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Ebola cured in monkeys - hope for humans? - Tekmira establishes regulatory framework for emergency use of TKM-Ebola

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http://news.nationalgeographic.com/...ence-health-ebola-virus-cure-vaccine-monkeys/

Photograph by Lynn Johnson, National Geographic
Amitabh Avasthi

for National Geographic News

Published June 9, 2010

Monkeys infected with the deadly Ebola virus have been treated successfully, possibly bringing humans a step closer to a cure.

According to a new study, a team of scientists used special gene-silencing drugs to selectively "knock out" viral proteins in Chinese rhesus macaques infected with a lethal dose of the Zaire Ebola virus. Zaire is the most virulent strain of Ebola?90 percent of infected people die during outbreaks.

(Related: "Where Does Ebola Hide Between Epidemics?")

Ebola spreads via bodily fluids or tainted needles and razors, and it's highly contagious. Infections in humans and other primates typically cause acute fever and headaches, followed by uncontrollable bleeding from the body's openings. Shock from heavy internal and external bleeding usually proves fatal.

Since the virus emerged in central Africa in the late 1970s, people have been searching for ways to prevent or treat Ebola infections. (Take an infectious diseases quiz.)

"Ebola is not only of interest because it can cause high mortality, but also because it can be used as a bioterror weapon," said study leader Thomas Geisbert, a virologist at Boston University.

"There are a lot of groups working on preventive vaccines, but this is the first time someone has developed a post-exposure treatment."
Ebola Virus Blocked From Replicating

Geisbert and colleagues used drugs based on synthetic versions of small interfering RNA, or siRNA, a type of molecule in the body that can interfere with the expression of particular genes. (Get a genetics overview.)

Since genes are the codes the body uses to make proteins, interfering with specific viral genes should stop production of proteins the Ebola virus needs to survive.

"We specifically targeted the L protein, as it kick-starts virus replication," Geisbert said. "If you knock out that protein, you can really inhibit the ability of the virus to replicate."

The team also targeted the VP24 and VP35 proteins, which are involved in disabling an infected host's immune response.

Seven of the nine monkeys in the study received the same amount of the drug over a six-day period. Three of the seven monkeys got the drug every other day, while four received it daily. One monkey in each group served as a control animal and didn't receive the drug.

Analysis of the treated monkeys revealed that, ten days after having been infected with Ebola, the first group of monkeys had very low levels of the virus in their blood. Researchers were unable to detect the virus at all in the group that had received daily doses.

"The siRNAs inhibited the replication of the virus and completely protected the monkeys against death from hemorrhagic fever," Geisbert noted. "This has never been done before."

(Related: "Ebola Killing Thousands of Gorillas, Study Says.")
Ebola Drug Easy to Update

Geisbert thinks the real novelty of the study?published May 29 in the journal The Lancet?is that the scientists were able to deliver the drug to infected cells. That can be a challenge, because synthetic siRNA drugs can activate the body's immune system, triggering inflammation.

To ferry the drug into cells while preventing unwanted side effects, the researchers packed the drug inside fat molecules.

"This capability offers a therapeutic option that has been lacking with certain hemorrhagic fever viruses that have a high level of mortality associated with infections," said Anthony Sanchez, an Ebola researcher at the U.S. Centers for Disease Control and Prevention.

Sanchez was part of a team that successfully tested several Ebola vaccines in nonhuman primates and is now trying to adapt the vaccines for use in humans.

"The interesting part of the technique is that the [siRNA drug] can be quickly synthesized for a specific strain of Ebola virus," Sanchez added. (Related: "New, Fast-Evolving Rabies Virus Found?And Spreading.")

"Thus, if a new strain suddenly appears, whether in Africa or in another region of the world, a therapeutic solution can be quickly generated and deployed for use."
Ebola Drug "Long Overdue"
Gaya Amarasinghe, a biochemist at Iowa State University, led the team that determined the chemical structure of the VP35 protein, one of the proteins knocked out in the new Ebola study.

Amarasinghe called the new work "very exciting," because it's possible the siRNA drug and delivery method could be applied to other filoviruses, the class of viruses?including Ebola?that cause severe hemorrhagic fever.

And in a commentary on the study, also published in the Lancet, Heinz Feldmann of the U.S. National Institute of Allergy and Infectious Diseases wrote that the new work is "long overdue and should be considered a milestone in what has been a difficult and frustrating specialty of filovirus research."

Study leader Geisbert believes success in curing Ebola in nonhuman primates could translate into a human model for treatment. But the question of human clinical trials for an Ebola drug boils down to funding.

