EX-99.1 2 s001204x1_ex99-1.htm EXHIBIT 99.1
Exhibit 99.1
 
     Phase 1/2a Multicenter, Controlled, Randomized, Open Label, Dose Escalation, Safety, Tolerability, and Pharmacokinetic Study Comparing EG-1962 and Nimodipine in Patients with Aneurysmal Subarachnoid Hemorrhage    Department of Neurosurgery, University Medical Center Mannheim, Ruprecht-Karls-University Heidelberg, Germany Director: Univ. Prof. Dr. Daniel Hänggi  Hänggi D, Etminan N, Macdonald RL, Steiger HJ, Mayer SA, Aldrich F, Diringer MN, Hoh BJ, Mocco J, Strange P, Faleck HJ, Miller M for the NEWTON Investigators  NEWTONNimodipine microparticles to Enhance recovery While reducing TOxicity after subarachNoid hemorrhage 
 

 Disclosure  2  PI worldwideScientific advisor / consultant: Edge Therapeutics 
 

         Aneurysmal SAH Overview    Aneurysmal subarachnoid hemorrhage  Day 0  Day 7            3     
 

 Nimodipine  PLGA  70 µm microparticlesBiodegradable polymerSingle intraventricular injectionSustained-release formulation Nimodipine release for 21 daysTargeted delivery  EG-1962      4 
 

 Nimodipine  PLGA  70 µm microparticlesBiodegradable polymerSingle intraventricular injectionSustained-release formulation Nimodipine release for 21 daysTargeted delivery  EG-1962        EG-1962  5 
 

         Phase 1/2 study: Safety, tolerability and pharmacokinetics of EG-1962 with enteral nimodipine  Aneurysmal SAH   Randomization  Screening period  EG-1962  Treatment period  Follow-up period   Day 0 Day 1 – 21 Day 30 Day 90  CT-scanSecondary Objective:Plasma CSF concentrations  Standard of careEnteral nimodipineClipping or coiling   GOSEmRSMoCABarthelNIHSSTICS  NEWTON Study Design  Trial registration: www.clinicaltrials.gov: NCT01893190  6  Hänggi D et al. Neurocrit Care, 2015  Identify maximum tolerated / feasible dose for pivotal phase 3 study  (3:1 randomization EG-1962 or enteral nimodipine)   Enteral nimodipine  Clinical outcome at Day 90 (GOSE)Angiographic vasospasm, DCI, delayed cerebral infarctionUse of rescue therapyICU, hospital length of stay 
 

         EG-1962                    Cohorts 1 to 6                  Enteral nimodipine    100 mg  200 mg  400 mg  600 mg  800 mg  1200 mg  Total  Demographic Variable  (N=18)    (N=9)  (N=9)  (N=9)  (N=9)  (N=9)  (N=9)  (N=54)  Age                            Mean  56(+/-2)    64 (+/-3)  54(+/-3)  49(+/-5)  56(+/-4)  52(+/-4)  54(+/-3)  55(+/-8)   Sex, n (%)                             Male  5 (28%)    1 (11%)  3 (33%)  5 (56%)  6 (67%)  7 (78%)  2 (22%)  24 (44%)   Female  13 (72%)    8 (89%)  6 (67%)  4 (44%)  3 (33%)  2 (22%)  7 (78%)  30 (56%)  NEWTON Demographics  N = number of subjects randomized to treatment group and received treatment.  7 
 

 NEWTON Safety  Group  Dose  Deaths(unrelated)  SAEs(related)  Drug-related Hypotension  DLTs  EG-1962  100 mg  0  0  0  0    200 mg  2  0  0  0    400 mg  0   1 (Allergic Reaction)  0  1(ICP)    600 mg  0  0  0  0    800 mg  1  0  0  1 (ICP)    1200 mg  0  0  0  0  EG-1962 (n=54)  All  3 (6%)  1 (2%)  0 (0%)    Enteral nimodipine (n=18)  60 mg x 4 hours x 21 days  1 (6%)  0 (0%)  3 (17%)    8 
 

