Additional Safety and Exploratory Efficacy Data at 48 and 60 Months from Open-HART, an Open-Label Extension Study of Pridopidine in Huntington Disease

Article type: Research Article

Authors: McGarry, Andrew^{a; *} | Auinger, Peggy^b | Kieburtz, Karl^b | Geva, Michal^g | Mehra, Munish^c | Abler, Victor^d | Grachev, Igor D.^d | Gordon, Mark Forrest^d | Savola, Juha-Matti^f | Gandhi, Sanjay^d | Papapetropoulos, Spyridon^e | Hayden, Michael^{g; h}

Affiliations: [a] Cooper University Health Care at Rowan University, Camden, NJ, USA | [b] University of Rochester Medical Center, Rochester, NY, USA | [c] Tigermed Data Solutions, Bengaluru, Karnataka, India | [d] Teva Pharmaceutical Industries, Kansas City, MO, USA | [e] Teva Pharmaceutical Industries, Frazer, PA, USA | [f] Teva Pharmaceuticals International GmbH, Basel, Switzerland | [g] Prilenia Therapeutics, Herzliya, Israel | [h] CMMT, UBC, Canada

Correspondence: [*] Correspondence to: Andrew McGarry, MD, Cooper University Health Care at Rowan University, 3 Cooper Plaza, Suite 320, Cherry Hill, New Jersey 08103, USA. Tel.: +1 856 342 2445; Fax: +1 856 964 0504; E-mail: [email protected].

Abstract: Background:Open-HART was an open-label extension of HART, a randomized, double-blind, placebo-controlled study of pridopidine in Huntington disease (HD). Previously, we reported safety and exploratory efficacy data after 36 months of treatment with pridopidine 45 mg twice daily. In the interim, emerging data suggests pridopidine may have neuroprotective effects mediated by sigma-1 receptor agonism. Objective:To report additional safety and exploratory efficacy data for continued open-label use of 45 mg BID pridopidine at 48 and 60 months. Methods:Patients in Open-HART were followed up to or greater than 60 months. Adverse events, concomitant medications, vital signs, laboratory values, and ECG data were monitored. Rates of decline in total functional capacity (TFC) and total motor score (TMS) over 60 months were evaluated in an exploratory analysis and compared between Open-HART and placebo recipients from the 2CARE trial. To account for missing data, sensitivity analyses were performed. Results:Of the original Open-HART baseline cohort (N = 118), 40 remained in the study at 48 months and 33 at 60 months. Pridopidine remained safe and well tolerated over the 60-month interval. TFC and TMS at 48 and 60 months remained stable, showing less decline at these timepoints compared to historical placebo controls from the 2CARE trial. TFC differences at 48 and 60 months observed remained nominally significant after sensitivity analysis. Conclusion:The 45 mg BID pridopidine dosage remained safe and tolerable over 60 months. Exploratory analyses show TFC and TMS stability at 48 and 60 months, in contrast to placebo historical controls from the 2CARE trial. Results are consistent with data reported from the recent Phase 2 PRIDE-HD trial showing less functional decline in the pridopidine 45 mg BID treated group at 52 weeks.

Keywords: Huntington disease, clinical trial, pridopidine, sigma-1-receptor

DOI: 10.3233/JHD-190393

Journal: Journal of Huntington's Disease, vol. 9, no. 2, pp. 173-184, 2020