assessment’of’anavex’2/73’in’a’ mecp2’re5’syndrome ......safeharbor’ this%...
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Assessment of ANAVEX 2-‐73 in a MECP2 Re5 Syndrome Mouse Model
2016 Epilepsy Pipeline Conference
February 26th 2016
Safe Harbor
This presenta,on contains forward-‐looking statements made within the meaning of the Private Securi,es Li,ga,on Reform Act of 1995 by Anavex™ Life Sciences Corp. and its representa,ves. These statements can be iden,fied by introductory words such as ``expects,'' ``plans,'' ``intends,'' ``believes,'' ``will,'' ``es,mates,'' ``forecasts,'' ``projects'' or words of similar meaning, and by the fact that they do not relate strictly to historical or current facts. Forward-‐looking statements frequently are used in discussing poten,al product applica,ons, poten,al collabora,ons, product development ac,vi,es, clinical studies, regulatory submissions and approvals, and similar opera,ng maNers. Many factors may cause actual results to differ from forward-‐looking statements, including inaccurate assump,ons and a broad variety of risks and uncertain,es, some of which are known and others of which are not. Known risks and uncertain,es include those iden,fied from ,me to ,me in the reports filed by Anavex Life Sciences Corp. with the Securi,es and Exchange Commission, which should be considered together with any forward-‐looking statement. No forward-‐looking statement is a guarantee of future results or events, and one should avoid placing undue reliance on such statements. Anavex Life Sciences Corp. undertakes no obliga,on to update publicly any forward-‐looking statements, whether as a result of new informa,on, future events or otherwise. Anavex Life Sciences Corp. cannot be sure when or if it will be permiNed by regulatory agencies to undertake clinical trials or to commence any par,cular phase of clinical trials. Because of this, statements regarding the expected ,ming of clinical trials cannot be regarded as actual predic,ons of when Anavex Life Sciences Corp. will obtain regulatory approval for any ”phase” of clinical trials. We also cannot be sure of the clinical outcome for efficacy or safety of our compounds. Poten,al investors should refer to the risk factors in our reports filed on Edgar.
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Re5 Syndrome
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§ ReN syndrome is a rare non-‐inherited gene,c postnatal progressive neurodevelopmental disorder that occurs almost exclusively in girls and leads to severe impairments
§ Affec,ng nearly every aspect of the child’s life: their ability to speak, walk, eat, and even breathe easily
§ It is caused by muta,ons in X-‐linked MECP2, encoding methyl-‐CpG-‐binding protein 2
§ It is characterized by normal early growth and development (6 to 18 months) followed by a slowing of development, loss of purposeful use of the hands, dis,nc,ve hand movements, slowed brain and head growth, problems with walking, seizures#, and intellectual disability
§ ReN syndrome strikes all racial and ethnic groups and occurs worldwide in approximately 1 in every 10,000-‐15,000 live female births
# 84% of Re/ syndrome pa8ents age 15-‐30 experience seizures (Glaze DG et al. Neurology. 2010 Mar 16; 74(11): 909–912)
ANAVEX™ 2-‐73
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§ Currently in a Phase 2a clinical trial for Alzheimer‘s disease (AD) § ANAVEX 2-‐73 is an orally available small molecule targe,ng protein
misfolding and cellular stress, factors in neurodegeneraKve diseases through ac,va,ng Sigma-‐1 Receptor
§ Phase 2a (PART A) results demonstrate a favorable safety, bioavailability, dose-‐response curve and tolerability/risk profile
§ Suppor,ve evidence indica,ng a cogni,ve benefit associated with ANAVEX 2-‐73 (Cogstate, MMSE, EEG/ERP improved sta,s,cally significantly at 5 weeks of treatment)
§ Guidance received from the FDA supports the Company’s plan to advance ANAVEX 2-‐73 for the treatment of Alzheimer’s disease in a larger double-‐blinded, randomized, placebo-‐controlled Phase 2/3 trial
§ Phase 2a PART B 52 week extension trial is ongoing § Addi,onal data, including updates on PART B to be presented at
upcoming scien,fic mee,ngs
Sigma-‐1 Receptor: Upstream Pluripotent Modulator
Su et al., Trends Pharmacol Sci. 2016 Feb 8. pii: S0165-‐6147(16)00004-‐3; Cauli et al., Neuroscience, Volume 190, 2011, Pages 27-‐36; Miki et al, Dec 9. doi: 10.1111/neup.12080 Neuropathology 2013; Glembotski et al., Circula8on Research. 2007;101:975-‐984
§ Reducing protein misfolding § Reducing oxida,ve stress § Reducing inflamma,on
ANAVEX2-73
§ Enabling neuroprotec,on § Modula,ng Ca2+ § Reducing mitochondrial dysfunc,on § Blocking NOS
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ANAVEX™ 2-‐73 Pre-‐Clinical Epilepsy Data
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Vehicle 10 mg/kg (p.o)
30 mg/kg (p.o.)
