Abstract 11 — Development of a Novel Treg Activator KINE-101 for a New Treatment Option for Rheumatoid Arthritis

Myun Soo Kim, Sunyoung Park, Chang Kyu Gu
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Abstract

Background KINE-101, a novel synthetic nonapeptide, is being developed for the treatment of rheumatoid arthritis with a distinctive mode of action. A study using a collagen-induced arthritis (CIA) mouse model showed that KINE-101 suppressed cartilage damage through inhibiting osteoclastogenesis. KINE-101 showed its therapeutic effects in suppressing auto-immune responses by activating Regulatory T cells (Tregs), a specialized subpopulation of T cells, in in-vivo studies using mouse models of RA. Following the in-vivo studies, the phase 1 clinical study for KINE-101 was conducted to assess the safety and tolerability in healthy subjects in the US. Methods Total 40 healthy subjects were enrolled to assign in 5 cohorts. Each cohort included 8 subjects composed of 6 active and 2 placebo treatment. The subjects of first 4 cohorts were administrated with 10, 30, 100, 300 mg of KINE-101 by intravenous (IV) infusion as single ascending doses (SAD), and the Cohort 5 subjects were subcutaneously (SC) injected with 96.8 mg of KINE-101. Results Except for 2 subjects in placebo group, all subjects completed the study. All the randomized subjects were included in the safety evaluation. No deaths, SAEs (Serious Adverse Events), or AEs (Adverse Events) leading to discontinuation were reported during the study periods. While total 9 TEAEs (Treatment-Emergent Adverse Events) were reported, all were assessed as mild. It included 3 headaches, 1 catheter site edema, 1 contusion and 1 nasal congestion in the treatment group, and 1 catheter site pain, 1 oral contusion and 1 COVID-19 infection in the placebo group. Oral contusion and COVID-19 occurred in the same subject, and all the other events were singular TEAEs reported in individual subjects. No injection site reactions were reported and no clinically significant changes in any laboratory values were noted. In terms of pharmacokinetic (PK) profile, KINE-101 was observed in the blood samples during and up to 5 minutes after infusion. Conclusion In the phase I clinical study, Treg activator KINE-101 demonstrated a favorable safety and tolerability profile. The most common AEs were headaches reported in 3 subjects, but all were mild and transient events. As typically seen in peptide drugs, KINE-101 has a short half-life. However, given that KINE-101 uses Treg as a proxy to exerts anti-inflammatory effects, its pharmacodynamic (PD) activity is likely to last longer. The next stage for KINE-101 will proceed to oral formulation and the Phase 2 clinical study in RA patients.
摘要 11 - 新型凝集素激活剂 KINE-101 的开发,为类风湿关节炎提供新的治疗方案
背景 KINE-101 是一种新型合成非肽,目前正在开发用于治疗类风湿性关节炎,具有独特的作用模式。一项利用胶原诱导的关节炎(CIA)小鼠模型进行的研究表明,KINE-101 可通过抑制破骨细胞生成来抑制软骨损伤。在利用小鼠关节炎模型进行的体内研究中,KINE-101通过激活调节性T细胞(Tregs)(T细胞的一种特殊亚群),显示了其抑制自身免疫反应的治疗效果。体内研究结束后,KINE-101 在美国进行了一期临床研究,以评估其在健康受试者中的安全性和耐受性。方法 共招募了 40 名健康受试者,分成 5 个队列。每组包括 8 名受试者,其中 6 名接受活性治疗,2 名接受安慰剂治疗。前4组受试者分别以单次升剂量(SAD)静脉注射10、30、100和300毫克KINE-101,第5组受试者皮下注射96.8毫克KINE-101。结果 除安慰剂组的两名受试者外,所有受试者均完成了研究。所有随机受试者均纳入了安全性评估。研究期间未出现死亡、SAE(严重不良事件)或导致停药的AE(不良事件)。共报告了 9 例 TEAE(治疗突发不良事件),但所有症状均被评估为轻微。其中,治疗组有 3 例头痛、1 例导管部位水肿、1 例挫伤和 1 例鼻塞;安慰剂组有 1 例导管部位疼痛、1 例口腔挫伤和 1 例 COVID-19 感染。口腔挫伤和 COVID-19 感染发生在同一受试者身上,所有其他事件均为个别受试者报告的单个 TEAE。没有注射部位反应的报告,也没有发现任何实验室数值发生有临床意义的变化。在药代动力学(PK)方面,KINE-101在输注期间和输注后5分钟内的血液样本中均可观察到。结论 在I期临床研究中,Treg激活剂KINE-101表现出良好的安全性和耐受性。最常见的不良反应是3名受试者出现头痛,但都是轻微和短暂的。与通常的多肽药物一样,KINE-101的半衰期较短。不过,鉴于KINE-101使用Treg作为代表来发挥抗炎作用,其药效学(PD)活性可能会持续更长时间。KINE-101的下一阶段将是口服制剂和对RA患者进行2期临床研究。
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