling to
take pills every day for the rest of their lives. The major remaining
medical need in this important therapeutic area is thus improved patient
compliance. If we could support or substitute the oral therapy with a
vaccine that would need to be given just every few months, I think we could
achieve a better control of high blood pressure."
Prof. Nussberger adds: "A particularly interesting finding of this
study is the excellent control of the blood pressure in the early morning
hours achieved by the vaccine. This is a crucial time period when serious
events like myocardial infarction and stroke are more likely to occur than
during other times of the day. Since currently available drugs often have
too short half-lives to affect the rise in early morning blood pressure,
this could become a major advantage of the novel vaccine approach. I am
looking forward to the next steps in clinical development for this
promising vaccine candidate."
About CYT006-AngQb
CYT006-AngQb is a therapeutic vaccine in development for treatment of
hypertension(1). It is designed to instruct the patient's immune system to
produce an antibody response against angiotensin II. Angiotensin II is a
small peptide in the body and part of the renin-angiotensin system (RAS),
which is an important regulator of blood pressure. Angiotensin II causes
blood vessels to narrow, resulting in increased blood pressure. Vaccination
with CYT006-AngQb has been shown to reduce blood pressure by induction of
antibodies that bind angiotensin II. Thereby, binding of angiotensin II to
its receptors and subsequent narrowing of blood vessels should be
decreased. The RAS has already been successfully targeted by three major
classes of antihypertensive drugs on the market: inhibitors of the
angiotensin-converting enzyme (ACEI), blockers of the angiotensin II
subtype I receptor (ARB) and direct renin inhibitors (DRI). Like other
antihypertensive drugs these also come with the need for daily dosing and
often fail to provide a good solution for improving patient compliance.
Treatment with CYT006-AngQb should allow for convenient dosing schedules
and smooth control of blood pressure due to a sustained antibody response
induced by vaccination.
About Hypertension
Hypertension, also termed high blood pressure, is a medical condition
where the blood pressure is chronically elevated. Although symptomless in
nature and in itself rarely an acute problem, persistent hypertension is
one of the most important preventable causes of premature death worldwide
and contributes to around half of all cardiovascular diseases(2). It is one
of the major risk factors for stroke, myocardial infarction, heart failure,
and vascular disease, and is a leading cause of chronic renal failure.
Genetic predisposition and lifestyle habits such as inadequate physical
activity, high fat diet, and high salt intake promote high blood pressure.
Up to 30% of adults in most countries suffer from hypertension. Despite
effective and relatively inexpensive treatment available, only about one
out of four hypertensive individuals in the U.S. have their blood pressure
controlled successfully(3). This poor overall treatment success is mainly
attributed to the symptomless nature of hypertension and the necessity for
long-term treatment with medications that require at least once daily
self-administration.
About Early Morning Blood Pressure
Blood pressure is not static but undergoes natural variations which
follow a circadian pattern. Highest levels are reached during the morning,
which then decline to reach a trough value at about midnight. In the early
morning, a steep increase in blood pressure occurs naturally. It has been
suggested that this morning rise in blood pressure triggers adverse
cardiovascular events. A large study has revealed a marked circadian
periodicity in the onset of myocardial infarction with the primary peak
incidence being in the morning. At this time, myocardial infarction is
three times as likely to onset as during the night(4). The same periodicity
was observed in the onset of stroke. Striking evidence suggests that the
morning rise in blood pressure is crucial in determining the rupture of
critically weakened arterial walls and subjects with a large rise in
morning blood pressure have a significantly elevated risk of intracerebral
haemorrhage(5) and stroke(6). Hypertension therapy therefore aims at a full
24-hour blood pressure control. Current small molecule inhibitors of the
RAS were reported to achieve an ambulatory blood pressure reduction from
baseline in the early morning hours of e.g. (SBP / DPB) - 8.7 / - 5.8 mmHg
(valsartan) and - 11.0 / - 7.6 mmHg (telmisartan), respectively. They,
however, do not abolish the rise in early morning blood pressure(7,8).
