Recent advances in small molecules for improving mitochondrial disorders

Meng L, Wu G. Recent advances in small molecules for improving mitochondrial disorders. RSC Advances. 2023 Jul;13(30):20476-20485. DOI: 10.1039/d3ra03313a. PMID: 37435377; PMCID: PMC10331567. 

 This review focuses on the latest advances in developing bioactive compounds for treating mitochondrial disease, aiming to provide a broader perspective of fundamental studies that have been carried out to evaluate the effects of small molecules in regulating mitochondrial function. Novel-designed small molecules ameliorating mitochondrial functions are urgent for further research.

Patient-reported, health economic and psychosocial outcomes in patients with Friedreich ataxia (PROFA): protocol of an observational study using momentary data assessments via mobile health app

Buchholz M, Weber N, Borel S, et alPatient-reported, health economic and psychosocial outcomes in patients with Friedreich ataxia (PROFA): protocol of an observational study using momentary data assessments via mobile health appBMJ Open 2023;13:e075736. doi: 10.1136/bmjopen-2023-075736 

The symptoms affect the patients’ health-related quality of life (HRQoL) and psychosocial health. FA leads to an increasing need for care, associated with an economic burden. Little is known about the impact of FA on daily lives and HRQoL. To fill that gap, we will assess patient-reported, psychosocial and economic outcomes using momentary data assessment via a mobile health application (app).

The use of digital outcome measures in clinical trials in rare neurological diseases: a systematic literature review

Poleur, M., Markati, T. & Servais, L. The use of digital outcome measures in clinical trials in rare neurological diseases: a systematic literature review. Orphanet J Rare Dis 18, 224 (2023). doi:10.1186/s13023-023-02813-3 

 We found two studies of patients with FRDA that used inertial technology. Remote monitoring of several voice parameters, upper limb function through 14 parameters that can be grouped into parameters related to movement velocity, spectral frequency, and parameters related to deviation of the ideal trajectory, and 15 spatiotemporal gait parameters was feasible over 1 week. The sensitivity of an upper limb composite score, the AIM-S, obtained through sensors contained in a spoon designed to detect deterioration in upper limb function, was greater than other measures.

Biogen to Acquire Reata Pharmaceuticals

CAMBRIDGE, Mass. and PLANO, Texas, July 28, 2023 (GLOBE NEWSWIRE) -- Biogen Inc. (Nasdaq: BIIB) and Reata Pharmaceuticals, Inc. (Nasdaq: RETA) today announced the companies have entered into a definitive agreement under which Biogen has agreed to acquire Reata for $172.50 per share in cash, reflecting an enterprise value of approximately $7.3 billion. 

Reata has made significant advancements developing therapeutics that regulate cellular metabolism and inflammation in serious neurologic diseases. Reata’s FDA-approved SKYCLARYS® (omaveloxolone) is the first and only approved treatment for Friedreich’s ataxia (FA) in the United States, with a commercial launch underway, and European regulatory review ongoing. In addition, Reata is developing a portfolio of innovative products for a range of neurological diseases.

Larimar Therapeutics Receives FDA Clearance to Proceed to 50 mg Cohort in CTI-1601’s Phase 2 Friedreich's Ataxia Trial and to Initiate Open Label Extension Trial

BALA CYNWYD, Pa., July 25, 2023 (GLOBE NEWSWIRE). Larimar Therapeutics, Inc.. Today announced that the U.S. Food and Drug Administration (FDA) has cleared the Company’s four-week, placebo-controlled, Phase 2 dose exploration trial of CTI-1601 in patients with Friedreich's ataxia (FA) to proceed to a 50 mg cohort in which participants will be dosed daily for the first 14 days, and then every other day until day 28. In addition, Larimar’s open label extension (OLE) trial was also cleared for initiation by the FDA. Participants in the OLE will receive 25 mg of CTI-1601 daily. CTI-1601 is a novel protein replacement therapy designed to deliver frataxin to the mitochondria of patients with FA who have low levels of frataxin. 

Larimar received clearance to advance its Phase 2 trial to a 50 mg cohort and initiate its OLE trial following a review by the FDA of Larimar’s complete response to its partial clinical hold that included unblinded safety, pharmacokinetic (PK), and pharmacodynamic (PD) data from the Phase 2 trial’s completed 25 mg cohort. Data from the completed 25 mg cohort (n = 13) indicated that CTI-1601 was generally well tolerated and showed increases in frataxin (FXN) levels from baseline compared to placebo in all evaluated tissues (skin and buccal cells) at day 14 (the final day of daily dosing in the trial). Further dose escalation in the Phase 2 and OLE trials and the initiation of additional U.S. clinical trials evaluating CTI-1601 are contingent on FDA review of results from the Phase 2 trial’s 50 mg cohort in accordance with a partial clinical hold.

