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Immunic, Inc. Announces That Oral Treatment IMU-838 Shows Evidence of Clinical Activity in Moderate COVID-19 in Phase 2 CALVID-1 Trial - Clinical Activity of IMU-838 Confirmed Based on Multiple Secondary Endpoints, Inclu

Key Takeaway: Immunic, Inc. Announces That Oral Treatment IMU-838 Shows Evidence of Clinical Activity in Moderate COVID-19 in Phase 2 CALVID-1 Trial of IMU-838 Confirmed Based on Multiple Secondary Endpoints, Including Clinically Meaningful Improvements in Time to Clinical Recovery and Clin

Full Press Release Details

Immunic, Inc. Announces That
Oral Treatment IMU-838 Shows Evidence of Clinical Activity in Moderate COVID-19 in Phase 2 CALVID-1 Trial
of IMU-838 Confirmed Based on Multiple Secondary Endpoints, Including Clinically Meaningful Improvements in Time to Clinical Recovery
and Clinical Improvement -
Key Secondary Endpoints Were Not Evaluable Due to the Very Low Rates of Serious Complications in the Population of Hospitalized
Patients With Moderate COVID-19 -
- High-Risk Patients
and Patients Aged Over 65 Years Experienced a More Substantial Treatment Effect of IMU-838 -
- Robust Anti-Inflammatory
Effect Observed, Based on a More Effective Reduction of C-Reactive Protein (CRP) in IMU-838 Treated Patients, as Compared to Placebo
From a Post Hoc Analysis of "Long COVID" Symptoms Indicates That IMU-838 May Have the Potential to Contribute to the
Prevention of Long-Term Fatigue -
and Webcast to be Held on February 18, 2021 at 8:00am ET -
YORK, February 17, 2021 - Immunic, Inc. (Nasdaq: IMUX), a clinical-stage biopharmaceutical company developing
a pipeline of selective oral immunology therapies aimed at treating chronic inflammatory and autoimmune diseases, today announced
that its lead asset, IMU-838, the company's selective oral DHODH inhibitor, has shown evidence of clinical activity in hospitalized
patients with moderate coronavirus disease 2019 (COVID-19). This planned main analysis of the company's phase 2 CALVID-1
trial is based on data from 204 randomized patients and includes top-line clinical efficacy, safety, disease marker, and virology
data. Although no formal statistical analysis was pre-specified for this main analysis, endpoints have been analyzed descriptively.
A final analysis of the complete randomized patient population of 223, which will comprise data on all endpoints, including subgroup
and sensitivity analyses, is expected to be available in the second quarter of 2021.
The primary endpoint of the randomized,
placebo-controlled, double-blind trial was defined as the proportion of patients without any need for invasive ventilation through
day 28. In contrast to the relatively high rates of ventilation reported in the first COVID-19 wave in early 2020, the CALVID-1
trial found an actual rate of less than 1% of invasive ventilation for hospitalized patients with moderate COVID-19. This very
low event rate, consistent with the findings of many recent third-party trials in COVID-19, prevented the primary endpoint from
Regarding the key secondary endpoints,
the trial was designed to investigate IMU-838's ability to reduce the probability of major complications for COVID-19 patients,
such as 28-day mortality, survival without respiratory failure, and probability of use of intensive care unit (ICU) treatment.
Similar to the low ventilation rates discussed above, the trial found a rate of less than 2% for 28-day mortality, balanced between
the two arms, and less than 4.5% of patients required an ICU stay. Based on the very low complication rates in this trial and due
to the known variability of the disease course, Immunic believes that the evaluation of these key secondary endpoints is also not
Despite the low mortality and invasive
ventilation rates observed in this trial, clinical activity of IMU-838 was confirmed based on the assessment of multiple secondary
Time to clinical recovery[1]:
The proportion of patients reaching clinical recovery at day 7 was 18.5% (N=15) in IMU-838 treated patients, compared with only
12.8% (N=10) in the placebo arm. At day 28, 71.3% (N=57) of the IMU-838 treated patients had recovered compared with only 66.7%
(N=58) in the placebo arm (FAS[2]).
Time to clinical improvement[3]:
Time to clinical improvement was found to be shorter in the IMU-838 treatment arm, as compared to placebo, and the incremental
benefit increased over time (mFAS[4]).
mFAS Population [4] (Days)
Probabiliy of Clinical Improvement (Centrally Calculated) IMU-838 Placebo Difference in Favor of IMU-838
50% 13.9 13.9 0.0
75% 15.0 17.9 2.9
90% 18.9 26.8 7.9
Table: IMU-838 Shows Acceleration of
Time to Clinical Improvement
High-risk patients and patients aged over
65 years experienced a more substantial treatment benefit from IMU-838 than in the general patient population:
Viral burden as well as biochemical inflammation
and disease markers:
IMU-838 was found to be safe and well-tolerated
in hospitalized patients with moderate COVID-19. No general safety signals regarding new or more severe adverse events were observed
for IMU-838 in this patient population, as compared to placebo. In addition, IMU-838's rate of serious adverse events and
adverse events leading to treatment discontinuation was not increased, as compared to placebo. The trial also found fewer COVID-19
related adverse events with increased intensity in IMU-838 treated patients (7.1%), as compared to placebo (12.6%) and IMU-838
