Rallybio Corporation, a clinical-stage biotechnology company with a mission to develop and commercialize life-transforming therapies for patients with severe and rare diseases, has announced preliminary phase 1 multiple ascending dose (MAD) data for RLYB116, an innovative, long-acting, low volume subcutaneously injected inhibitor of complement component 5 (C5), in development for patients with complement-mediated diseases.
The phase 1 MAD study for RLYB116 evaluated the safety, tolerability, pharmacokinetics (PK), and pharmacodynamics (PD) of subcutaneous RLYB116 in healthy participants with multiple dose administration. The MAD study utilized an adaptive design and included four cohorts of 12 participants receiving doses of up to 200 mg per week of RLYB116 or placebo, with a four-week treatment duration and a 10-week follow-up period.
The preliminary results showed: A 100 mg low volume (1 mL) once-a-week dose of subcutaneously administered RLYB116 achieved sustained mean reductions in free C5 of greater than 93%, including at Day 29 with measurement prior to the last dose. The reduction in free C5 at 24 hours after the first dose of 100 mg was greater than 99%. These data and additional work we have conducted with RLYB116 reinforce our confidence that RLYB116 has the potential to be an effective treatment for patients with certain complement-mediated diseases, including generalized myasthenia gravis (gMG).
RLYB116 also demonstrated low inter-subject variability and consistent increases in exposure relative to dose. The mean estimated elimination half-life for RLYB116 was >300 hours.
In comparison to 100 mg weekly administration, higher concentrations of RLYB116 were observed in a cohort with 100 mg administered twice per week and were associated with a greater than 97% mean reduction in free C5.
RLYB116 administered as a 100 mg once-a-week dose was observed to be generally well tolerated. The most common adverse event (AE) in the cohort was injection site reaction (ISR), which occurred in 60% of the participants in the cohort. All AEs during subcutaneous administration with the 100 mg weekly dose were mild in severity.
The ISR rate for all participants in the 4 cohorts was 59% and all were mild in severity. There were no serious AEs reported for participants receiving study treatment.
A participant with a history of hepatitis A receiving the 150 mg dose experienced liver enzyme test elevation that resulted in discontinuation and a reduction in the dose for the 3rd cohort from 150 mg to 125 mg.
The measurement of anti-drug antibody (ADA) formation in the study did not demonstrate an effect on PK or PD parameters and did not appear to be associated with an effect on AE incidence or severity.
“The preliminary results from this phase 1 multiple ascending dose study of RLYB116 support continued development in patients with gMG,” said Eric Watsky, M.D., RLYB116 Programme Lead for Rallybio. “We are encouraged by the free C5 reductions demonstrated by RLYB116 as well as the exposures achieved with subcutaneous administration. Through enhancements in the manufacturing process, we believe we have the opportunity to increase the dose of RLYB116 and improve the tolerability thereby opening up the opportunity to treat a wider range of complement mediated diseases. Our market research is consistent with our belief that an effective, once-a-week, well-tolerated therapy that can be rapidly self-administered with an autoinjector would be an attractive alternative for patients.”
About RLYB116 phase 1 Study
RLYB116 is an innovative, long-acting, subcutaneously injected inhibitor of C5 in development for the treatment of patients with complement-mediated diseases. Phase 1 in healthy participants included the study of RLYB116 as a single ascending dose and multiple ascending dose. The multiple ascending dose (MAD) study of RLYB116 included an adaptive single-blind design initiated in the first quarter of 2023 with a 4-week treatment duration to evaluate the safety, tolerability, pharmacokinetics, and pharmacodynamics of subcutaneous RLYB116 in healthy participants with multiple dose administration.
The MAD study of RLYB116 included 4 cohorts: Cohort 1 (weekly dosing of 100 mg), Cohort 2 (3 doses of 100 mg the first week followed by weekly dosing), Cohort 3 (150 mg weekly dosing reduced to 125 mg weekly dosing) and Cohort 4 (75 mg twice the first week followed by 100 mg twice per week).
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