Takeda presents efficacy for nacrolepsy type 1 Orexin receptor agonist TAK-925

Takeda’s presentation has shown TAK-925 was well tolerated in patients with narcolepsy type 1 and increased wakefulness compared to placebo.

− A second Phase 1 study in healthy sleep-deprived adults demonstrated that TAK-925 was well tolerated and increased wakefulness at night compared to placebo

− TAK-994, an oral selective OX2R agonist, reduced narcolepsy symptoms in narcolepsy mouse models and is progressing in Phase 1 studies

CAMBRIDGE, Mass. & OSAKA, Japan–(BUSINESS WIRE)–Takeda Pharmaceutical Company Limited (TSE:4502/NYSE:TAK) (“Takeda”) announced results of a Phase 1 clinical proof of concept study of the novel investigational compound TAK-925, a selective orexin type-2 receptor (OX2R) agonist, in individuals with narcolepsy type 1 (NT1). The company also presented data on the effects of TAK-925 in healthy sleep-deprived adults. These studies evaluated safety, tolerability, pharmacokinetic and pharmacodynamic effects of TAK-925 during a single 9-hour intravenous administration. In both studies, TAK-925 was well tolerated at all doses tested. These studies were presented for the first time at the World Sleep 2019 Biennial Congress in Vancouver, Canada.

“Narcolepsy type 1 is a debilitating disease that includes excessive daytime sleepiness and the sudden loss of muscle tone when a person is awake, also known as cataplexy,” said Dr. Makoto Honda, Sleep Disorders Project Leader, Tokyo Metropolitan Institute of Medical Science. “There is a considerable need for improved treatments for individuals with NT1, which is caused by the loss of orexin-producing neurons in the brain. These results suggest that use of a selective OX2R agonist may be an effective approach to treating excessive daytime sleepiness in NT1.”

In individuals with NT1, TAK-925 showed increased wakefulness compared to placebo. A total of 14 NT1 participants were enrolled in three sequential dose cohorts to evaluate the effect of TAK-925 on exploratory pharmacodynamic endpoints. In each cohort, the evaluation was conducted in a randomized, double-blinded, placebo-controlled, two-way crossover fashion.

Pharmacodynamic outcomes in NT1 patients included i) sleep latency in the Maintenance of Wakefulness Test (MWT), which was 40 minutes (mins) in duration and conducted four times at two-hour intervals during the nine-hour TAK-925 or placebo infusion and ii) the Karolinska Sleepiness Scale, which was done hourly before and during the infusion. The mean sleep latency in MWT was 2.9 mins for placebo (N=13), 22.4 mins for TAK-925 at 5mg (N=6), 37.6 mins for TAK-925 at 11.2mg (N=4) and 40 mins for TAK-925 at 44.8mg (N=4). Karolinska Sleepiness Scale results supported those obtained on the MWT for time to sleep onset; participants reported lower sleepiness scores during infusion of TAK-925 than placebo.

In healthy sleep-deprived adults, TAK-925 effectively maintained wakefulness at night. This study was conducted as a single-center, randomized, double-blind, placebo- and active-controlled, crossover design in 20 sleep-deprived healthy male adults. The primary objective was sleep latency on the MWT. The mean sleep latency in MWT was 8.6 mins for placebo (N=20), 25.4 mins for TAK-925 at 44mg (N=18) and 38.8 mins for TAK-925 at 112mg (N=18). Karolinska Sleepiness Scale results generally reflected the results obtained on the MWT.

“Orexin has been identified as a master regulator of sleep-wake states, and these early results demonstrate that an OX2R agonist may reduce daytime sleepiness in NT1, where there is a loss of orexin,” said Deborah Hartman, PhD, Global Program Lead, Takeda Neuroscience. “What is equally exciting is that we also saw wake-promoting effects in healthy individuals, who are presumed to have normal orexin levels. We’re encouraged by the results of these early studies and are exploring further clinical investigation of selective OX2R agonists in NT1 and other disorders characterized by excessive daytime sleepiness, such as narcolepsy type 2 and idiopathic hypersomnia, and also as a possible treatment for residual excessive daytime sleepiness in obstructive sleep apnea.”

Takeda also presented preclinical data on TAK-994, an oral selective OX2R agonist currently in Phase 1 clinical studies, in two posters at the World Sleep Congress. In two mouse models of narcolepsy, TAK-994 increased wakefulness during the active phase and suppressed cataplexy-like episodes.

“We aspire to help restore a more balanced life to all individuals with NT1 and other sleep-wake disorders,” said Emiliangelo Ratti, Global Head, Takeda Neuroscience. “Takeda is aggressively pursuing multiple approaches to better understand the therapeutic potential of OX2R agonists across a range of indications. We will continue to build strong partnerships with the scientific, medical and patient communities to maintain our focus on research and development of transformative therapies.”

TAK-925 has been awarded Sakigake designation by the Ministry of Health, Labour and Welfare in Japan, as well as Breakthrough Therapy and Orphan Drug Designations by the U.S. Food & Drug Administration.