Pivotal Phase 3 ARTEMIS Trial Data Demonstrates Consistent Safety and Efficacy of AR101 in Children and Adolescents with Peanut Allergy

June 2, 2019 Off By BusinessWire

LISBON, Portugal–(BUSINESS WIRE)–Aimmune Therapeutics, Inc. (Nasdaq: AIMT), a biopharmaceutical company
developing treatments for life-threatening food allergies, today
presented topline results from the pivotal European Phase 3 ARTEMIS
clinical trial, which it previously announced had met its primary
endpoint, demonstrating the efficacy and safety of AR101 in
peanut-allergic children and adolescents after six months of dose
escalation and a three-month therapeutic dosing phase. The findings from
the ARTEMIS trial reinforce the consistent clinical profile of AR101,
demonstrating that patients tolerated 1,000 mg of peanut protein after
only nine months of treatment, which was the primary endpoint of the
study. The ARTEMIS study builds on the results of the landmark PALISADE
trial, which met its primary endpoint of patients tolerating 600 mg of
peanut protein at 12 months. AR101 is an investigational biologic drug
for use in oral immunotherapy as a treatment to reduce the frequency and
severity of allergic reactions following exposure to peanuts. These data
were presented here today in an oral session at the European Academy of
Allergy and Clinical Immunology (EAACI) Congress 2019 in Lisbon.

The proportion of AR101-treated patients who tolerated the 1,000 mg
(2,043 mg cumulative) dose of peanut protein in the double-blind,
placebo-controlled food challenge (DBPCFC) was significantly higher than
in the placebo group: 58% vs. 2% (p<0.00001). The AR101-treated patients
had less severe symptoms during the exit peanut DBPCFC, compared with
the placebo-treated patients.

Results of the European ARTEMIS trial provide further clinical
validation of the safety and efficacy of AR101 for children and
adolescents with peanut allergy,” said Prof. Montserrat Fernández-Rivas,
M.D., Ph.D., ARTEMIS investigator and Chief of the Allergy Department at
Hospital Clínico San Carlos in Madrid. “Almost six out of 10 patients
treated with AR101 were able to tolerate a significant dose of peanut
protein, 1000 mg, which is equivalent of three to four peanuts, well
beyond the amount typically involved in an accidental exposure. These
findings support the ability of AR101 to reduce the frequency and
severity of allergic reactions, including anaphylaxis, upon exposure to
peanut in children and adolescents who face these risks on a daily
basis.”

In the study, 175 subjects aged 4 to 17 years in seven European
countries were randomized 3:1 to AR101 or placebo, up-dosed to 6 mg on
day 1 and received dose escalations every two weeks for 20-40 weeks
until the therapeutic dose of 300 mg was reached. This was followed by
approximately three months of continued 300 mg/day therapeutic dosing.
The primary endpoint was the ability to tolerate at least 1,000 mg of
peanut protein as a single dose without dose-limiting symptoms at exit
DBPCFC.

The full results from 175 patients who started the trial showed:

  • 58.3% of AR101-treated patients successfully tolerated 1,000 mg of
    peanut protein at the exit food challenge, compared to 2.3% in placebo
    group (p<0.00001).
  • 68.2% of AR101-treated patients successfully tolerated 600 mg at the
    exit food challenge, compared to 9.3% in the placebo group.
  • 73.5% of AR101-treated patients successfully tolerated 300 mg of
    peanut protein at the exit food challenge, compared to 16.3% in the
    placebo group.

The safety profile of AR101 was consistent with previous AR101 studies
with the frequency and severity of allergic reactions as expected for an
oral desensitization therapy. Mild or moderate systemic allergic
reactions were reported in 12.1% of AR101-treated subjects and 2.3% of
placebo-treated subjects. Epinephrine/adrenaline use was reported in
6.8% of AR101 treated participants versus 2.3% of placebo, all for
mild/moderate reactions and lower than reported in PALISADE.
Discontinuations due to related adverse events affected 9.8% of
AR101-treated subjects, with no serious adverse events reported that led
to discontinuation, and no deaths or suspected unexpected serious
adverse reactions (SUSARs). There were no reported cases of eosinophilic
esophagitis (EoE) and no cases of severe anaphylaxis.

