assessment’of’anavex’2/73’in’a’ mecp2’re5’syndrome ......safeharbor’ this%...

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Assessment of ANAVEX 273 in a MECP2 Re5 Syndrome Mouse Model 2016 Epilepsy Pipeline Conference February 26 th 2016

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Page 1: Assessment’of’ANAVEX’2/73’in’a’ MECP2’Re5’Syndrome ......SafeHarbor’ This% presentaon% contains% forward2looking% statements% made% within% the% meaning% of% the%

Assessment  of  ANAVEX  2-­‐73  in  a  MECP2  Re5  Syndrome  Mouse  Model  

 2016  Epilepsy  Pipeline  Conference  

February  26th  2016  

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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.    

2  

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Re5  Syndrome  

3  

§  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)  

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ANAVEX™  2-­‐73  

4  

§  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  

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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  

5  

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ANAVEX™  2-­‐73  Pre-­‐Clinical  Epilepsy  Data

0  

10  

20  

30  

40  

50  

60  

70  

80  

90  

100  

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  

0  

10  

20  

30  

40  

50  

60  

70  

80  

90  

100  

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

   #  

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AnK-­‐Depressant  and  AnK-­‐Anxiety  Effect  of  ANAVEX™  2-­‐73  in  Porsolt  Swim  Test  (PST)  and  in  Open  Field  Test  

7  

§  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  

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Preclinical  Re5  Syndrome  

8  

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  

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Clasping  

9  

§  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  

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Clasping  at  8  and  12  Weeks  

10  

§  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)  

0

10

20

30

40

50

60

70

80

90

100

Clasping

 Hindlim

bs  (%

)

Mecp2_WT  Vehicle Mecp2_HET  Vehicle

Mecp2_HET  AV2-­‐73  (10  mg/kg) Mecp2_HET  AV2-­‐73  (30  mg/kg)

***

*

0

10

20

30

40

50

60

70

80

90

100

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  

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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  

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Startle  at  8  Weeks  

12  

§  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)  

0

100

200

300

400

500

600

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  

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Rotarod

Source:  PsychoGenics,  Inc.  13  

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Rotarod  at  12  Weeks  

14  

§  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)  

0

5

10

15

20

25

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)

***

** *

0

20

40

60

80

100

120

140

160

180

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  

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NeuroCube  

15  

§  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.  

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NeuroCube  Body  MoKon  Features  

16  

Body Movement Features Measurement

MinDia DiamY500 550 600 650 700 750 800 850 900

Frame#

40

50

60

70

80

90

100

110

120

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.  

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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  

17  

Some  gait  differences  appear  to  be  rescued  

p<0.05   p<0.05  

p<0.05  p<0.01  

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NeuroCube  at  8  Weeks  

18  

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  

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Summary  

19  

§  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