"The technology is pretty much ready to go," Geisbert said. But "the small global market for this drug is not much of a financial incentive for drug companies to pursue a vaccine. Investors aren't going to do that?it has to be the government."

Amarasinghe agrees, and he also points to the rising cost of doing research with high-priority pathogens. That's because, inflation aside, researchers need highly secure?and thus expensive?biocontainment facilities to study these deadly diseases.

"Under the FDA's 'animal rule,' potential drugs that perform well in animal-efficacy studies can be substituted for human clinical trials, as long as appropriate human safety studies have been conducted," he explained.

"Ebola can qualify under that rule, and if promising candidates [for drugs] are identified, at the very least, mechanisms are in place to move them forward into the product-development phase."
The new Ebola drug study included scientific collaboration with Tekmira Pharmaceuticals and the United States Army Medical Research Institute of Infectious Diseases.
 
Re: Ebola cured in monkeys - hope for humans?

Re: Ebola cured in monkeys - hope for humans?

http://news.nationalgeographic.com/...ence-health-ebola-virus-cure-vaccine-monkeys/

The new Ebola drug study included scientific collaboration with Tekmira Pharmaceuticals and the United States Army Medical Research Institute of Infectious Diseases.

Company News:

December 13, 2013

Tekmira's Anti-Ebola Program to Proceed in Clinical Study With More Potent Formulation

Supporting Studies Demonstrate Significant Increases in Potency

VANCOUVER, British Columbia, Dec. 13, 2013 (GLOBE NEWSWIRE) --Tekmira Pharmaceuticals Corporation (Nasdaq:TKMR) (TSX:TKM), a leading developer of RNA interference (RNAi) therapeutics, today announced it has received clearance to proceed with the use of a more potent formulation in its TKM-Ebola Phase I clinical trial, which is expected to begin enrolling patients early next year.

"After receiving favorable U.S. FDA review of all of the information describing the improved formulation, including data from chemistry, manufacturing and control studies, we are pleased to report that we can now proceed with the use of an anti-Ebola therapeutic that integrates improvements in LNP technology within our Phase I clinical program. Our preclinical data indicate that the new formulation is significantly more potent, achieving greater levels of anti-viral activity and 100% survival at significantly lower doses than earlier generation products," said Dr. Mark J. Murray, Tekmira's President and CEO.

"Our next steps include IRB approval of the FDA approved clinical protocol before enrolling healthy volunteer subjects in a Phase I clinical trial. We remain on track to dose our first patient in the first quarter of 2014, with data available in the second half of the year," added Dr. Murray.
Other supply chain innovations have also been applied to the TKM-Ebola product, including the development of a lyophilized or "freeze dried" format. Lyophilization significantly increases the stability of LNP, even under extreme environmental conditions such as might be experienced in regions prone to naturally occurring Ebola outbreaks.

TKM-Ebola, an anti-Ebola viral therapeutic, is being developed under a contract with the U.S. Department of Defense's (DoD) Joint Project Manager Medical Countermeasure Systems (JPM-MCS) , with a total contract value of approximately $140 million. Earlier preclinical studies were published in the medical journal The Lancet and demonstrated that when siRNA targeting the Ebola virus and delivered by Tekmira's LNP technology were used to treat previously infected non-human primates, the result was 100 percent protection from an otherwise lethal dose of Zaire Ebola virus (Geisbert et al., The Lancet, Vol 375, May 29, 2010). More recent preclinical data from the TKM-Ebola program has been generated showing survival in non-human primates despite delayed treatment after infection with the most lethal Zaire variant of Ebola virus.
...
http://investor.tekmirapharm.com/releasedetail.cfm?ReleaseID=813835
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March 5, 2014

Tekmira Receives Fast Track Designation From FDA for Its Anti-Ebola Viral Therapeutic

VANCOUVER, British Columbia, March 5, 2014 (GLOBE NEWSWIRE) -- Tekmira Pharmaceuticals Corporation (Nasdaq:TKMR) (TSX:TKM), a leading developer of RNA interference (RNAi) therapeutics, today announced that the U.S. Food and Drug Administration (FDA) has granted Fast Track designation for the development of TKM-Ebola, an anti-Ebola viral therapeutic.