The results from ARTEMIS are remarkably similar to what was observed
with the highest exit challenge dose level first tested in the Phase 3
PALISADE trial. In PALISADE, 50.3% of AR101-treated patients tolerated
the highest test dose of 1,000 mg of peanut protein after approximately
six months of dose escalation followed by six months at a daily
therapeutic dose of 300 mg compared to 2.4% of placebo patients,” said
Daniel Adelman, M.D., Chief Medical Officer of Aimmune. “ARTEMIS,
PALISADE and RAMSES are the only successful Phase 3 clinical trials for
any food allergy and represent the largest, most clinically robust
clinical dataset ever assembled of a therapeutic approach to peanut
allergy. These results add to our understanding of peanut-allergic
patients and how we can advance the treatment of this potentially
life-threatening condition.”

Dr. Adelman continued, “With the ARTEMIS data now in hand, we remain on
track to submit a Marketing Authorization Application for AR101 to the
European Medicines Agency mid-year. AR101 could become the first
approved treatment for children and adolescents with peanut allergy in
both the U.S. and Europe.”

About ARTEMIS

The randomized, double-blind, placebo-controlled Phase 3 ARTEMIS (AR101
Trial in Europe Measuring oral Immunotherapy Success)
trial evaluated the efficacy and safety of AR101 in peanut-allergic
patients ages 4 to 17 years who were enrolled at 18 sites in seven
European countries (France, Germany, Ireland, Italy, Spain, Sweden and
the United Kingdom). A total of 175 children and adolescents were
randomized 3:1 to AR101 or placebo. Study participants represented a
highly allergic population with a high prevalence of comorbidities who
reacted to low doses of peanut protein when given a double-blind,
placebo-controlled food challenge (DBPCFC) at screening. Study
participants received approximately six months of dose escalation and
then three months of therapeutic dosing of AR101 300 mg/day or placebo,
followed by an exit DBPCFC. The primary endpoint was the patient’s
ability to tolerate at least a 1,000 mg single dose of peanut protein
(the equivalent of approximately three to four peanut kernels) without
dose-limiting symptoms when given the DBPCFC.

About Peanut Allergy

Peanut allergy is one of the most common food allergies, affecting more
than 6 million people in the U.S. and Europe, and reactions to peanut
are often severe and potentially life-threatening. Peanut allergy
usually persists into adulthood1, 2, 3, 4 and while rare,
accounts for the majority of deaths related to food allergy.5
There are no approved treatment options for peanut allergy.6
The standard of care has been a strict elimination diet and the timely
administration of rescue medications in case of an allergic reaction
from accidental exposure.7,8,9 Despite vigilance, accidental
exposures may occur10 and cause reactions of unpredictable
severity,11 leading to a lifelong risk of severe reactions.

About AR101

AR101 is a new, peanut-derived investigational oral biologic drug for
use in oral immunotherapy in patients with peanut allergy. The drug,
which is manufactured in accordance with current Good Manufacturing
Practices (cGMP), delivers a daily dose of peanut protein with a
consistent protein profile, analyzed to ensure reliable major allergen
content. The amount of active ingredient in each AR101 capsule is
controlled to ensure minimal variability of allergen content across
doses of a given strength. AR101 is administered as an oral powder in
graduated doses in pull-apart capsules or foil-laminate sachets. The
contents are mixed thoroughly with a few spoonfuls of age-appropriate,
unheated food of the patient’s choice.

Aimmune’s Biologics License Application (BLA) for AR101 was accepted for
review by the U.S. Food and Drug Administration (FDA) in March 2019. The
Allergenic Products Advisory Committee (APAC) of the FDA will review the
BLA for AR101 at its meeting scheduled for September 13, 2019. The
company plans to submit a Marketing Authorization Application (MAA) for
AR101 to the European Medicines Agency in mid-2019.

About Aimmune Therapeutics

Aimmune Therapeutics, Inc., is a biopharmaceutical company developing
oral treatments for life-threatening food allergies. The company’s Characterized
Oral Desensitization
ImmunoTherapy
(CODIT™) approach is intended to provide meaningful levels of protection
against allergic reactions resulting from exposure to food allergens by
desensitizing patients with defined, precise amounts of key allergens.
Aimmune’s first investigational biologic product, AR101, is being
developed as a treatment to reduce the frequency and severity of adverse
events following exposure to peanut. The BLA for AR101 is under review
by the U.S. FDA, which in 2015 granted AR101 Breakthrough Therapy
Designation for the desensitization of peanut-allergic patients 4 to 17
years of age. Aimmune expects to file for marketing approval of AR101 in
Europe in mid-2019. Aimmune has filed an IND application for its second
product, AR201 for the treatment of egg allergy, and intends to start a
randomized Phase 2 clinical trial in mid-2019. For more information,
please see www.aimmune.com.

