Potent and Selective CRTh2 Antagonists are Efficacious in Models of Asthma, Allergic Rhinitis and Atopic Dermatitis Laura L. Carter, Yoshi Shiraishi, Yooseob Shin, Laurence Burgess, Christine Eberhardt, A. Dale Wright, Nathalie Klopfenstein, Maralee McVean, Anna Gomez, David Chantry, Adam Cook, Katsyua Takeda and Erwin W. Gelfand Array BioPharma, Boulder, Colorado National Jewish Health, Denver, Colorado 2010 AAAAI Annual Meeting February 26 - March 2, New Orleans, LA Abstract 490 1
Central Role for PGD 2 and CRTh2 in Allergic Inflammation Early Phase: Vascular Permeability Bronchoconstriction Congestion Edema Late Phase: Eosinophilia Mucus Production Tissue Damage Allergen IL-4 IL-5 Mast Cell IgE Receptor Degranulation Histamine Proteases Histamine Cytokines Leukotrienes Omalizumab Anti-Histamines Steroids Montelukast Prostaglandin D2 (PGD 2 ) Eosinophil Th2 Th2 T Cell Basophil CRTh2 IL-13 MBP Peroxides ECP PGD 2 is a potent prostanoid released upon mast cell activation Links early & late phase allergen responses CRTh2 is the biologically relevant GPC-receptor for PGD 2 & its more stable metabolites 2 Chemoattractant Receptor-homologous molecule expressed on Th2 lymphocytes
CRTh2 Antagonism: Target Validation Selective CRTh2 antagonists have demonstrated preclinical efficacy Significant reduction of eosinophil accumulation in OVA-sensitized mice model of asthma Reduction in pulmonary neutrophilia in a cigarette-smoke mouse model of COPD Ramatroban, a weak, non-selective CRTh2 antagonist, is approved for allergic rhinitis (Japan) Improved the symptoms, nasal obstruction & daily discomfort compared to terfenadine in a Phase 3 study OC000459, a selective CRTh2 antagonist, improved lung function in mild to moderate asthmatics in a Phase 2a study FEV1 increased over baseline by 9.2% (treatment) vs. 1.8% (placebo) FEV1 did not plateau still improving at week 4 Significant improvement in peak expiratory flow Significant decreases in serum IgE & sputum eosinophil counts No serious AE s 3
ARRY-005, ARRY-006: In Vitro Potency, Selectivity and Functional Activity Human CRTh2 Binding IC 50 1 nm PGD 2 exposed to eosinophils in whole blood results in a shape change Activation of the intracellular motile apparatus Occurs exclusively through CRTh2 ARRY-005 ARRY-006 Human CRTh2 Binding IC 50 (4% HSA) 35 nm 107 nm Selectivity vs. 30 GPCR s,, Ion Channels and Transporters No significant activity @500 nm No significant activity @500 nm CRTh2 FLIPR Calcium Mobilization IC 50 5 nm 5 nm Human Isolated Basophil Chemotaxis IC 50 1 nm 1 nm IC 50 3 nm ARRY-005 IC 50 Human Whole Blood Eosinophil Shape Change 33 nm Human Whole Blood Receptor Internalization 24 nm 4
Murine Model of Allergic Rhinitis Mice Female Balb/c mice (6 weeks old) Drug treatment Vehicle (0.5% methylcellulose) ARRY-005 (0.1, 0.5, 1, 10, PO) Oral Doses of ARRY-005 (1 h prior to challenge) 20 mg OVA i.p. with 2.25 mg alum Intranasal OVA challenge (without anesthesia) (10% OVA-saline, 15 µl each nostril) Day 0 Day 14 Day 28 31 33 34 Baseline Early Response Late Response Respiratory frequency Respiratory frequency and cytokines in nasal tissue 5
