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REGN475

Phase 3

Osteoarthritis, Knee | Monoclonal antibody | Musculoskeletal |Regeneron Pharmaceuticals, Inc.|Trials Updated: Oct 13, 2023

REGN475 development status

Highest phase Phase 3 (NCT03161093)
Phase scored for REGNPhase 2
Registered trials 13 across 1 sponsor since Jul 2009

REGN475 target and mechanism

Molecular targetNGF
Target classProtein
ModalityMonoclonal antibody

Also known as REGN475 (SAR164877), Fasinumab, MT-5547, Fasinumab AI, Fasinumab PFS

Success Probability

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Market & Valuation

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Trial Design

RandomizedDouble-BlindCONTROLLEDDMC
Total Trials9
Total Enrollment11,911

FDA Designations

No designations recorded

REGN475 clinical trials

REGN475 · 9 trials · 6 indications

Phase 3 3Phase 2 4Phase 1 2
NCT03304379Study to Determine the Safety and the Efficacy of Fasinumab Compared to Placebo and Nonsteroidal Anti-inflammatory Drugs (NSAIDs) for Treatment of Adults With Pain From Osteoarthritis of the Knee or HipOsteoarthritis, Knee
COMPLETED1,650 Analytics
NCT03161093A Study to Determine the Safety and the Efficacy of Fasinumab Compared to Placebo and Naproxen for Treatment of Adults With Pain From Osteoarthritis of the Knee or HipOsteoarthritis, Knee
COMPLETED3,307 Analytics
NCT02683239Long-Term Safety and Efficacy Study of Fasinumab in Patients With Pain Due to Osteoarthritis (OA) of the Knee or HipOsteoarthritis of the Knee or Hip
COMPLETED5,331 Analytics
PHASE3COMPLETED
Study to Determine the Safety and the Efficacy of Fasinumab Compared to Placebo and Nonsteroidal Anti-inflammatory Drugs (NSAIDs) for Treatment of Adults With Pain From Osteoarthritis of the Knee or Hip
Osteoarthritis, KneeUnlock trial analytics
PHASE3COMPLETED
A Study to Determine the Safety and the Efficacy of Fasinumab Compared to Placebo and Naproxen for Treatment of Adults With Pain From Osteoarthritis of the Knee or Hip
Osteoarthritis, KneeUnlock trial analytics
PHASE3COMPLETED
Long-Term Safety and Efficacy Study of Fasinumab in Patients With Pain Due to Osteoarthritis (OA) of the Knee or Hip
Osteoarthritis of the Knee or HipUnlock trial analytics

Study Endpoints

Primary Endpoints

Change From Baseline in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Pain Subscale Scores up to Week 24 in Participants Treated With Fasinumab Compared to Placebo
Baseline up to Week 24

WOMAC pain subscale was a 5-item questionnaire used to assess the amount of pain experienced due to osteoarthritis in the index joint (knee or hip) in past 48 hours. It was calculated as the mean of the scores from the 5 individual questions scored on a numerical rating scale (NRS) of 0 (no pain) to 10 (higher pain), where higher scores indicated higher pain.

Change From Baseline in WOMAC Physical Function Subscale Scores up to Week 24 in Participants Treated With Fasinumab Compared to Placebo
Baseline up to Week 24

Physical function referred to participant's ability to move around and perform usual activities of daily living. The WOMAC physical function subscale was a 17-item questionnaire used to assess the degree of difficulty experienced due to osteoarthritis in index joint (knee or hip) during past 48 hours. It was calculated as mean of the scores from 17 individual questions scored on a NRS of 0 (minimum difficulty) to 10 (maximum difficulty), where higher scores indicated maximum difficulty.

Change in the WOMAC Pain Subscale Scores From Baseline to Week 16 in Participants Treated With Fasinumab 1mg SC Q4W Compared With That of Participants Treated With Placebo
Baseline to Week 16

The WOMAC index is comprised of 24 parameters grouped in 3 subscales (pain-5 questions, physical function -17 questions and stiffness - 2 questions), with 0-10 grading of each question. The scores for each subscale are summed up, divided by number of questions, and each subscale is reported using Numerical Rating Scale score of 0-10. In addition to subscales, a total score is provided as the sum of normalized subscale scores divided by three, and reported using a Numerical Rating Scale score of 0-10. Higher scores indicate worse pain, stiffness and functional limitations.

