Approval Probability
TA Base Rate
Adjusted LOA
ML Risk
BCX7353 · 9 trials · 5 indications
The angioedema event rate and the treatment comparisons between each berotralstat dose and placebo in the rate of expert-confirmed angioedema events during the entire dosing period was analyzed using a negative binomial regression model. The number of expert-confirmed angioedema events was included as the dependent variable, the treatment was included as a fixed effect, the stratification variable (baseline monthly angioedema event rate) and study (for the combined study analysis) were included as covariates, and the logarithm of duration on treatment was included as an offset variable. The estimated rate of angioedema events for each treatment group, the treatment differences expressed as the angioedema event rate ratio (berotralstat) over placebo rate ratio), and their associated 95% confidence intervals (CIs) were provided from the negative binomial regression model.
The safety data was assessed for the safety population for subjects who entered Part 2, and includes TEAEs that occurred in Part 1 and Part 2 for these subjects with a data cut-off date of 10-April-2020. TEAEs are defined as AEs that occurred on or after first dose of study treatment, whether in Part 1 or 2, and were assigned to the relevant treatment depending on when the TEAE began (Part 1 or Part 2 treatment). TEAEs were assessed for severity (graded) using the Division of Microbiology and Infectious Disease (DMID) criteria for grading AEs. TEAEs not covered by the DMID criteria were assessed as Mild (Grade 1), Moderate (Grade 2), Severe (Grade 3) or Life-threatening (Grade 4).
The safety data was assessed for the safety population for subjects who entered Part 3, and includes TEAEs that occurred in Part 3 for these subjects.
Treatment comparisons between each berotralstat dose and placebo in the rate of investigator-confirmed HAE attacks during the Part 1 dosing period were analyzed using a negative binomial model. The number of investigator-confirmed attacks was included as the dependent variable, the treatment was included as a fixed effect, the stratification variable (baseline attack rate) was included as a covariate, and the logarithm of duration on treatment was included as an offset variable. The estimated attack rate for each treatment group, the treatment differences expressed as the attack rate ratio (berotralstat over placebo rate ratio), and the associated 95% confidence intervals (CIs) were provided from the negative binomial model.
The safety data was assessed for the safety population, for subjects who entered Part 2 and Part 3, and includes TEAEs that began in Part 2 or 3, respectively, for these subjects. Safety data for Part 2 and Part 3 is combined to clearly show TEAEs occurring in subjects as the proceeded through the 2 study parts. TEAEs are defined as AEs that occurred on or after first dose of study treatment, whether in Part 1 or 2, and were assigned to the relevant treatment depending on when the TEAE began (Part 2 or Part 3 treatment). No statistical analysis was performed on this safety data.
The number and percentage of subjects with treatment-emergent adverse events.
Subjects completed a 3-component VAS on a 100 mm scale for severity of abdominal pain, skin pain and skin swelling associated with the HAE attack, where zero indicated no pain or swelling and 100 mm indicated worst possible pain or swelling. Subjects completed the VAS immediately prior to study drug administration, then at 1, 2, 3, 4, approximately 8 \& at 24 hours post-dose. The primary endpoint was the proportion of subject attacks with an improved or stable 3-symptom composite VAS score at 4 hours post dose. The 3-symptom composite was calculated as the average of the VAS scores for abdominal pain, skin pain, and skin swelling. A subject was considered improved or stable if the change from baseline (CFB; time of drug administration) in VAS was ≤ 0.
The proportion of attacks for which subjects took SOC-Rx in the 24 hours following treatment with study drug. HAE Rescue Medications included C1-INH (Berinert, Cinryze, Ruconest) and Firazyr/Icatibant.
Efficacy was evaluated by the number of acute angioedema attacks. To ensure that consistent, objective assessments were used in accepting subject-reported attack data, a panel of expert physicians in the treatment of HAE patients adjudicated all subject-reported attacks prior to their inclusion in primary efficacy analyses.
