Dalazatide, first-in-class Kv1.3 channel blocker, an immunomodulators journey from sea to clinic Aurora Biomed Ion Channels Retreat 2015 Shawn Iadonato
Dalazatide: Potential Autoimmune Blockbuster Immune regulating therapy First in Class Novel Kv1.3 inhibitor Broad autoimmune indications Immune sparing No target organs of toxicity Well tolerated in clinical studies Expansive commercial opportunities Strong global patent estate Phase 2 Ready 4
DALAZATIDE: FIRST IN CLASS KV1.3 INHIBITOR 5
Kv1.3: A Novel Target for Autoimmune Disease Effector Memory T cells (T EM ) cause autoimmune disease T EM cells depend on the Kv1.3 channel for activation Blockade of Kv1.3 suppresses inflammation from T EM cells Kv1.3 HIGH autoreactive T EM cells identified in multiple autoimmune diseases 6
Kv1.3 HIGH T cells Are Abundant in Atopic Dermatitis Lesional Skin CD3 Kv1.3 CD3 Kv1.3 AD (20x) AD (40x) Most autoreactive, infiltrating Th1/2 cells in AD are Kv1.3 HIGH Confidential 8
Kv1.3: T Cells in Inflamed Mucosa of Ulcerative Colitis 23% of CD8 + and 54% of CD4 + T cells in UC biopsies are Kv1.3 HIGH From Koch et al. J Crohns Colitis. 2014 Nov 1;8(11):1378-91. 9
RA Synovium OA Synovium Type 1 Diabetes Type 2 Diabetes MS Myelin Ctrl Myelin Asthma Sputum Ctrl Sputum Kv1.3 channels / cell Large Number of Kv1.3 Channels Found Across Autoimmune T Cell Populations 2500 2000 1500 1000 500 0 Number of Kv1.3 channels on disease T cells 2 3 fold higher than control cells From Koshy et al. J Biol Chem. 2014 May 2;289(18):12623-32 and Beeton et al. Proc Natl Acad Sci U S A. 2006 Nov 14;103(46):17414-9. 10
Kv1.3 Expression Well-Established Across Autoimmune Space Kv1.3 HIGH Autoreactive T EM cells identified in: CNS Multiple Sclerosis GI Crohn s Disease Ulcerative Colitis Rheumatology Lupus (SLE) Lupus Nephritis Vasculitis PsA RA Opthalmology Uveitis / Dry Eye Dermatology Psoriasis Atopic Dermatitis Other Type 1 Diabetes Asthma GVHD 11
Dalazatide: Novel MOA Through Kv1.3 Blockade Highly specific and potent antagonist of Kv1.3 channel Blocks activation of autoreactive, Kv1.3 HIGH, effector memory T cells (T EM ) Does not block Naïve, Central Memory or Regulatory T cells Targeting of autoreactive T EM reduces number of disease causing cells and proinflammatory mediators Blockade of Kv1.3 may lead to a remission by immunomodulation or induction of tolerance Dalazatide is a first in class Kv1.3 inhibitor that targets a differentiated pathway 12
Effector Memory Autoimmunity Central Memory Naïve Dalazatide is Targeted and Immune Sparing CD3 CTLA4 IL-12/23 JAK PDE4 Integrin, S1PR integrin, S1PR Calcineurin dalazatide IL-1 TNFα IL-6 IL17 Resting Activated K + CD4 + or CD8 + T Cells KCa3.1 K + Inflammatory Mediators CD4 + or CD8 + T Cells KCa3.1 K + K + Inflammatory Mediators CD4 + or CD8 + T Cells Kv1.3 Th1/ Th17 K + Th1/ Th17 K + Inflammatory Mediators Kv1.3 Channel KCa3.1 Channel MoA Pathway 13
Dalazatide: Novel Kv1.3 Inhibitor 37 amino acid synthetic cyclic peptide Derived from the stichodactyla sea anemone Phase 1 clinical formulation: twice weekly subcutaneous injection to abdominal fat pad Phase 2: ready-to-use, pre-filled single use syringe Developmental formulations: 8 12 week subcutaneous sustained release formulation Eye drop Topical cream Dalazatide is a first in class Kv1.3 inhibitor that targets a differentiated pathway 14
DALAZATIDE: NON-CLINICAL PD, EFFICACY & TOXICOLOGY 15
Cumulative Clinical Score Cum Clin Score Animal Models: Dalazatide Effective in Multiple Sclerosis 3.5 3.0 80 Cum Clin Score D34 P=0.05 P<0.001 2.5 2.0 60 1.5 40 1.0 0.5 20 0.0 0 5 10 15 20 25 30 day post onset Daily Placebo (P6N) Daily (100 g/kg) Every 3 Days (100 g/kg) 0 Placebo 1 g/kg 3 g/kg 10 g/kg Dalazatide effective in animal model of relapsing MS over broad range of doses and dose frequencies From Tarcha et al. J Pharmacol Exp Ther. 2012 Sep;342(3):642-53. 16
Clinical Score Animal Models: Dalazatide Effective in Arthritis Model 10 8 6 DAL 4 2 0 0 5 10 15 20 Days Post-Onset Controls DAL 100 g/kg DAL 10 g/kg Dalazatide demonstrated efficacy in pristane-induced arthritis model Beeton et al. Proc Natl Acad Sci U S A. 2006 Nov 14;103(46):17414-9. 17