Change in the WOMAC Physical Function Subscale Scores From Baseline to Week 16 in Participants Treated With Fasinumab 1mg Q4W Compared With That of Participants Treated With Placebo
Baseline to Week 16

The WOMAC index is comprised of 24 parameters grouped in 3 subscales (pain-5 questions, physical function -17 questions and stiffness - 2 questions), with 0-10 grading of each question. The scores for each subscale are summed up, divided by number of questions, and each subscale is reported using Numerical Rating Scale score of 0-10. In addition to subscales, a total score is provided as the sum of normalized subscale scores divided by three, and reported using a Numerical Rating Scale score of 0-10. Higher scores indicate worse pain, stiffness and functional limitations.

Change in the WOMAC Pain Subscale Scores From Baseline to Week 16 in Participants Treated With Fasinumab 1mg SC Q8W Compared With That of Participants Treated With Placebo
Baseline to Week 16

The WOMAC index is comprised of 24 parameters grouped in 3 subscales (pain-5 questions, physical function -17 questions and stiffness - 2 questions), with 0-10 grading of each question. The scores for each subscale are summed up, divided by number of questions, and each subscale is reported using Numerical Rating Scale score of 0-10. In addition to subscales, a total score is provided as the sum of normalized subscale scores divided by three, and reported using a Numerical Rating Scale score of 0-10. Higher scores indicate worse pain, stiffness and functional limitations.

Change in the WOMAC Physical Function Subscale Scores From Baseline to Week 16 in Participants Treated With Fasinumab 1mg Q8W Compared With That of Participants Treated With Placebo
Baseline to Week 16

The WOMAC index is comprised of 24 parameters grouped in 3 subscales (pain-5 questions, physical function -17 questions and stiffness - 2 questions), with 0-10 grading of each question. The scores for each subscale are summed up, divided by number of questions, and each subscale is reported using Numerical Rating Scale score of 0-10. In addition to subscales, a total score is provided as the sum of normalized subscale scores divided by three, and reported using a Numerical Rating Scale score of 0-10. Higher scores indicate worse pain, stiffness and functional limitations.

Number of Participants With Any Treatment-Emergent Adverse Event (TEAE)
Baseline up to week 52
Number of Participants With Any Serious TEAE
Baseline up to week 52
Number of Participants With Any Adverse Event (AE) up to Week 72
Baseline up to week 72
Number of Participants With Any Serious AE up to Week 72
Baseline up to week 72
Number of Participants With Adjudicated Arthropathy (AA)
Baseline up to week 52 and week 72

Adjudicated arthropathy (AA) is a composite term that encompasses the following conditions: Rapidly progressive OA type 1 and 2, Subchondral insufficiency fractures, and Primary Osteonecrosis. AAs were also evaluated to determine if they met Destructive Arthropathy criteria.

Number of Participants With Adjudicated Arthropathy (AA) Meeting Destructive Arthropathy (DA) Criteria
Baseline up to week 52 and week 72

DA is a unique clinical form of rapidly destructive arthropathy over and above that seen in the normal progression of OA. DA criteria can be associated with Rapidly Progressive OA type 2, Subchondral Insufficiency fracture, and Primary Osteonecrosis confirmed by an arthropathy adjudication committee.

Number of Participants With at Least One Peripheral Sensory Event That Required a Neurology Consultation
Baseline up to week 72

Any participant with a peripheral sensory event that persisted for 2 months was referred for a neurology or other specialty consultation and reported as an adverse event of special interest (AESI).

Number of Participants With Sympathetic Nervous System (SNS) Dysfunction
Baseline up to week 72

Potential events of sympathetic nervous system (SNS) dysfunction were monitored throughout the study through physical examination, AE reporting, assessment of orthostatic hypotension, and the Survey of Autonomic Symptoms. Sympathetic nervous system dysfunction was diagnosed after consultation with an appropriate specialist, such as a neurologist and/or cardiologist.

Number of Participants With at Least One All-Cause Joint Replacement (JR) Surgery
Baseline up to weeks 52, 72, and end of study (52 weeks post last dose)

All joint replacement surgery events regardless of cause at weeks 52 and 72. An end of study phone contact was also conducted approximately 52 weeks following the last dose of study drug.