ARRY-005 Exhibits Dose Dependent Inhibition of the Early Phase Response in Allergic Rhinitis Model 6 RF (breaths/min) 350 300 250 200 150 100 Baseline 4-7 9-12 14-17 14-17 19-22 24-27 29-32 : P < 0.05 vs OVA/OVA, vehicle Time after 4 th challenge (min) OVA/Saline, vehicle OVA/OVA, vehicle OVA/OVA, ARRY-005 (0.1 ) OVA/OVA, ARRY-005 (0.5 ) OVA/OVA, ARRY-005 (1 ) OVA/OVA, ARRY-005 (10 )
ARRY-005 Exhibits Dose Dependent Inhibition of the Late Phase Response in Allergic Rhinitis Model RF (breaths/min) 350 300 250 200 150 OVA/Saline, vehicle OVA/OVA, vehicle OVA/OVA, ARRY-005 (0.1 ) OVA/OVA, ARRY-005 (0.5 ) OVA/OVA, ARRY-005 (1 ) OVA/OVA, ARRY-005 (10 ) 100 : P < 0.05 vs OVA/OVA, vehicle Baseline LPR [24 hours after 6 th Challenge] 7
ARRY-005 Reduces Cytokine Levels in the Late Phase of Allergic Rhinitis Model pg/mg of nasal tissue 100 80 60 40 20 0 IL-4 Vehicle OVA 0.1 0.5 1 10 100 80 60 40 20 0 IL-5 50 40 30 20 10 0 Vehicle OVA 0.1 0.5 1 10 IL-13 Vehicle OVA 0.1 0.5 1 10 8
Murine Model of Asthma Mice Female Balb/c mice (6 weeks old) Drug treatment Vehicle (0.5% methylcellulose) ARRY-006 (1, 5, 10, 30, PO) 20 mg OVA i.p. with 2.25 mg alum Oral Doses of ARRY-006 (1 h prior to challenge) Inhaled OVA challenge (1.6% OVA-saline, nebulized) Day 0 Day 14 Day 28 30 32 Airway Hyperreactivity, BALF Methacholine Challenge / Lung Resistance Cell counts in BAL Fluid 9
ARRY-006 Inhibits Airway Hyperreactivity in Asthma Model ARRY-006 (1 ) ARRY-006 (5 ) ARRY-006 (10 ) ARRY-006 (30 ) 10
ARRY-006 Inhibits Cell Infiltration in BALF in Asthma Model ARRY-006 (1 ) ARRY-006 (5 ) ARRY-006 (10 ) ARRY-006 (30 ) 11
NC/Nga Mouse Model of Atopic Dermatitis Mice Male NC/Nga mice (8 weeks old) Drug treatment Vehicle ARRY-005 (30, QD, PO) Protopic Cream (0.25, BID, Topical) Oral Doses of ARRY-005 (QD), Topical Doses of 0.03% Tacrolimus or vehicle (BID) Day 0 Day 1 Day 7 Day 14 Day 21 Day 28 Day 30 Baseline scratching behavior Ear Thickness and Clinical Scoring (erythema, edema, oozing/crusts/hemorrhage) Scratching behavior 12
ARRY-005 Inhibits Ear Thickness and Decreases Clinical Scores in Atopic Dermatitis Model Ear thickness (mm; mean + SEM) Ear Swelling 1.25 Vehicle 1.00 0.75 0.50 0.25 0.00 0 10 20 30 40 Days 13 ARRY-005 Protopic Oozing Score (Mean ±SEM) + SEM) 2.5 2.0 1.5 1.0 0.5 0.0-0.5 Oozing/crusts/hemorrhage 0 10 20 30 40 Days Erythema Score (Mean ±SEM) + SEM) 2.00 1.75 1.50 1.25 1.00 0.75 0.50 0.25 0.00 Vehicle ARRY-005 Protopic Vehicle ARRY-005 Protopic Erythema 0 10 20 30 40 Days p<0.05 compared to vehicle
ARRY-005 Inhibits Scratching Behavior in Atopic Dermatitis Model Total Scratching: Day 0 and Day 30 1400 Total Scratching (sec) 1200 1000 800 600 400 200 Day 0 Day 30 0 Vehicle ARRY-005 Protopic p<0.05 compared to respective vehicle 14
Summary CRTh2 is an important target in allergic disease ARRY-005 and ARRY-006 are potent, selective CRTh2 antagonists that demonstrate functional activity ARRY-005 and ARRY-006 demonstrate efficacy in murine models of allergic disease upon oral dosing Control of early and late nasal reactivity Control of airway hyperreactivity and cellular influx in the lung Control of ear swelling, skin inflammation and pruritus 15