Protein/Creatinine WBC / HPF 10 g/kg DAL 100 g/kg DAL Placebo 1 g/kg DAL Protein (mg/dl) RBC / HPF 1750 1500 1250 1000 750 500 250 0 30 20 10 Animal Models: Dalazatide Effective in KIN2012-32 PCL Urine Protein Autoimmune Glomerulonephritis RBC in urine KIN2012-32 PCL Protein/Creatinine 0 7 14 21 28 35 42 49 56 Study Day 80 Placebo 1 g/kg DAL 10 g/kg 60 DAL 100 g/kg DAL 40 20 0 0 7WBC 21 28in 35urine 42 49 56 100 Study Day Placebo 10ug/Kg ShK 1ug/Kg ShK 80 100ug/Kg ShK 60 40 20 Placebo 1 µg/kg 0 0 7 14 21 28 35 42 49 56 Study Day Placebo 1 g/kg ShK-186 14 21 28 35 42 49 56 Study Day 10 g/kg ShK-186 100 g/kg ShK186 0 Placebo 1ug/Kg ShK 0 7 21 28 35 42 49 56 Study Day 10ug/Kg ShK 100ug/Kg ShK Dalazatide effective in glomerulonephritis model of SLE and preserved kidney function 18
Safety Established in Pre-clinical Toxicology Program Toxicology studies conducted in rat and cyno monkey Following ICH S6 guidance Six month chronic toxicology conducted in both species Established safety margins range 17-25X No target organs of toxicity identified NOAEL was highest dose tested Histopathology Evaluation Clinical Chemistry/Hematology/Urinalysis Safety Pharmacology Cardiovascular Respiratory Neurological Toxicity No No No No No No safety pharm concerns or target organs of toxicity identified 20
DALAZATIDE: CLINICAL PROGRAM 22
Dalazatide Clinical Development Status 1A 1B 1B Single Ascending Dose Safety Study 32 Healthy Volunteers One Dose One site in Netherlands Multiple Ascending Dose Safety Study 32 Healthy Volunteers Twice-weekly dosing for 4 weeks One site in the U.S. Safety and Biomarker Study in Psoriasis 24 Mild-moderate active plaque psoriasis Twice-weekly dosing for 4 weeks Two sites in Canada Phase 2 Ready Asset 23
Initial Phase 1 Studies Demonstrate Dalazatide Safety in Healthy Volunteers Open IND in Rheumatology Division of FDA 186-01 Single Ascending Dose Study (NL) 186-02 Multiple Ascending Dose 28-Day Study (USA) Subcutaneous administration to abdominal fat pad Results Drug well tolerated in both studies No significant findings in labs, vitals, ECGs, physical exams, neurological exams AE s were considered to be mild Maximum tolerated dose not determined No subject developed anti-drug antibody Dalazatide is well tolerated in clinical studies 24
Dalazatide Demonstrates Clinical Proof-of- Concept in Phase 1b Psoriasis Trial 186-03 study of the safety, tolerability and pharmacodynamics of dalazatide in active plaque psoriasis. Active plaque psoriasis with 3% BSA and multiple target lesions Received twice-weekly injections at 2 dose levels (30 mcg or 60 mcg) for 4 weeks followed by 4-week follow-up Safety & Tolerability Drug well tolerated; all subjects completed all scheduled doses Most AEs judged to be mild, consistent with previous trials No subjects withdrew, reduced dose or missed a dose Dalazatide is well tolerated in active plaque psoriasis population 25
Dalazatide Demonstrates Clinical Proof-of- Concept in Phase 1b Psoriasis Trial Clinical Activity Study not powered to evaluate clinical efficacy 50% of subjects in 60 mcg group achieved clinical improvement in target lesion Improvements observed as early as day 15 and for up to 4 weeks following last dose (end-of-study) 90% of subjects in 60 mcg group had reduction in PASI score Mean PASI score reduction reached statistical significance (p=.004) in 60 mcg group Biomarker Studies Ongoing with James Krueger (Rockefeller U.) Gene expression and immunohistochemistry of biopsies Inflammatory mediators concentration in blood plasma T cell subsets/pd marker evaluation by flow cytometry Dalazatide treatment results in improvements in validated psoriasis endpoints in up to 90% of subjects 26
Dalazatide Clinical Activity - 30µg Dose BL Baseline Day 32 D32 Significant improvement in target lesions following 4 weeks of treatment.
Why Dalazatide? dalazatide CD3 CTLA4 JAK PDE4 Calcineurin IL-12/23 integrin, S1PR IL-1 IL-6 TNFα IL17 Broad Autoimmune Indications Immune sparing Potential for Durable Remission Post Therapy Patient Safety Tolerability in Clinical Trials Dalazatide offers differentiation in indications and safety from competing therapies 28
Dalazatide Collaborators UC Irvine George Chandy Michael Cahalan Many others Baylor College of Medicine Christine Beeton Peptides International Mike Pennington Monash University Ray Norton UC Davis Heike Wulff Kineta Eric Tarcha Ernesto Munoz Kayla Norton David Peckham John Grigg Jose Mercado Many others 35
Thank You & Questions For more information, please contact: Shawn Iadonato, PhD shawn@kineta.us 36