The FDA's Fast Track is a process designed to facilitate the development and expedite the review of drugs to treat serious conditions and fill an unmet medical need. The purpose is to get important new drugs to the patient earlier. Fast Track addresses a broad range of serious conditions.1

"This is an important milestone for Tekmira and our TKM-Ebola program. Receiving a Fast Track designation from the FDA supports our work to advance the development of this therapeutic as quickly as possible. Our leadership in developing anti-viral therapies has been supported by our collaboration with the U.S. Department of Defense, which is funding the development of TKM-Ebola," said Dr. Mark J. Murray, Tekmira's President and CEO.

"In January, we announced that the first subject had been dosed in a Phase I clinical trial evaluating the safety of our TKM-Ebola therapeutic, which utilizes a third-generation LNP formulation. We continue to enroll subjects and remain on track to have data from this trial available in the second half of this year," added Dr. Murray.
...
About the TKM-Ebola Phase I Clinical Trial

The TKM-Ebola Phase I clinical trial is a randomized, single-blind, placebo-controlled study involving single ascending doses and multiple ascending doses of TKM-Ebola. The study is assessing the safety, tolerability and pharmacokinetics of administering TKM-Ebola to healthy adult subjects. Four subjects are planned per cohort. There are four planned cohorts for a total of 16 subjects in the single dose arm, and three planned cohorts for a total of 12 subjects in the multiple dose arm of the trial. Each cohort will enroll three subjects who receive TKM-Ebola, and one who will receive a placebo.
...
http://investor.tekmirapharm.com/releasedetail.cfm?ReleaseID=830680
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July 3, 2014

Tekmira Receives Notice of Clinical Hold for TKM-Ebola Phase I Clinical Trial

VANCOUVER, British Columbia, July 3, 2014 (GLOBE NEWSWIRE) -- Tekmira Pharmaceuticals Corporation (Nasdaq:TKMR) (TSX:TKM), a leading developer of RNA interference (RNAi) therapeutics, today announced that the Company has received verbal notice from the U. S. Food and Drug Administration (FDA) that the TKM-Ebola Phase I healthy volunteer clinical study has been placed on clinical hold. This notice applies only to this study.

"We have completed the single ascending dose portion of this study in healthy volunteers without the use of steroid pre-medication. The FDA has requested additional data related to the mechanism of cytokine release, observed at higher doses, which we believe is well understood, and a protocol modification designed to ensure the safety of healthy volunteer subjects, before we proceed with the multiple ascending dose portion of our TKM-Ebola Phase I trial," said Dr. Mark Murray, President and CEO of Tekmira Pharmaceuticals. "We will continue our dialogue with the FDA, provided for under our Fast Track status, in order to advance the development of this important therapeutic agent."

About the TKM- Ebola Phase I Clinical Trial

The TKM-Ebola Phase I clinical trial is a randomized, single-blind, placebo-controlled study and involves single ascending doses and multiple ascending doses of TKM-Ebola. The study is assessing the safety, tolerability and pharmacokinetics of administering TKM-Ebola to healthy adult volunteers without administering any steroid pre-medications.
...

http://investor.tekmirapharm.com/releasedetail.cfm?ReleaseID=857714

Previous news:
http://investor.tekmirapharm.com/releases.cfm?Year=&ReleasesType=&PageNum=1
 
Re: Ebola cured in monkeys - hope for humans?

Re: Ebola cured in monkeys - hope for humans?

Company News:

July 21, 2014

Tekmira Provides Update on TKM-Ebola Phase I Clinical Hold
...

VANCOUVER, British Columbia, July 21, 2014 (GLOBE NEWSWIRE) -- Tekmira Pharmaceuticals Corporation (Nasdaq:TKMR) (TSX:TKM), a leading developer of RNA interference (RNAi) therapeutics, today announced an update on the TKM-Ebola Phase I clinical hold. The Company has received the clinical hold letter from the U.S. Food and Drug Administration (FDA) and is preparing a Complete Response to the Agency. The Company anticipates this matter will be resolved by Q4, 2014.
...
The clinical hold letter confirms that the FDA is seeking data to elucidate the mechanism of potential cytokine release and a modification to the protocol for the multiple ascending dose portion of the trial to ensure the safety of healthy volunteers.

"It is important to highlight that the study protocol for the TKM-Ebola Phase I trial called for an interim review of the data from the single ascending dose portion of the trial before proceeding to the multiple ascending dose portion of the study. I wish to emphasize this trial is unique. It represents the first RNAi study involving the daily treatment of healthy volunteers, without steroid pre-medication or any other type of pre-medication, and with multiple ascending doses," said Dr. Mark Murray, President and CEO of Tekmira Pharmaceuticals. "Furthermore, the multiple ascending dose portion of the study, as originally proposed, reflects the intense dosing regimen that would be used in patients lethally infected with Ebola virus."