did not intensify any hematological effects of COVID-19. In addition, IMU-838 did not increase the rate of infections and infestations
as well as the rate of liver events in patients with COVID-19, as compared to placebo.
"I am truly excited to report that
our CALVID-1 trial showed clinical activity of IMU-838 in hospitalized patients with moderate COVID-19 and also reproduced in this
patient population the drug's already established favorable safety and tolerability profile," stated Daniel Vitt,
Ph.D., Chief Executive Officer and President of Immunic. "The reductions in hospitalization and clinical recovery times
observed thus far in our CALVID-1 trial are clinically meaningful, and particularly interesting in the high-risk and elderly populations.
In addition, we have seen effects on preventing long-term COVID-19 symptoms which suggest that IMU-838 could be a promising new
therapeutic intervention that could provide meaningful clinical benefit. I strongly believe that this trial underlines the potential
of IMU-838 to be a convenient, safe and well-tolerated oral treatment option for patients with moderate COVID-19 and may even pave
the way for testing IMU-838 in earlier stage COVID-19 patients in the future. We look forward to analyzing the final data on the
full 223 patient population, but we are also mindful of the rapidly changing COVID-19 landscape for decisions on future plans.
In the meantime, we look forward to discussing the results of this main analysis as well as the upcoming full analysis with clinical
and regulatory experts. In parallel, we plan to explore options for the further development of IMU-838 in this indication and for
"The Immunic team is forever indebted
to the countless physicians, nurses, study coordinators and other healthcare personnel who participated in this trial while, at
the same, working under challenging conditions in this pandemic situation, in order to improve lives and outcomes for patients
infected with the SARS-CoV-2 virus," added Andreas Muehler, M.D., Chief Medical Officer of Immunic. "With the
help of our collaborators, we were able to show clinical activity of IMU-838 in COVID-19 patients and, consistent with prior data
sets in other patient populations, administration of IMU-838 in this trial was observed to be safe and well-tolerated, thereby
providing evidence of an attractive target profile for IMU-838 as a convenient oral treatment option in the moderate COVID-19 patient
population. The treatment effect of IMU-838 versus placebo appears to be commensurate with that of other medications which were
successfully tested in COVID-19. Based on these promising clinical data from the main analysis of our CALVID-1 trial, later also
complemented by the more detailed efficacy and virology data from the full analysis of all randomized patients, we will evaluate
the way forward for IMU-838 as a potential treatment option for COVID-19 patients."
A total of 204 patients were
included in the main analysis of the CALVID-1 trial, as per the protocol requirement of approximately 200 patients. 202 patients
received at least one dose of study drug, of whom 99 patients received 45 mg/day of IMU-838 and 103 patients received placebo.
The main analysis contains top-line data for the treatment period until day 14 and the follow-up period until day 28 as well as
the full safety data until day 28. Additional data will be reported after the full analysis of all 223 randomized patients, which
is expected to be available in the second quarter of 2021. This supplemental data set will contain full efficacy, virology, and
drug trough level data, as well as the safety follow-up until day 60.
The aim of the CALVID-1 trial was to investigate
IMU-838 as an oral treatment option for COVID-19 and to support potential use of IMU-838 as a treatment for current and potential
future viral pandemic threats. The prospective, multicenter, randomized, placebo-controlled, double-blind phase 2 trial was designed
to evaluate efficacy, safety and tolerability of IMU-838 in patients with moderate COVID-19. Patients were enrolled at 20 sites
in eleven countries, including the United States, Germany, and a range of other European countries. Patients were randomized to
receive either 22.5 mg of IMU-838 twice daily (45 mg/day), or placebo twice daily, for 14 consecutive days. Patients in both arms
were also eligible to receive investigator's choice of standard-of-care therapy throughout the duration of the study. Inclusion
criteria called for hospitalized adult patients with a confirmed SARS-CoV-2 infection fulfilling clinical status category 3 or
4, as assessed with the nine-category ordinal scale proposed by the World Health Organization (WHO) COVID-19 Therapeutic Trial
Synopsis, as well as certain additional clinical and laboratory criteria.
more information on this clinical trial, please visit: www.clinicaltrials.gov, NCT04379271.
Conference Call and Webcast Information
management team will host a public conference call and webcast on February 18, 2021 at 8:00 a.m. Eastern Time to discuss
the data from the main phase 2 analysis of the CALVID-1 trial of IMU-838 in hospitalized patients with moderate COVID-19.
participate in the conference call, dial 1-877-870-4263 (USA) or 1-412-317-0790 (International) and ask to be joined into the Immunic,
Last updated: Feb 18, 2021