16 August 2024 | Friday | News
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Vimgreen Pharmaceuticals, a science-driven pharmaceutical company focused on the modulation of adenosine signaling, announced the completion of enrollment of its Phase 2 clinical trial of VG081821AC, a novel adenosine A2A receptor (A2AR) antagonist that also functions as an inverse A2AR agonist, for the treatment of early-to-mid stage Parkinson's disease. A total of 150 participants have been enrolled and randomized into one of three cohorts, a high-dose VG081821 group, a low-dose VG081821 group, and a placebo group at a ratio of 1:1:1.
The 12-week Phase 2 trial is a multicenter, randomized, placebo-controlled, double-blind study to investigate the safety and efficacy of VG081821 as monotherapy in early-to-mid stage PD patients. The primary endpoint was the difference of change from baseline in movement disorder society-unified Parkinson's disease rating scale (MDS-UPDRS) part III (motor symptoms) score between VG081821 and placebo over the 12 weeks of administration.
For PD patients, current therapies are mainly dependent on dopamine replacement strategies with L-Dopa (top choice), dopamine agonists, MAO-B inhibitors and COMT inhibitors. These medicines either increase dopamine levels or mimic dopamine function. However, despite L-Dopa's efficacy in reducing the motor symptoms of PD, the onset of motor complications (wearing-off, ON–OFF, dyskinesia) is almost inevitable with long-term treatment. It is a well-known limit of the dopamine replacement therapy. In addition, the current therapies for PD are only symptomatic treatments. These therapies are unable to slow down the progression of PD.
As an A2AR antagonist, which works non-dopaminergically, VG081821 has the potential to avoid, decrease or delay motor complications (wearing-off, ON–OFF, dyskinesia) if used early. What's special about VG081821 is that it is not only a highly potent A2A antagonist, but also a highly potent A2A receptor inverse agonist. More than a classical A2A antagonist, VG081821 may have extra therapeutic effect and greater efficacy on motor dysfunction in PD. Furthermore, VG081821 may provide not only symptomatic benefits, but also disease modifying benefits. VG081821 is expected to bring better treatment options and clinical benefits for PD patients.
"In most previous trials of A2A antagonists for the treatment of Parkinson's Disease, A2A antagonists were used as an add-on treatment to alleviate off episodes in combination with L-Dopa for advanced PD patients. Although it has led to the approval of Istradefylline in US and Japan, it is not the best use of A2A antagonists for PD treatment," stated Sanxing Sun, President and Chief Executive Officer of Vimgreen. "VG081821 is to be used as monotherapy for improving movements in early-to-mid stage of PD. Later on, as the disease progresses, it can be used in combination with low doses of L-Dopa. This L-dopa sparing effect may minimize the problem of L-Dopa and prolong the quality of life of PD patients."
It is known that A2AR gene expression in human peripheral blood mononuclear cells (PBMCs) are higher for PD patients. In the current Phase 2 trial of VG081821, the A2AR gene expression levels in PBMCs are to be analyzed. The potential correlation between drug efficacy and A2AR expression level may make VG081821 a precision medicine.
The Phase 2 trial is to be completed in November.
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