On May 21, 2014, the Company disclosed the results of the single ascending dose portion of the study which demonstrated the administration of TKM-Ebola in the absence of any steroid-containing pre-medication was well-tolerated at a dose level of 0.3 mg/kg, determined to be the maximum tolerated dose in the absence of steroid cover. At that time, Dr. Murray said, "These (TKM-Ebola Phase I) results are significant as they establish the safety of 'third generation' LNP formulations and confirm that dosing at efficacious levels may be accomplished without the need for pre-medication."

The Company is assembling the data requested by the FDA and shares its commitment to patient safety. Dr. Murray added, "The mechanism for cytokine release is understood and we will be modifying our study protocol to further ensure subject safety. Our team is working expediently to respond to the FDA. We are mindful of the need for this important therapeutic in situations such as the ongoing Ebola outbreak in West Africa. However, TKM-Ebola is currently an unapproved agent and the regulatory framework to support its use in Africa has not been established at this time."

The Company will provide a full business update at the upcoming earnings release on August 13, 2014.

...
http://investor.tekmirapharm.com/releasedetail.cfm?ReleaseID=860962
 
Re: Ebola cured in monkeys - hope for humans?

Re: Ebola cured in monkeys - hope for humans?

U.S. FDA says 'stands ready' to work with companies developing Ebola drugs

By Julie Steenhuysen
CHICAGO Sat Aug 2, 2014 7:14am IST
08/01/2014

...
The U.S. Food and Drug Administration on Friday said in an emailed statement the agency "stands ready" to work with companies and investigators working with patients "in dire need of treatment."

A senior official within FDA told Reuters the agency would consider proposals for providing treatments under special emergency new drug applications, if the benefits of the treatment outweighed the potential safety risks.

"We take this very, very seriously," the source said.

FDA's statement follow calls by doctors fed up by the lack of progress on Ebola treatments, a market deemed too small to gain much attention by large pharmaceutical companies.

Earlier this month, the agency put a hold on a Tekmira Pharmaceuticals Corp clinical trial of TKM-Ebola, one of the few Ebola treatments advanced enough to be tested in people.

The hold prompted a North Carolina physician with family members in West Africa to say enough.

"This should be the last Ebola epidemic without a cure," said Dr. Ahmed Tejan-Sie, an internist from Burlington. Tejan-Sie started a petition on Change.org to urge FDA to lift its hold on the drug. It now has 15,000 signatures.
...
Tekmira's drug has only been tested in a few dozen healthy people. The FDA stopped its study in July because of safety concerns among people taking the highest doses of the drug who experienced problematic immune responses.
...
Dr. Thomas Geisbert of the University of Texas Medical Branch has done animal studies on the Tekmira drug and said there are few companies willing to develop Ebola treatments. There is "little financial incentive," given the small market potential for a drug that treats a rare disease afflicting developing countries, he said.

Geisbert said the drug "works great in monkeys in the lab," but that is largely because it is given relatively early in the course of infection.

"What if you start giving it to people who are almost dead and they die, but it's not the drug's fault? Then you blame the drug."

...
Full text:
http://in.reuters.com/article/2014/08/02/health-ebola-fda-idINL2N0Q733H20140802
 
Re: Ebola cured in monkeys - hope for humans?

Re: Ebola cured in monkeys - hope for humans?

Company News

August 7, 2014

FDA Modifies Tekmira's TKM-Ebola Clinical Hold to Partial Hold Enabling Use of Tekmira's Investigational Therapeutic in Ebola-Infected Patients

VANCOUVER, British Columbia, Aug. 7, 2014 (GLOBE NEWSWIRE) --

Tekmira Pharmaceuticals Corporation (Nasdaq:TKMR) (TSX:TKM), a leading developer of RNA interference (RNAi) therapeutics, today announced that the U.S. Food & Drug Administration (FDA) has verbally confirmed they have modified the full clinical hold placed on the TKM-Ebola Investigational New Drug Application (IND) to a partial clinical hold. This action enables the potential use of TKM-Ebola in individuals infected with Ebola virus.

"We are pleased that the FDA has considered the risk-reward of TKM-Ebola for infected patients. We have been closely watching the Ebola virus outbreak and its consequences, and we are willing to assist with any responsible use of TKM-Ebola. The foresight shown by the FDA removes one potential roadblock to doing so," said Dr. Mark Murray, CEO and President, Tekmira Pharmaceuticals. "This current outbreak underscores the critical need for effective therapeutic agents to treat the Ebola virus. We recognize the heightened urgency of this situation, and are carefully evaluating options for use of our investigational drug within accepted clinical and regulatory protocols."