Number of Participants With Potentially Clinically Significant Abnormal Laboratory Values up to Week 52
Baseline to week 52

Number of participants with potentially clinically significant abnormal values in hematology, chemistry, and urinalysis during the treatment period were reported. Clinical significance was determined by the investigator.

Number of Participants With Potentially Clinically Significant Abnormal Laboratory Values Post-Treatment up to Week 72
End of treatment up to week 72

Number of participants with potentially clinically significant abnormal values in hematology, chemistry, and urinalysis during the post-treatment period were reported. Clinical significance was determined by the investigator.

Number of Participants With Anti-drug Antibody (ADA) up to Week 72
Baseline up to week 72

Immunogenicity was characterized by ADA responses \& titers. Responses categories: Negative - ADA negative response at all time points, regardless of missing samples; Pre-existing immunoreactivity - ADA positive response at baseline with all post first dose negative results or positive response at baseline with all post first dose ADA responses less than (\<) 9-fold over baseline titer levels; Treatment-boosted response - positive response in the assay post first dose, greater than or equal to (≥) 9-fold over baseline titer levels, when baseline results are positive; Treatment-emergent response - ADA positive response in the fasinumab ADA assay post first dose when baseline results = negative or missing.

Change From Baseline to Week 16 in the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) Pain Subscale Score
Baseline to Week 16

The WOMAC index is comprised of 24 parameters grouped in 3 subscales (pain-5 questions, physical function -17 questions and stiffness - 2 questions), with 0-10 grading of each question. The scores for each subscale are summed up, divided by number of questions, and each subscale is reported using Numerical Rating Scale score of 0-10. In addition to subscales, a total score is provided as the sum of normalized subscale scores divided by three, and reported using a Numerical Rating Scale score of 0-10. Higher scores indicate worse pain, stiffness and functional limitations.

Change From Baseline to Week 16 in WOMAC Physical Function Subscale Score
Baseline to Week 16

The WOMAC index is comprised of 24 parameters grouped in 3 subscales (pain-5 questions, physical function -17 questions and stiffness - 2 questions), with 0-10 grading of each question. The scores for each subscale are summed up, divided by number of questions, and each subscale is reported using Numerical Rating Scale score of 0-10. In addition to subscales, a total score is provided as the sum of normalized subscale scores divided by three, and reported using a Numerical Rating Scale score of 0-10. Higher scores indicate worse pain, stiffness and functional limitations.

Change From Baseline in Peroneal Motor Nerve Conduction Velocity at Week 16
Baseline, Week 16

Peroneal motor nerve conduction velocity was evaluated by electrical stimulation of the nerve and recorded the compound muscle action potential from surface electrodes overlying a muscle supplied by the nerve. Change from baseline in peroneal motor nerve conduction velocity at Week 16 was reported.

Change From Baseline in Peroneal Motor Nerve Action Potential Amplitude at Week 16
Baseline, Week 16

Peroneal motor nerve action potential amplitude was evaluated at ankle by electrical stimulation of the nerve and recorded the compound muscle action potential from surface electrodes overlying a muscle supplied by the nerve. Change from baseline in peroneal motor nerve action potential amplitude at Week 16 was reported.

Change From Baseline in Sural Sensory Nerve Conduction Velocity at Week 16
Baseline, Week 16

Sural sensory nerve conduction velocity was evaluated by electrically stimulating sensory fibers and recorded the nerve action potential at a point further along that nerve. Change from baseline in sural sensory nerve conduction velocity at Week 16 was reported.

Change From Baseline in Sural Sensory Nerve Action Potential Amplitude at Week 16
Baseline, Week 16

Sural sensory nerve action potential amplitude was evaluated by electrically stimulating sensory fibers and recorded the nerve action potential at a point further along that nerve. Change from baseline in sural sensory nerve action potential amplitude at Week 16 was reported.

Change From Baseline in Ulnar Sensory Nerve Conduction Velocity at Week 16
Baseline, Week 16

Ulnar sensory nerve conduction velocity was evaluated by electrically stimulating sensory fibers and recorded the nerve action potential at a point further along that nerve. Change from baseline in ulnar sensory nerve conduction velocity at Week 16 was reported.