Forward-Looking Statements

Statements contained in this press release regarding matters that are
not historical facts are “forward-looking statements” within the meaning
of the Private Securities Litigation Reform Act of 1995. Because such
statements are subject to risks and uncertainties, actual results may
differ materially from those expressed or implied by such
forward-looking statements. Such statements include, but are not limited
to, statements regarding: Aimmune’s expectations regarding the potential
benefits of AR101; Aimmune’s expectations regarding the review of the
BLA for AR101; Aimmune’s expectations regarding the planned timing and
filing for marketing approval of AR101 in Europe; Aimmune’s expectations
on the timing of initiating a phase 2 clinical trial for AR201; and
Aimmune’s expectations regarding potential applications of the CODIT™
approach to treating life-threatening food allergies. Risks and
uncertainties that contribute to the uncertain nature of the
forward-looking statements include: Aimmune’s or any of its
collaborative partners’ ability to initiate and/or complete clinical
trials; the unpredictability of the regulatory process; the possibility
that Aimmune’s or any of its collaborative partners’ clinical trials
will not be successful; Aimmune’s dependence on the success of AR101;
Aimmune’s reliance on third parties for the manufacture of Aimmune’s
product candidates; possible regulatory developments in the United
States and foreign countries; and Aimmune’s ability to attract and
retain senior management personnel. These and other risks and
uncertainties are described more fully in Aimmune’s most recent filings
with the Securities and Exchange Commission, including its Quarterly
Report on Form 10-Q for the quarter ended March 31, 2019. All
forward-looking statements contained in this press release speak only as
of the date on which they were made. Aimmune undertakes no obligation to
update such statements to reflect events that occur or circumstances
that exist after the date on which they were made.

This press release concerns AR101, a product candidate that is under
clinical investigation, and AR201, a product candidate that Aimmune
expects will be under clinical investigation in 2019. Neither AR101 nor
AR201 has been approved for marketing by the FDA or the European
Medicines Agency (EMA). AR101 and AR201 are currently limited to
investigational use, and no representation is made as to their safety or
effectiveness for the purposes for which they are being investigated.

1 References Crespo JF, James JM, Fernandez-Rodriguez
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2 Moreno MA. Guidelines for children with peanut allergy. JAMA
Pediatr.
2017;171:100.

3 Skolnick HS, Conover-Walker MK, Koerner CB, Sampson HA,
Burks W, Wood RA. The natural history of peanut allergy. J Allergy
Clin Immunol.
2001;107:367-74.

4 Fleischer DM, Conover-Walker MK, Christie L, Burks AW, Wood
RA. The natural progression of peanut allergy: resolution and the
possibility of recurrence. J Allergy Clin Immunol. 2003;112:183-9.

5 Bock SA, Muñoz-Furlong A, Sampson HA. Fatalities due to
anaphylactic reactions to foods. J Allergy Clin Immunol.
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6 Yu W, Freeland DMH, Nadeau KC. Food allergy: immune
mechanisms, diagnosis and immunotherapy. Nat Rev Immunol.
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7 Boyce JA, Assa’ad A, Burks AW, et al. Guidelines for the
diagnosis and management of food allergy in the United States: report of
the NIAID-sponsored expert panel. J Allergy Clin Immunol.
2010;126:Suppl:S1-S58.

8 Sampson HA, Aceves S, Bock SA, et al. Food allergy: a
practice parameter update — 2014. J Allergy Clin Immunol.
2014;134(5):1016-25.e43.

9 Muraro A, Werfel T, Hoffmann-Sommergruber K, et al. EAACI
food allergy and anaphylaxis guidelines: diagnosis and management of
food allergy. Allergy. 2014;69:1008-25.

10 Rimbaud L, Heraud F, La Vieille S, Leblanc J-C, Crépet A.
Quantitative risk assessment relating to the inadvertent presence of
peanut allergens in various food product. Int Food Risk Anal J.
2013;3:1-11.

11 Allen KJ, Remington BC, Baumert JL, et al. Allergen
reference doses for precautionary labeling (VITAL 2.0): clinical
implications. J Allergy Clin Immunol. 2014;133:156-64. 12 add
deschldre

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(650) 376-5582 or
[email protected]

Media:
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Pitts
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Strong
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