100 mg/kg (p.o.)
MES-‐induced convulsions
PTZ-‐induced convulsions
Significant Seizure Reduc,on with ANAVEX2-‐73 in both MES and PTZ-‐Induced Seizure Models
ANAVEX 2-‐73 also shows synergis8c ac,vity with three genera,ons of epilepsy drugs currently on the market: ETS (Zaron,n®), VPA (Depakene®) and Gabapen,n (Neuron,n®)
Long-‐Las,ng Effect Shown in PTZ-‐Induced Seizures
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Vehicle 60 mg/kg (p.o.)
4 hours
6 hours
*** ***
% of S
eizure re
ducKon
*** p<0.001
*** *** *** ***
6 Presented at AES Mee8ng 2015, # results have been confirmed by the NINDS screening program
% of S
eizure re
ducKon
#
AnK-‐Depressant and AnK-‐Anxiety Effect of ANAVEX™ 2-‐73 in Porsolt Swim Test (PST) and in Open Field Test
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§ Effect of ANAVEX2-‐73 on immobility ,me on PST. P<0.01, *p<0.05 and **p<0.01 for 50 and 100 mg/kg vs vehicle treated group. Sta,s,cal analysis performed with ANOVA followed by DunneN’s post-‐hoc test
No observed “sedaKve” effect of ANAVEX 2-‐73
§ Effect of ANAVEX2-‐73 on the number of crosses (mo,lity-‐exploratory behavior) in the Open Field Test. Sta,s,cal analysis performed with ANOVA followed by DunneN’s post-‐hoc test. P<0.05, **p<0.01
Presented at AES Mee8ng 2015
Preclinical Re5 Syndrome
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Breeding info § Female mice with heterozygous (HET) MECP2-‐null muta,on# § A mouse with a MECP2-‐null muta,on causes neurological symptoms that
mimic ReN syndrome § Breeding done at Jackson Laboratories, mice provided at 4-‐5 weeks of age MECP2 females tesKng at 8 and 12 weeks of age § 20 WT## – vehicle (0.25% MC/dH2O) § 20 HET – vehicle (0.25% MC/dH2O) § 20 HET – AV2-‐73 (10 mg/kg) § 20 HET – AV2-‐73 (30 mg/kg) § Chronic dosing (p.o.) daily, star,ng at ~5.5 weeks of age and con,nuing
through the 12-‐week behavioral tes,ng ,me point 60 min pre-‐treatment during behavioral tes,ng
§ Experiment was performed by PsychoGenics, Inc.
# HET = (B6.129P2(C)-‐MECP2(tm1.1Bird), ## WT = wild type
Clasping
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§ Mice are lixed gently by the tail with front limbs remaining on surface
§ Clasping of hind legs is noted (normal is a spread in the hind legs)
Normal Impaired
Clasping at 8 and 12 Weeks
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§ Vehicle-‐treated mutant (HET) mice clasped more than vehicle-‐treated wild type (WT) mice (p<0.001 at 8 weeks; p<0.01 at 12 weeks)
§ Mice treated with AV2-‐73 (30 mg/kg) clasped less than vehicle-‐treated mutant mice (p<0.05 at 8 and 12 weeks)
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Clasping
Hindlim
bs (%
)
Mecp2_WT Vehicle Mecp2_HET Vehicle
Mecp2_HET AV2-‐73 (10 mg/kg) Mecp2_HET AV2-‐73 (30 mg/kg)
***
*
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10
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30
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Clasping
Hindlim
bs (%
)
Mecp2_WT Vehicle Mecp2_HET Vehicle
Mecp2_HET AV2-‐73 (10 mg/kg) Mecp2_HET AV2-‐73 (30 mg/kg)
**
*
Clasping at 8 weeks Clasping at 12 weeks
p<0.001
p<0.05
p<0.05
p<0.01
Startle
Image: www.med-associates.com
§ The acous,c startle measures an uncondi,oned reflex response to external auditory s,mula,on
§ Wild type mice have a higher startle response compared to impaired mice
Source: PsychoGenics, Inc. 11
Startle at 8 Weeks
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§ Vehicle-‐treated mutant (HET) mice startled less compared to vehicle-‐treated wild type (WT) mice (p<0.001)
§ AV2-‐73 (30 mg/kg) treated mice showed an increased startle response compared to vehicle-‐treated mutant mice (p<0.05)
