Zafgen Announces New Weight Loss and Safety Data from Phase 2 Trial of Beloranib in Hypothalamic Injury Associated Obesity at ENDO 2015
Poster Number LBS-095
"We are very pleased with the results from this latest study of patients with HIAO, which demonstrated proof of concept for both the safety and effectiveness of beloranib on body weight and cardiovascular risk markers in this patient population," said
HIAO is a rare form of medically induced obesity resulting from damage to the hypothalamus following resection of central nervous system tumors such as craniopharyngiomas. The hypothalamus is a homeostatic control center in the brain that provides oversight of multiple hormonal systems, metabolic rate, hunger, and satiety. Patients affected by HIAO fail to regulate metabolism and food intake normally, resulting in rapid and intractable weight gain, treatment resistant severe obesity, and associated co-morbidities.
Beloranib is a novel, first-in-class injectable small molecule therapy with a unique mechanism of action that reduces hunger while stimulating the use of stored fat as an energy source.
This Phase 2 randomized, double-blind, placebo-controlled trial evaluated the efficacy, safety and tolerability of beloranib 1.8 mg administered as twice-weekly subcutaneous injections for four weeks followed by an optional 4-week, open-label extension. The trial enrolled 14 patients who were mostly women with a mean age of 31.9 years, mean body mass index (BMI) of 42.9 kg/m2 and mean body weight (BW) of 126.4 kg. All patients had radiographic evidence of hypothalamic damage with documentation of subsequent rapid and significant BW gain. Patients were not counseled to adhere to any diet or exercise regimens as part of the trial.
Results from this trial showed that after four weeks of treatment, patients randomized to beloranib lost on average (± standard error of mean) -3.40 ± 0.6 kg of BW vs. -0.25 ± 0.8 kg for placebo (p=0.01). Results from the open-label extension suggested no apparent waning of the effect of beloranib within eight weeks of treatment. Furthermore, known markers of beloranib response, including major cardiovascular risk factors such as lipid parameters and markers of inflammation, were also improved at both four and eight weeks of treatment, corresponding with beloranib treatment.
In this Phase 2 trial, there were no early discontinuations due to adverse events (AEs), severe AEs or serious AEs in patients receiving beloranib. In addition, no clinically significant abnormal laboratory measures, vital signs, or electrocardiography (ECG) findings were observed. The most common AEs occurring in more than one patient treated with beloranib were dizziness, headache, and nasopharyngitis. These AEs were generally mild and transient in nature.
"The results of this proof of concept study are important, as they show that beloranib has a unique mechanism of action which mediates weight loss through actions independent from a fully functional hypothalamus," said
About Beloranib
Beloranib is a novel, first-in-class injectable small molecule therapy with a unique mechanism of action that reduces hunger while stimulating the use of stored fat as an energy source. Beloranib is a potent inhibitor of methionine aminopeptidase 2, or MetAP2, an enzyme that modulates the activity of key cellular processes that control metabolism. MetAP2 inhibitors work, at least in part, by directing MetAP2 binding to cellular stress mediators, and, thus, reducing the tone of signals that drive lipid synthesis by the liver and fat storage throughout the body. In this manner, MetAP2 inhibition increases metabolism of fat as an energy source.
About Hypothalamic Injury-Associated Obesity (HIAO)
HIAO is most commonly caused by damage incurred during removal of a central nervous system tumor called craniopharyngioma but it can also result from less common types of hypothalamic injury such as strokes, brain trauma, or radiation therapy to the brain. Craniopharyngioma is a rare form of benign brain tumor that occurs most commonly during childhood and infiltrates near the optic nerve, pituitary gland and the hypothalamus. Treatment of these tumors commonly involves surgical removal of the tumor mass, followed by radiation treatment, which results in disruption or removal of neighboring structures including the hypothalamus. Post-treatment hypothalamic dysfunction results in hyperphagia and significant obesity in up to 50% of these patients, resulting in a variety of co-morbid conditions and a deteriorated quality of life. Craniopharyngioma-associated obesity occurs in males and
females equally and in all races, with the same incidence around the world. The incidence estimates have ranged from 0.13 to 0.17 per 100,000 per year, or approximately 400 to 500 new cases per year in
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