Assessment of the proportion of subjects who had no HAE attacks during the entire dosing period
| Arm | Type | Description |
|---|---|---|
| BCX7353 110mg once daily | EXPERIMENTAL | BCX7353 capsules administered orally once daily |
| BCX7353 150mg once daily | EXPERIMENTAL | BCX7353 capsules administered orally once daily |
| Placebo | PLACEBO_COMPARATOR | Matching placebo oral capsules administered orally once daily |
| BCX7353 110 mg once daily | EXPERIMENTAL | BCX7353 administered as oral capsules once daily |
| BCX7353 150 mg once daily | EXPERIMENTAL | BCX7353 administered as oral capsules once daily |
| Part1: BCX7353 750 mg | EXPERIMENTAL | - |
| Part 2: BCX7353 500 mg | EXPERIMENTAL | - |
| Part 3: BCX7353 250 mg | EXPERIMENTAL | - |
| Parts 1, 2 and 3: placebo | PLACEBO_COMPARATOR | - |
| Part 1: BCX7353 350 mg once daily | EXPERIMENTAL | BCX7353 capsules, 350 mg dose administered once per day for 28 days |
| Parts 2 and 3: BCX7353 250 mg once daily | EXPERIMENTAL | BCX7353 capsules, 250 mg dose administered once per day for 28 days |
| Parts 2 and 3: BCX7353 125 mg once daily | EXPERIMENTAL | BCX7353 capsules, 125 mg dose administered once per day for 28 days |
| Part 3: BCX7353 62.5 mg once daily | EXPERIMENTAL | BCX7353 capsules, 62.5 mg dose administered once per day for 28 days |
| BCX7353 API in capsule | EXPERIMENTAL | fasted administration of BCX7353 API in capsule |
| BCX7353 blend in capsule | EXPERIMENTAL | fasted administration of BCX7353 blend in capsule |
| BCX7353 blend in capsule with food | EXPERIMENTAL | administration of BCX7353 blend in capsule following high-fat meal |
| Cohort 1 | EXPERIMENTAL | Day 1: Digoxin 0.25 mg oral dose Day 11-18: BCX7353 350 mg oral dose Day 19: Digoxin 0.25 mg oral dose and BCX7353 350 mg oral dose Day 20-21: BCX7353 350 mg oral dose |
| Cohort 2 | EXPERIMENTAL | Day 1: Rosuvastatin 10 mg oral dose Day 7-14: BCX7353 350 mg oral dose Day 15: Rosuvastatin 10 mg oral dose and BCX7353 350 mg oral dose Day 16: BCX7353 350 mg oral dose |
| Cohort 3 | EXPERIMENTAL | Day 1: BCX7353 350 mg oral dose Day 14: single oral dose of Cyclosporine 600 mg and BCX7353 350 mg |
| Metabolic Probes and BCX7353 | EXPERIMENTAL | Day 1: 1 mg midazolam will be administered as an IV bolus simultaneously to administration of 500 mg tolbutamide, 40 mg omeprazole, and 30 mg dextromethorphan orally. Day 2: a single oral dose of 2 mg midazolam. Days 3 to 9: 350 mg BCX7353 once a day. Day 10: 1 mg midazolam will be administered as an IV bolus simultaneously to administration of 500 mg tolbutamide, 40 mg omeprazole, 30 mg dextromethorphan and 350 mg BCX7353, orally. Day 11: a single oral dose of 2 mg of midazolam along with 350 mg BCX7353. |
| BCX7353 | EXPERIMENTAL | BCX7353 capsules administered orally |
| Name | Type | Description |
|---|---|---|
| BCX7353 capsules | DRUG | BCX7353 capsules administered orally once daily |
| Placebo oral capsule | DRUG | Matching placebo capsules administered orally once daily |
| BCX7353 | DRUG | BCX7353 mg oral capsules administered once daily |
| Placebo | DRUG | oral liquid formulation to match BCX7353 |
| Digoxin | DRUG | Day 1 of Cohort 1 |
| BCX7353 + digoxin | DRUG | Day 19 of Cohort 1 |
| Rosuvastatin | DRUG | Day 1 of Cohort 2 |
| rosuvastatin + BCX7353 | DRUG | Day 15 of Cohort 1 |
| Cyclosporine + BCX7353 | DRUG | Day 14 of Cohort 3 |
| BCX7353 and probes | DRUG | - |
| Placebo to match BCX7353 | DRUG | - |
Key Inclusion Criteria: * A clinical diagnosis of hereditary angioedema (HAE) Type 1 or Type 2, defined as having a C1-INH functional level and a C4 level below the lower limit of the normal (LLN) reference range, as assessed during the Screening period. * Access to and ability to use one or more a...
| Company | Ticker | Trials | Lead Phase | Drugs |
|---|---|---|---|---|
| Intellia Therapeutics, Inc. | NTLA | 3 | PHASE3 | NTLA-2002, Normal Saline Administration |
| BioCryst Pharmaceuticals, Inc. | BCRX | 2 | PHASE3 | Berotralstat |
| Ionis Pharmaceuticals, Inc. | IONS | 1 | PHASE3 | Donidalorsen |
| Pharvaris N.V. | PHVS | 1 | PHASE2 | deucrictibant |
| BioMarin Pharmaceutical Inc. | BMRN | 1 | PHASE1 | Dose 1 of BMN 331 |
| Astria Therapeutics, Inc. | ATXS | 1 | PHASE2 | STAR-0215 |
BCX7353 is an investigational small molecule being developed for the treatment of hereditary angioedema (HAE), a rare genetic condition characterized by recurrent episodes of severe swelling. It is currently in Phase 3 clinical development and has not been approved by regulatory authorities.
BCX7353 is being developed by BioCryst Pharmaceuticals, Inc., a biopharmaceutical company traded on the NASDAQ under the ticker symbol BCRX. The company is conducting clinical trials to evaluate the drug's safety and efficacy in patients with hereditary angioedema.
BCX7353 is currently in Phase 3 clinical development for hereditary angioedema. It is an investigational drug, meaning it has not yet received regulatory approval and is still undergoing clinical trials to assess its safety and effectiveness in treating the condition.
BCX7353 has been studied in six completed clinical trials with a total enrollment of 728 participants. These include early-phase studies such as NCT02448264, a first-in-human trial in healthy volunteers, and NCT02819102, NCT03136237, and NCT03202784, which evaluated drug interactions and formulations. All trials were conducted in the United Kingdom.
BCX7353 is the investigational code name for the drug also known as berotralstat. BioCryst Pharmaceuticals is developing this oral small molecule for hereditary angioedema, and it is currently in Phase 3 clinical trials. The drug has not yet been approved for commercial use.