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Mean Startle
Respo
nse
Mecp2_WT Vehicle Mecp2_HET Vehicle
Mecp2_HET AV2-‐73 (10 mg/kg) Mecp2_HET AV2-‐73 (30 mg/kg)
***
*p<0.05 p<0.001
Rotarod
Source: PsychoGenics, Inc. 13
Rotarod at 12 Weeks
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§ Vehicle-‐treated mutant (HET) mice fell significantly more rapidly and at lower speeds compared to vehicle-‐treated wild type (WT) mice (p<0.001)
§ AV2-‐73-‐treated mice at both doses (10 and 30 mg/kg) took significantly more ,me to fall off the rod and fell at higher speeds compared to vehicle-‐treated mutant mice (p<0.01 and p<0.05)
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Speed at Fa
ll (rpm
)
Mecp2_WT Vehicle Mecp2_HET Vehicle
Mecp2_HET AV2-‐73 (10 mg/kg) Mecp2_HET AV2-‐73 (30 mg/kg)
***
** *
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Latency to Fa
ll (s)
Mecp2_WT Vehicle Mecp2_HET Vehicle
Mecp2_HET AV2-‐73 (10 mg/kg) Mecp2_HET AV2-‐73 (30 mg/kg)
***
** *
p<0.001 p<0.001 p<0.01 p<0.01 p<0.05 p<0.05
NeuroCube
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§ A plazorm that employs computer vision to detect changes in gait geometry and gait dynamics in rodent models of neurological disorders, pain & neuropathies
§ Mice are allowed to walk in the chamber for 5 min
§ When the paw touches the screen, LED light reflects crea,ng bright spots
§ Images are captured and processed using proprietary computer vision and bio-‐informa,cs data mining algorithms
Source: PsychoGenics, Inc.
NeuroCube Body MoKon Features
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Body Movement Features Measurement
MinDia DiamY500 550 600 650 700 750 800 850 900
Frame#
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Shift Amplitude
§ Shix – the difference between the first and the last values
§ Amplitude – the difference between maximal and minimal values
§ Vola,lity = Shix / Amplitude
Source: PsychoGenics, Inc.
3 0
3 2
3 4
3 6
3 8
Fro
nt
Ste
p L
en
gth
(m
m)
*
*
M e c p 2 _ W T V e h ic le M e c p 2 _ H E T V e h ic le
M e c p 2 _ H E T A V 2 -7 3 (1 0 m g /k g ) M e c p 2 _ H E T A V 2 -7 3 (3 0 m g /k g )
4 0
5 0
6 0
7 0
Str
ide
Le
ng
th (
mm
)
M e c p 2 _ W T V e h ic le M e c p 2 _ H E T V e h ic le
M e c p 2 _ H E T A V 2 -7 3 (1 0 m g /k g ) M e c p 2 _ H E T A V 2 -7 3 (3 0 m g /k g )
* *
*
NeuroCube at 8 Weeks
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Some gait differences appear to be rescued
p<0.05 p<0.05
p<0.05 p<0.01
NeuroCube at 8 Weeks
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WT vehicle v. Het vehicle
Het vehicle v. Het AV2-‐73, 10 mg/kg
Het vehicle v. Het AV2-‐73, 30 mg/kg
Overall
90, p=0 53, p> 0.69 62, p> 0.24
GAIT
78, p< 0.01 63, p> 0.09 69, p< 0.05
Paw Features
91, p< 0.001 52, p> 0.78 55, p> 0.56
CorrelaKon
53, p> 0.66 56, p> 0.40 76, p< 0.005
Body MoKon
71, p< 0.02 60, p> 0.20 81, p< 0.003
Paw PosiKoning
84, p< 0.0001 53, p> 0.57 57, p> 0.36
Comprehensive Analysis:
Gait, CorrelaKon, Body MoKon demonstrate significant improvement
Bold represents significance
Summary
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§ Administra,on of ANAVEX 2-‐73 results in both significant and dose related improvements in an array of behavioral paradigms in the MECP2 HET ReN syndrome disease model
§ Taken together, these behavioral paradigms measure different aspects of muscular coordina,on, balance, motor learning and muscular strengths, some of the core deficits observed in ReN syndrome
Coupled with posi,ve human safety and cogni,on data, as well as preclinical an,-‐seizure and an,-‐anxiety data, ANAVEX 2-‐73 might be a poten,al drug candidate
to inves,gate in ReN syndrome