Change From Baseline in Ulnar Sensory Nerve Action Potential Amplitude at Week 16
Baseline, Week 16

Ulnar sensory nerve action potential amplitude was evaluated by electrically stimulating sensory fibers and recorded the nerve action potential at a point further along that nerve. Change from baseline ulnar sensory nerve action potential amplitude at Week 16 was reported.

Change From Baseline to Week 16 in the Average Daily Low Back Pain Index Numeric Rating Scale (LBPI NRS) Score
Baseline to Week 16

Average daily low back pain (LBP) was assessed on an 11-point numeric rating scale (NRS) and was defined as the average of the non-missing daily LBPI NRS scores for the 7 days before and including nominal visit. Participants described their average low back pain during the past 24 hours on a scale ranging from 0 (no pain) to 10 (worst possible pain), where higher scores indicate higher pain.

The primary endpoint in the study is the change from baseline to week 16 in the Western Ontario and McMaster Osteoarthritis Index (WOMAC) pain subscale score.
Baseline to week 16
Sciatic pain between baseline and end of week 4
4 weeks
Percentage of device-associated product technical failure (PTF) for the AI based on the total number of fasinumab injections administered by patients/caregivers in an unsupervised setting
Baseline to Week 16
The incidence of TEAEs in patients treated with REGN475 or placebo, reported between administration of study drug on Day 1 and the completion of study at the end of week 24 (Day 169).
24 weeks

Secondary Endpoints

Percentage of Participants With Greater Than or Equal to (≥) 30 Percent (%) Reduction From Baseline up to Week 24 in WOMAC Pain Subscale Score in Participants Treated With Fasinumab Compared to Placebo
Baseline up to Week 24
Change From Baseline in Patient Global Assessment (PGA) Score up to Week 24 in Participants Treated With Fasinumab Compared to Placebo
Baseline up to Week 24
Change From Baseline in WOMAC Pain Subscale Scores up to Week 24 in Participants Treated With Fasinumab Compared to Participants Treated With NSAIDs
Baseline up to Week 24
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Study Design & Arms

AllocationRANDOMIZED
MaskingTRIPLE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
Dosing regimen 1EXPERIMENTAL -
Dosing regimen 2EXPERIMENTAL -
Dosing regimen 3EXPERIMENTAL -
Dosing regimen 4EXPERIMENTAL -
Fasinumab dosing regimen 1EXPERIMENTALFasinumab Subcutaneous (SC) dosing regimen 1 and naproxen-matching placebo oral
Fasinumab dosing regimen 2EXPERIMENTALFasinumab SC dosing regimen 2 and naproxen-matching placebo oral
Fasinumab-matching placebo and naproxenEXPERIMENTAL -
Fasinumab-matching placebo and naproxen-matching placeboEXPERIMENTAL -
PlaceboEXPERIMENTAL -
FasinumabEXPERIMENTAL -
Fasinumab 6 mg SC Q4W and Placebo IV Q8WEXPERIMENTALParticipants randomized to the fasinumab 6 mg SC Q4W arm received fasinumab 12 mg SC on Day 1 (loading dose) and then 6 mg SC (planned maintenance dose) at Weeks 4, 8, and 12 for a total of 4 doses. Matching placebo was received via intravenous (IV) infusion Q8W on Day 1 and at Week 8.
Fasinumab 9 mg SC Q4W and Placebo IV Q8WEXPERIMENTALParticipants randomized to the fasinumab 9 mg SC Q4W arm received 18 mg SC on day 1 (loading dose) and then 9 mg SC (planned maintenance dose) at weeks 4, 8, and 12 for a total of 4 doses. Matching placebo IV Q8W was received on Day 1 and at Week 8.
Fasinumab 9 mg IV Q8W and Placebo SC Q4WEXPERIMENTALParticipants randomized to the fasinumab 9 mg IV Q8W arm received IV infusions of fasinumab 9 mg on Day 1 and Week 8, for a total of 2 doses. Matching placebo SC Q4W was received on day 1 and at weeks 4, 8, and 12.
Placebo SC Q4W and Placebo IV Q8WEXPERIMENTALParticipants randomized to the matching placebo subcutaneously (SC) every four weeks (Q4W) arm received SC placebo in a manner similar to the SC loading dose of the active groups (placebo loading dose) on Day 1 and then an SC injection of placebo at weeks 4, 8, and 12 for a total of 4 doses. Matching placebo intravenously (IV) every 8 weeks (Q8W) was received on Day 1 and at Week 8.
Group AEXPERIMENTALGroup A will receive REGN475 dosing regimen 1
Group BEXPERIMENTALGroup B will receive REGN475 dosing regimen 2
Group CEXPERIMENTALGroup C will receive REGN475 dosing regimen 3
Group DEXPERIMENTALGroup D will receive REGN475 dosing regimen 4
Group EEXPERIMENTALGroup E will receive matching placebo
placebo injectionPLACEBO_COMPARATOR -
activeEXPERIMENTALsubcutaneous injection of REGN475
active 2EXPERIMENTALsubcutaneous injection of REGN475
Auto-injector (AI)EXPERIMENTAL -
Prefilled syringe (PFS)EXPERIMENTAL -
Dose 1EXPERIMENTAL -
Dose 2EXPERIMENTAL -
Dose 3EXPERIMENTAL -