TKM-Ebola is being developed by Tekmira Pharmaceuticals and the U.S. Department of Defense's Medical Countermeasure Systems BioDefense Therapeutics (MCS-BDTX) Joint Product Management Office.

The Company remains on clinical hold as it relates to the multi-ascending dose portion of the Phase I clinical study in healthy volunteers with TKM-Ebola. "We are focused on an expedient resolution of this so that we can advance our TKM-Ebola to evaluate the multiple ascending dose regimen," said Dr. Mark Murray, CEO and President, Tekmira Pharmaceuticals.
...
http://investor.tekmirapharm.com/releasedetail.cfm?ReleaseID=865208
 
Re: Ebola cured in monkeys - hope for humans? - Tekmira establishes regulatory framework for emergency use of TKM-Ebola

Company News:

September 22, 2014

Tekmira Establishes Regulatory Framework for Emergency Use of TKM-Ebola

VANCOUVER, British Columbia, Sept. 22, 2014 (GLOBE NEWSWIRE) --

Tekmira Pharmaceuticals Corporation (Nasdaq:TKMR) (TSX:TKM), a leading developer of RNA interference (RNAi) therapeutics, today announced that the FDA has authorized Tekmira to provide TKM-Ebola for treatment under expanded access protocols to subjects with confirmed or suspected Ebola virus infections.

"Tekmira is reporting that an appropriate regulatory and clinical framework is now in place to allow the use of TKM-Ebola in patients. We have worked with the FDA and Health Canada to establish this framework and a treatment protocol allowing us to do what we can to help these patients," said Dr. Mark J. Murray Tekmira's President and CEO.

"We have insisted on acting responsibly in the interest of patients and our stakeholders," added Dr. Murray. "Today we are reporting that, working closely with regulators in the United States and Canada, we have established a framework for TKM-Ebola use in multiple patients. In the US, the FDA has granted expanded access use of TKM-Ebola under our Investigational New Drug application (IND) and Health Canada has established a similar framework, both of which allow the use of our investigational therapeutic in more patients."

"We have already responded to requests for the use of our investigational agent in several patients under emergency protocols, in an effort to help these patients, a goal we share with the FDA and Health Canada. TKM-Ebola has been administered to a number of patients and the repeat infusions have been well tolerated. However, it must be kept in mind that any uses of the product under expanded access, does not constitute controlled clinical trials. These patients may be infected with a strain of Ebola virus which has emerged subsequent to the strain that our product is directed against, and physicians treating these patients may use more than one therapeutic intervention in an effort to achieve the best outcome," said Dr. Murray. "Our TKM-Ebola drug supplies are limited, but we will continue to help where we can, as we continue to focus on the other important objectives we have to advance therapies to meet the unmet needs of patients."

TKM-Ebola is an investigational therapeutic, being developed under an FDA approved IND, which is currently the subject of a partial clinical hold under which the FDA has allowed the potential use of TKM-Ebola in individuals with a confirmed or suspected Ebola virus infection.

About FDA Expanded Access Program

Expanded access is the use of an investigational drug outside of a clinical trial to treat a patient, with a serious or immediately life-threatening disease or condition, who has no comparable or satisfactory alternative treatment options. FDA regulations allow access to investigational drugs for treatment purposes on a case-by-case basis for an individual patient, or for intermediate-size groups of patients with similar treatment needs who otherwise do not qualify to participate in a clinical trial. (Source: www.fda.com)

About TKM-Ebola, an Anti-Ebola Virus RNAi Therapeutic

TKM-Ebola, an anti-Ebola virus RNAi therapeutic, is being developed under a $140 million contract with the U.S. Department of Defense's Medical Countermeasure Systems BioDefense Therapeutics (MCS-BDTX) Joint Product Management Office. Earlier preclinical studies were published in the medical journal The Lancet and demonstrated that when siRNA targeting the Ebola virus and delivered by Tekmira's LNP technology were used to treat previously infected non-human primates, the result was 100 percent protection from an otherwise lethal dose of Zaire Ebola virus (Geisbert et al., The Lancet, Vol. 375, May 29, 2010). In March 2014, Tekmira was granted a Fast Track designation from the U.S. Food and Drug Administration for the development of TKM-Ebola.

...
http://investor.tekmirapharm.com/releasedetail.cfm?ReleaseID=871918
 
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