 NEWTON Plasma nimodipine Concentration  Note: Values are mean +/- ….  9 
 

 56% Favorable Outcome(n = 5)  78% Favorable Outcome(n = 7)  67% Favorable Outcome(n = 6)  44% Favorable Outcome(n = 4)  56% Favorable Outcome(n = 5)      Cohort 1 (100 mg; N = 9)  enteral nimodipine(N = 18)  Cohort 2(200 mg; N = 9)  Cohort 3(400 mg; N = 9)  0% EG-1962 related hypotension  Cohort 4(600 mg; N = 9)  Cohort 5(800 mg; N = 9)  NEWTON Clinical Outcome  Dead  Glasgow Outcome Scale (GOSE) – 90 Day Outcome  Vegetative State  Lower Severe Disability  Upper Severe Disability  Lower Moderate Disability  Upper Moderate Disability  Lower Good Recovery  Upper Good Recovery  1  2  3  4  5  6  7  8  Unfavorable Outcome  Favorable Outcome  EG-1962   Active Control  17% (n = 3) related hypotension   Favorable Outcome(n = 5)  28%  10 
 

 56% Favorable Outcome(n = 5)  78% Favorable Outcome(n = 7)  67% Favorable Outcome(n = 6)  44% Favorable Outcome(n = 4)  56% Favorable Outcome(n = 5)      enteral nimodipine(N = 18)  0% EG-1962 related hypotension  NEWTON Clinical Outcome  Dead  Glasgow Outcome Scale (GOSE) – 90 Day Outcome  Vegetative State  Lower Severe Disability  Upper Severe Disability  Lower Moderate Disability  Upper Moderate Disability  Lower Good Recovery  Upper Good Recovery  1  2  3  4  5  6  7  8  Unfavorable Outcome  Favorable Outcome  EG-1962   Active Control  17% (n = 3) related hypotension   Cohorts 1-5(N = 45)  Favorable Outcome(n = 5)  28%  60%  Favorable Outcome(n = 27)  11 
 

 EG-1962 Cohorts 1-5 (N = 45)   NEWTON Exploratory Outcomes  Vasospasm / DCI  Cohort 1 (100 mg; N = 9)  Enteral nimodipine(N = 18)  Cohort 2(200 mg; N = 9)  Cohort 3(400 mg; N = 9)  Cohort 4(600 mg; N = 9)  Cohort 5(800 mg; N = 9)              (N = )  (5)  (2)  (4)  (2)  (2)  (15)  Delayed Cerebral Infarction  (N = )  (1)  (0)  (0)  (0)  (2)  (2)  Rescue Therapy  (N = )  (4)  (1)  (3)  (1)  (2)  (10)  (N = 15; 33% )  (N = 3; 7% )  (N = 11; 24% )  12 
 

 NEWTON Health Economics  Reduced ICU Length of Stay (LoS)by 3.5 days  Reduced Hospital LoS by 2.5 days  Median ICU LoS  Median Hospital LoS  (n=45)  (n=45)  (n=18)  (n=18)  13 
 

       NEWTON Study  All endpoints metMTD/MFD definedNo safety concerns       Improved clinical outcomeLess rescue therapyReduced ICU and hospital length of stay                      14 
 

                                                                                                                                                                                                                                                                                                                                                                                                                                                 NEWTON Study  15  Pivotal phase 3 study planned (US, Canada, Europe, Australasia)       
 

   http://www.umm.uni-heidelberg.de/inst/nch/daniel.haenggi@medma.uni-heidelberg.de    Department of Neurosurgery, University Medical Center Mannheim, Ruprecht-Karls-University Heidelberg, Germany Director: Univ. Prof. Dr. Daniel Hänggi  Phase 1/2a Multicenter, Controlled, Randomized, Open Label, Dose Escalation, Safety, Tolerability, and Pharmacokinetic Study Comparing EG-1962 and Nimodipine in Patients with Aneurysmal Subarachnoid Hemorrhage  NEWTONNimodipine microparticles to Enhance recovery While reducing TOxicity after subarachNoid hemorrhage