Full Press Release Details
Immunic Reports Pre-Planned Phase 1b Interim
Analysis of IMU-935 in Psoriasis Patients Confounded by High Placebo Rate
Interim Analysis Revealed Unexpected High Placebo Rate; Two Active Arms Did Not Separate From Placebo -
No New Safety Signals Observed for IMU-935 in this Trial -
Company Expects to Continue IMU-935 Development in Psoriasis -
October 20, 2022 - Immunic, Inc. (Nasdaq: IMUX), a clinical-stage biopharmaceutical company developing a pipeline
of selective oral immunology therapies focused on treating chronic inflammatory and autoimmune diseases, today announced the outcome of
a pre-planned interim group-level data analysis of its phase 1b clinical trial of IMU-935 in patients with moderate-to-severe psoriasis.
The overall trial is ongoing and remains blinded. The pre-planned interim analysis revealed that the group averages for Psoriasis Area
and Severity Index (PASI) reductions in the two active arms did not separate from placebo at four weeks. Although the active arms performed
in line with prior expectations, the trial experienced a greater decrease than expected in PASI in the placebo arm based on similarly
The trial, conducted in Australia, New Zealand
and Bulgaria, was structured as a 28-day, double-blind, placebo-controlled trial. A total of 41 patients were enrolled and the trial evaluated
IMU-935 at doses of 150 mg once-daily and 150 mg twice-daily versus placebo (randomized 3:1). The primary objective was the evaluation
of the safety and tolerability of IMU-935 in moderate-to-severe psoriasis patients.
At this point, the company only has access to
very limited information. The interim analysis only revealed mean values at group-level up to the end of the four-week treatment period.
Immunic does not yet have access to unblinded individual patient data. Moreover, pharmacodynamic, biomarker - including skin punches
and IL-17 levels in serum - or pharmacokinetic data, at either an individual or group-level, are not yet available. Based on the
already available preclinical and clinical safety and tolerability data, Immunic has the flexibility to consider additional higher-dose
or longer treatment cohorts. Supported by the broad availability of activity data from in vitro and in vivo studies in various
disease models and settings, the company continues to believe in IMU-935's potential therapeutic activity.
Finally, although the safety data remains blinded,
administration of IMU-935 and placebo in this trial were demonstrated to be safe and well-tolerated, and no new safety signals were observed.
"Although we did not see the desired activity
signal over placebo in this group-level interim analysis, we retain a high degree of conviction on IMU-935's potential promise in
psoriasis and beyond," stated Daniel Vitt, Ph.D., Chief Executive Officer and President of Immunic. "Given the proven binding
of IMU-935 to the molecular target ROR t, potent target inhibition as measured by transcription inhibition and secretion of pro-inflammatory
cytokines, including IL-17A, IL-17F and IFN from human peripheral blood mononuclear cells (PBMC), proven inhibition of Th17 cell
differentiation, and consistent activity in different animal models, including psoriasis, multiple sclerosis and graft-versus-host disease,
we believe IMU-935 holds the potential to provide a safe, efficacious and meaningful treatment option to patients with psoriasis. That
said, we look forward to a full and final analysis of data from this trial which hopefully allows us to better understand these early
observations to determine the best next steps for this exciting program."
"The unexpected high placebo rates observed
in this interim analysis are disappointing and confound the evaluation of activity in the investigated active treatment arms. This requires
further investigation throughout the coming weeks and months," stated Andreas Muehler, M.D., Chief Medical Officer of Immunic. "These
were the first two dose levels tested in patients. Based on IMU-935's very favorable pharmacokinetic, safety and tolerability profile,
to date, including absence of any dose-limiting toxicities in humans at doses exceeding those in this trial, and the preclinical safety
and tolerability data, we have significant flexibility to explore higher dosing and longer treatment periods of this promising molecule.
Availability of the full, unblinded individual patient data, and in particular the quantitative immunological markers, should help us
to further guide the optimal development path for IMU-935."
