Kadmon announced topline results from an ongoing Phase 2 clinical trial evaluating KD025, its Rho-associated coiled-coil kinase 2 (ROCK2) inhibitor, in patients with idiopathic pulmonary fibrosis (IPF) who were previously treated with or offered pirfenidone and/or nintedanib. KD025 was well tolerated and demonstrated clinical benefit, with a median decline in forced vital capacity (FVC), a measure of lung function, of 48 mL at week 24, compared to a median decline of 175 mL in patients treated with best supportive care (BSC), an absolute difference of 127 mL and a relative difference of 73%.
“KD025 represents a novel mechanism of action in IPF by inhibiting ROCK, a central regulator of fibrosis that mediates several pro-fibrotic responses, including stress fiber formation, myofibroblast activation and pro-fibrotic gene transcription,” said Kevin F. Gibson, MD, Professor and Medical Director, Dorothy P. and Richard P. Simmons Center for Interstitial Lung Disease, University of Pittsburgh Medical Center and lead investigator of the study. “In this proof-of-concept trial, KD025 has demonstrated clinical activity at 24 weeks and was well tolerated, with no apparent safety signals, potentially offering a new option for patients with IPF.”
In the open-label trial (KD025-207), patients who were previously treated with or offered pirfenidone and/or nintedanib were randomized 2:1 to receive KD025 400 mg QD monotherapy or BSC. The primary endpoints were safety and tolerability of KD025 and change in FVC from baseline to 24 weeks. Patients have the option to continue treatment with KD025 beyond 24 weeks.
As of a data cutoff date of February 1, 2018, 20 evaluable patients have completed 24 weeks of KD025 treatment, and 9 evaluable patients in the BSC arm have completed 24 weeks of follow-up. Approximately 44% of all patients enrolled in the trial had received prior treatment with pirfenidone and/or nintedanib. Following are key results:
- The median decline in FVC at 24 weeks was 48 mL in the KD025 arm, compared to a median decline of 175 mL in the BSC arm, a relative difference of 73%.
- The median decline in FVC % predicted from baseline to week 24 was 1% in KD025 patients, compared to a median decline of 2% in BSC patients, a relative difference of 50%.
- Treatment with KD025 reduced the proportion of patients who experienced IPF progression: At 24 weeks, 20% of KD025 patients experienced FVC % predicted decline ≥5%, compared to 44% of BSC patients, a relative difference of 55%.
- KD025 patients experienced less FVC decline on an annualized basis relative to the year prior to enrollment: Evaluable patients randomized to KD025 had an annualized decline in FVC of 126 mL in the year prior to randomization, compared to an annualized decline of 32 mL at 24 weeks of KD025 treatment.
- KD025 was well tolerated, with no drug-related serious adverse events. In addition, 90% of patients who received KD025 for 24 weeks have elected to continue KD025 treatment beyond week 24.