Interventions

NameTypeDescription
FasinumabDRUGSolution for injection in pre-filled syringe
DiclofenacOTHERNSAID active comparator (capsule)
CelecoxibOTHERNSAID active comparator (capsule)
Matching placeboDRUGFasinumab-matching placebo (solution for injection in pre-filled syringe); NSAID-matching placebo (capsule)
NaproxenDRUGPharmaceutical form: Capsule
Fasinumab-matching placeboDRUGSolution for injection in pre-filled syringe
Naproxen-matching placeboDRUGCapsule
PlaceboDRUGParticipants will receive sub-cutaneous (SC) injections of matching placebo
REGN475DRUG -
Placebo InjectionDRUGPlacebo Subcutaneous injection
Fasinumab AIDRUGSelf-administered with auto injector
Fasinumab PFSDRUGPrefilled syringe administered by study staff
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Eligibility Criteria

Age Range18 Years to N/A
SexALL
Healthy VolunteersNo
Study Sites71

Key Inclusion Criteria (additional criteria may apply at screening): 1. A clinical diagnosis of osteoarthritis (OA) of the knee or hip based on the American College of Rheumatology criteria with radiologic evidence of OA (K-L score ≥2 for the index joint) at the screening visit. 2. Willing to disco...

Countries:United StatesDenmarkGermanyHungaryLithuaniaPolandRomaniaRussiaSouth AfricaSpainUkraineUnited KingdomBulgariaChileColombiaEstoniaHong KongItalyMexicoPeruSwedenCanadaCzechia
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Competitive Landscape -Osteoarthritis 143 trials (matched to "Osteoarthritis, Knee")

Frequently asked questions about REGN475

What is REGN475 used for?

REGN475 is an investigational monoclonal antibody being studied for pain conditions, specifically osteoarthritis of the knee and sciatica. It was developed to treat pain associated with knee osteoarthritis and sciatic pain. The clinical program explored its use in patients with these musculoskeletal pain indications.

What does REGN475 target?

REGN475 targets nerve growth factor, or NGF, a protein involved in pain signaling. By binding NGF, the antibody is designed to interfere with NGF-mediated pain pathways. NGF is a well-characterized target in musculoskeletal pain research, and REGN475 is a monoclonal antibody directed against this protein.

Who is developing REGN475?

REGN475 is being developed by Regeneron Pharmaceuticals, Inc., which trades on Nasdaq under the ticker REGN. The drug is also identified as REGN475 (SAR164877), reflecting a collaboration naming convention. Regeneron is the sponsor of the clinical studies conducted for this asset.

What phase is REGN475 in?

REGN475 is in Phase 1 development and is investigational. It has not been approved by the FDA. Clinical work completed to date includes Phase 1 and Phase 2 studies, and no active trials are currently listed for the program.

What clinical trials is REGN475 in?

REGN475 has been studied in completed trials including NCT02447276, a Phase 2 study in knee or hip osteoarthritis pain with 421 patients, NCT00991172, a Phase 2 study in sciatic pain with 159 patients, and NCT00944892, a Phase 1 study in knee osteoarthritis with 200 patients. All were conducted in the United States.

Is REGN475 the same as SAR164877?

Yes, REGN475 is also known as SAR164877. The dual name REGN475 (SAR164877) appears in trial titles and reflects the same monoclonal antibody asset. Readers searching for either name are looking at the same investigational compound developed by Regeneron Pharmaceuticals.