About Cytos Biotechnology AG
Cytos Biotechnology AG is a public Swiss biotechnology company that
specializes in the discovery, development and commercialization of a new
class of biopharmaceutical products - the Immunodrugs(TM). Immunodrugs(TM)
are intended for use in the treatment and prevention of common chronic
diseases, which afflict millions of people worldwide. Immunodrugs(TM) are
designed to instruct the patient's immune system to produce desired
therapeutic antibody or T cell responses that modulate chronic disease
processes. Taking advantage of the high flexibility of its Immunodrug(TM)
platform, Cytos Biotechnology has built a pipeline of different
Immunodrug(TM) candidates in various disease areas, of which 6 are
currently in clinical development. The Immunodrug(TM) candidates are
developed both in-house and together with Novartis and Pfizer Animal
Health. Founded in 1995 as a spin-off from the Swiss Federal Institute of
Technology (ETH) in Zurich, the company is located in Schlieren (Zurich).
Currently, the company has 130 employees. Cytos Biotechnology AG has been
listed on the SWX Swiss Exchange (SWX:CYTN) since October 2002.
References
1. Journal of Hypertension, 2007, 25:63.
2. World Health Organization, Atlas of Heart Disease and Stroke, 2004.
3. Hypertension 2003; 42:1206.v
4. New England Journal of Medicine, 1985, 313:1315.
5. Hypertension, 2006, 47:149.
6. Hypertension Research, 2006, 29:581.
7. American Journal of Hypertension, 2004, 17:347.
8. Hypertension, 2003, 42:1137.
Ambulatory blood pressure: blood pressure measured continuously during
a normally active day; takes numerous automatic readings over a 24-hour
period or longer and applies non-invasive ambulatory blood pressure
monitoring devices.
Angiotensin II: a molecule of the RAS inducing vasoconstriction of
blood vessels and other effects to raise blood pressure.
Antibody: class of blood proteins generated by the immune system.
Antihypertensive drugs: a class of drugs used for treatment of high
blood pressure.
Cardiovascular events: refer to conditions affecting the cardiovascular
system, which comprises the heart, the blood vessels, and the cells and
plasma that make up the blood.
Circadian: a circadian rhythm is a roughly 24-hour cycle in the
physiological processes of living beings.
Compliance: a patient's adherence to a recommended course of treatment.
Diastolic blood pressure (DBP): the lowest pressure within the arterial
blood stream occurring during each heart beat.
Double-blind: a set-up often applied in clinical trials where neither
the doctor nor the patient knows if placebo or the active drug substance is
applied.
Half-life: time required in which half the amount of a biological
substance (e.g. antibodies) is removed from the organism.
mmHg: blood pressure values are universally stated in millimetres of
mercury (mmHg).
Myocardial infarction: commonly known as a heart attack; is a disease
state that occurs when the blood supply to a part of the heart is
interrupted.
Peptide: a fragment of a protein comprised of two or more amino acids.
Phase IIa: clinical trial that examines a new drug candidate's safety
and exploratory efficacy and may involve between 10 and 100 patients.
Placebo: dummy medical treatment.
Renin-angiotensin system (RAS): hormone system that regulates long-term
blood pressure and blood volume in the body.
Receptor: a protein molecule that binds and responds to a certain
interaction partner such as hormones, immune mediators or other substances.
Small molecule drugs: low molecular weight chemical compounds. Many
pharmaceutical drugs are small molecules.
Stroke: a sudden interruption in the blood supply of the brain.
Systolic blood pressure (SBP): the highest pressure within the arterial
blood stream occurring during each heart beat.
Therapeutic vaccine: a preparation of disease-related molecules
(antigens) of foreign or self origin that is capable of activating the
immune system against such antigens with the goal to modulate disease
processes.
This foregoing press release may contain forward-looking statements
that include words or phrases such as "designed", "potential", "would",
"should", "could", "promising", "suggest", "aim", "intend" or other similar
expressions. These forward-looking statements are subject to a variety of
significant uncertainties, including scientific, business, economic and
financial factors, and therefore actual results may differ significantly
from those presented. There can be no assurance that any other therapeutic
entities will enter clinical trials, that clinical trial results will be
predictive for future results, that therapeutic entities will be the
subject of filings for regulatory approval, that any drug candidates will
receive marketing approval from the U.S. Food and Drug Administration or
equivalent regulatory authorities, or that drugs will be marketed
successfully. Against the background of these uncertainties readers should
not rely on forward-looking statements. The company assumes no
responsibility to update forward-looking statements or adapt them to future
events or developments. This document does not constitute an offer or
invitation to subscribe or purchase any securities of Cytos Biotechnology
AG.
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