The company reiterates its prior guidance that
current cash, cash equivalents and marketable securities are expected to fund operating and capital expenditures into the fourth quarter
of 2024. Regarding the company's upcoming clinical milestones, as previously announced, data from the interim analysis of the phase
2 CALLIPER trial of vidofludimus calcium in progressive multiple sclerosis are expected to be available in the second half of 2023 and
top-line data at the end of 2024. Moreover, the read-out of the first of the phase 3 ENSURE trials of vidofludimus calcium in relapsing
multiple sclerosis is targeted for end of 2025. Finally, initial clinical efficacy data of the Part C portion of the ongoing phase 1 clinical
trial of IMU-856 in celiac disease patients are expected in 2023.
is a highly potent and selective inverse agonist of ROR /ROR t
(retinoic acid receptor-related orphan nuclear receptor gamma / truncated). The nuclear
receptor ROR t is believed to be the main driver for the differentiation of Th17 cells and
the release of cytokines involved in various inflammatory and autoimmune diseases. This target is believed to be an attractive alternative
to approved antibodies for targets, such as IL-23, the IL-17 receptor and IL-17 itself. IMU-935 showed strong cytokine inhibition targeting
both Th1 and Th17 responses in preclinical testing, as well as indications of activity in animal models for psoriasis, graft-versus-host
disease, multiple sclerosis and inflammatory bowel disease. Preclinical experiments indicated that, while leading to a potent inhibition
of Th17 differentiation and cytokine secretion, IMU-935 did not affect thymocyte maturation. A phase 1 clinical trial evaluating single
and multiple ascending doses in healthy human subjects showed a favorable safety, tolerability and pharmacokinetic profile of IMU-935.
IMU-935 is an investigational drug product that has not been approved in any jurisdiction.
(Nasdaq: IMUX) is a clinical-stage biopharmaceutical company with a pipeline of selective oral immunology therapies focused on treating
chronic inflammatory and autoimmune diseases. The company is developing three small molecule products: its lead development program, vidofludimus
calcium (IMU-838), a selective immune modulator that inhibits the intracellular metabolism of activated immune cells by blocking the enzyme
DHODH and exhibits a host-based antiviral effect, is currently being developed as a treatment option for multiple sclerosis, and primary
sclerosing cholangitis. IMU-935, a selective inverse agonist of the transcription factor ROR /ROR t, is targeted for development
in psoriasis, and castration-resistant prostate cancer. IMU-856, which targets the restoration of the intestinal barrier function, is
targeted for development in diseases involving bowel barrier dysfunction. For further information, please visit: www.imux.com.
Statement Regarding Forward-Looking Statements
This press release contains "forward-looking
statements" that involve substantial risks and uncertainties for purposes of the safe harbor provided by the Private Securities
Litigation Reform Act of 1995. All statements, other than statements of historical facts, included in this press release regarding strategy,
future operations, future financial position, future revenue, projected expenses, sufficiency of cash, expected timing and results of
clinical trials, prospects, plans and objectives of management are forward-looking statements. Examples of such statements include, but
are not limited to, statements relating to Immunic's three development programs and the targeted diseases; the potential for IMU-935
to safely and effectively target diseases; interpretation of preclinical and clinical data for IMU-935 and potential effects; plans to
continue the phase 1b clinical trial of IMU-935 in patients with moderate-to-severe psoriasis, the timing of current and future clinical
trials and anticipated clinical milestones; the nature, strategy and focus of the company and further updates with respect thereto; and
the development and commercial potential of any product candidates of the company. Immunic may not actually achieve the plans, carry out
the intentions or meet the expectations or projections disclosed in the forward-looking statements and you should not place undue reliance
on these forward-looking statements. Such statements are based on management's current expectations and involve substantial risks
and uncertainties. Actual results and performance could differ materially from those projected in the forward-looking statements as a
result of many factors, including, without limitation, the COVID-19 pandemic, impacts of the Ukraine - Russia conflict on clinical
trials, risks and uncertainties associated with the ability to project future cash utilization and reserves needed for contingent future
liabilities and business operations, the availability of sufficient financial and other resources to meet business objectives and operational
requirements, the fact that the results of earlier preclinical studies and clinical trials may not be predictive of future clinical trial
results, the protection and market exclusivity provided by Immunic's intellectual property, risks related to the drug development
and the regulatory approval process and the impact of competitive products and technological changes. A further list and descriptions
of these risks, uncertainties and other factors can be found in the section captioned "Risk Factors," in the company's
Annual Report on Form 10-K for the fiscal year ended December 31, 2021, filed with the SEC on February 24, 2022, and in the company's
subsequent filings with the Securities and Exchange Commission. Copies of these filings are available online at www.sec.gov or ir.imux.com/sec-filings.
Any forward-looking statement made in this release speaks only as of the date of this release. Immunic disclaims any intent or obligation
to update these forward-looking statements to reflect events or circumstances that exist after the date on which they were made. Immunic
expressly disclaims all liability in respect to actions taken or not taken based on any or all the contents of this press release.
Head of Investor Relations and Communications
Rx Communications Group