“Gaining clearance to advance to a 50 mg cohort in our Phase 2 trial and initiate the OLE trial are crucial steps in CTI-1601’s development as potentially the first therapy to increase frataxin levels in patients with FA,” said Carole Ben-Maimon, MD, President, and Chief Executive Officer of Larimar. “Given the inability of current treatments to address the frataxin deficiency underlying Friedreich's ataxia, we believe CTI-1601 has the potential to improve the treatment paradigm for this devastating disease. We now look forward to data from our Phase 2 trial’s 50 mg cohort in the first half of 2024, which will help us further characterize the safety and PK profiles of CTI-1601 and its ability to increase frataxin levels in a dose-dependent fashion as seen in our earlier Phase 1 studies.”

Leriglitazone

National Center for Biotechnology Information. PubChem Compound Summary for CID 4147757, Hydroxypioglitazone. https://pubchem.ncbi.nlm.nih.gov/compound/Hydroxypioglitazone. Accessed July 23, 2023.

Understanding the Impact of Entrada Therapeutics Inc. on NASDAQ:TRDA

JUL 22, 2023. CORP THESPYWHOBILLEDME. The company’s innovative approach to drug development has been a key factor in its success. Entrada Therapeutics Inc. uses its proprietary Endosomal Escape Vehicle (EEV) technology to develop drugs that can penetrate cells and deliver therapeutic agents directly to the site of disease. Investors have shown a keen interest in Entrada Therapeutics Inc., largely due to the company’s promising drug pipeline. 

The company’s lead candidate, ET-01, is currently in preclinical development for the treatment of Friedreich’s Ataxia, a debilitating genetic disease. The potential of ET-01, along with the company’s other drug candidates, has contributed to the positive performance of NASDAQ:TRDA

Patient Dosing Complete for Part 1 of Gene Therapy Trial in Friedreich Ataxia Cardiomyopathy

Neurologylive; Jul 20, 2023. According to a recent announcement, patient dosing in the first cohort of the SUNRISE-FA study (NCT05445323), a phase 1/2 trial assessing LX2006 (Lexeo Therapeutics), an adeno-associated virus (AAV) gene therapy, in patients with friedreich ataxia (FA) cardiomyopathy, has completed. 

The first patient in the second dose cohort of the trial has commenced as well. Thus far, preliminary data from the first dose cohort indicated that the therapy was well tolerated, with no unexpected events or toxicities.

 "We look forward to continuing to progress this program with data readouts expected in the first half of 2024."

Quantification of human mature frataxin protein expression in nonhuman primate hearts after gene therapy

Ian Blair, Teerapat Rojsajjakul, Juliette Hordeaux et al. Quantification of human mature frataxin protein expression in nonhuman primate hearts after gene therapy, 29 June 2023, PREPRINT (Version 1) available at Research Square doi:10.21203/rs.3.rs-3121549/v1 

Therefore, increasing expression of heart hFXN-M using gene therapy offers a way to prevent early mortality in FRDA. We used rhesus macaque monkeys to test the pharmacology of an adeno-associated virus (AAV)hu68.CB7.hFXN therapy. The advantage of using non-human primates for hFXN-M gene therapy studies is that hFXN-M and monkey FXN-M (mFXN-M) are 98.5% identical, which limits potential immunologic side-effects.

PPAR-gamma agonist pioglitazone recovers mitochondrial quality controls in fibroblasts from PITRM1-deficient patients

DArio Brunetti, A. D., Donfrancesco, C., Berlingieri, C., Frascarelli, M., Giacomello, A. P., Magalhaes Rebelo, L., Bindoff, S., Reeval, P., Filippo, M., Santorelli, G., Massaro, C. F., Viscomi, M., & Zeviani, D. (s/f). PPAR-gamma agonist pioglitazone recovers mitochondrial quality controls in fibroblasts from PITRM1-deficient patients. Front. Pharmacol. Sec. Experimental Pharmacology and Drug Discovery, 14. doi:10.3389/fphar.2023.1220620 

 We found that the pharmacological stimulation of Peroxisome Proliferator-Activated Receptor Gamma (PPARG) by Pioglitazone upregulates IDE and also PITRM1 protein levels restoring the presequence processing machinery and improving Frataxin maturation and mitochondrial function. Our findings provide mechanistic insights and suggest a potential pharmacological strategy for this rare neurodegenerative mitochondrial disease.