FibroGen Announces FG-3019 Found Safe and Well Tolerated in Patients
with Idiopathic Pulmonary Fibrosis
Phase 1 Study Results of Investigational Anti-CTGF Therapy Reported
at CHEST
South San Francisco, California - October 27, 2004 -
FibroGen, Inc., today announced that FG-3019, the Company's lead
investigational anti-fibrotic agent, was found safe and well tolerated
in a Phase 1 clinical study conducted in patients with idiopathic
pulmonary fibrosis (IPF). FG-3019 is a fully human monoclonal antibody
designed to delay or halt the progression of fibrotic disease by blocking
connective tissue growth factor (CTGF), a protein that plays a key role in
fibrosis (excessive and persistent formation of scar tissue). Results of
the Phase 1 study of FG-3019 were presented at CHEST, the annual meeting
of the American College of Chest Physicians being held October 23-28,
Seattle, Washington.
"Based on encouraging results of this study, FG-3019 shows promise as a
safe therapy for IPF that could be easily administered as an infusion,"
said Lead Principal Investigator Ganesh Raghu, M.D., Professor of
Medicine, University of Washington Medical Center, Seattle, WA, who
presented the Phase 1 results at CHEST." There is growing evidence
that CTGF plays a causal role in the progressive lung scarring that is
characteristic of IPF, which suggests that FG-3019 may help to prevent
disease progression and improve lung function by reducing or preventing
the fibrotic effects of this pathological growth factor."
The Phase 1 trial was an open-label, single dose, sequential-group,
dose-escalation study designed to evaluate safety, tolerability,
pharmacokinetics, and immunogenicity of FG-3019 in patients with a
well-established diagnosis of IPF as defined by American Thoracic Society
criteria. The study enrolled 21 patients: 1 mg/kg (six patients),
3 mg/kg (nine patients), and 10 mg/kg (six patients). No dose
limiting toxicities were reported. The mean plasma levels of FG-3019
varied from patient to patient but were above the minimum effective
concentration determined in animal models of fibrosis for approximately
13 days and 23 days for the 3.0 mg/kg and 10.0 mg/kg dose
levels, respectively. The results of this study suggest that a single
2-hour infusion of FG-3019 is safe and well tolerated.
"This is an important step in our program to develop a therapy for
chronic fibrosis," said Pedro Urquilla, M.D., Vice President of
Medical Affairs at FibroGen. "Based on these results, we plan to
initiate a Phase 2 study of FG-3019 in patients with IPF in 2005."
About IPF
IPF is a debilitating and life-threatening lung disease characterized
by a progressive scarring of the lungs that hinders oxygen uptake.
The cause of IPF is unknown but is believed to be related to unregulated
cycles of inflammation and fibrosis. As scarring progresses, patients
with IPF experience shortness of breath and difficulty with performing
routine functions, such as walking and talking. The prevalence of IPF
has been estimated to be over 50,000 cases in the U.S., with an annual
incidence of approximately 15,000. There are no FDA-approved treatments
for IPF, and approximately two-thirds of patients die within five years
after diagnosis. Patients are typically treated with anti-inflammatory
agents; however, none have been clinically proven to improve survival
or quality of life for patients with IPF.
About CTGF and Pulmonary Fibrosis
Several lines of clinical and preclinical evidence implicate CTGF
in IPF. Transbronchial biopsy specimens from patients with IPF showed
an increased expression of the CTGF gene. Further, increased expression
of CTGF has been found in fibrotic lung tissue and in bronchoalveolar
lavage cells from patients with IPF. Other studies show that CTGF is
expressed predominantly in activated fibroblasts in the interstitium of
fibrotic lung tissues and in proliferating type II alveolar epithelial
cells in IPF. CTGF levels were shown to be much higher in fibrotic lung
tissues than in normal tissues.
Preclinical models of acute lung fibrosis demonstrate that CTGF
acts synergistically with other factors, such as transforming growth
factor-beta (TGF-beta), and pathological conditions to induce extensive
collagen deposition and massive scarring. Recently, CTGF has been shown
to be necessary to cause pulmonary fibrosis in experimental models of
lung fibrosis induced by the chemotherapeutic agent bleomycin, suggesting
that CTGF is crucial to the pathogenesis of IPF.
CTGF is a key downstream mediator for the critical fibrotic activities
of TGF-beta; notably, fibroblast proliferation and differentiation and
extracellular matrix production, the primary mechanisms responsible
for fibrosis. While mild scarring can be caused by either factor in
experimental models, the combination of TGF-beta and CTGF results in
massive scarring. Because TGF-beta has other roles outside of fibrosis,
including immunosuppression and tumor suppression, complete blockade
of TGF-beta activity would be undesirable in a clinical setting.
Similarly, endothelin-1 is a peptide shown to stimulate fibrosis and
matrix production through upregulation of TGF-beta and fibronectin.
Recent studies suggest that the CTGF gene can be directly activated by
endothelin stimulation and that CTGF may be a downstream mediator of the
fibrotic activities of endothelin-1. While TGF-beta and endothelin-1
are actively studied targets for IPF therapy, FibroGen believes that
anti-CTGF therapy could offer a more selective and effective approach
to the treatment of IPF and other fibrotic disorders.
Several other proteins implicated in IPF have been shown to operate
through CTGF including vascular endothelial growth factor (VEGF),
angiotensin II, and thrombin. VEGF, which induces production of CTGF
through pathways independent of TGF-beta, is upregulated along with an
increase in myofibroblasts in fibrotic lesions in experimental models of
pulmonary fibrosis. Angiotensin II, which has been implicated in the
apoptosis of activated alveolar epithelial cells in interstitial lung
injuries, operates in part by directly upregulating CTGF via a response
element on the promoter of the CTGF gene. Similarly, thrombin, which
promotes myofibroblast differentiation, endothelial cell activation,
matrix deposition, and fibrosis in the development of pulmonary fibrosis,
has recently been shown to upregulate CTGF and cause the release of CTGF
from activated platelets.
FibroGen research collaborations have also shown that CTGF is a necessary
factor in the differentiation of fibroblasts into myofibroblasts,
which are characteristic of fibrotic lesions and appear to be involved
in extracellular matrix production and tissue contraction. Fibroblasts
isolated from IPF patients are characteristically more myofibroblast-like
than are those from normal subjects. CTGF has been shown to be a survival
factor for myofibroblasts by preventing apoptosis.
About FG-3019
FG-3019, a fully human monoclonal antibody directed against CTGF, is
FibroGen's lead investigational anti-fibrotic therapy designed to
bind and neutralize CTGF. In animal models of lung, kidney, and systemic
fibrosis including heart and liver, treatment with FG-3019 reduces scar
tissue formation and preserves organ structure and function. FibroGen
believes that FG-3019 could be effective in treating patients with IPF
by reducing the scarring associated with the overexpression of CTGF and
the resulting excess deposition of extracellular matrix components,
such as collagen, and preventing the formation of myofibroblasts, allowing
normal apoptosis of aberrant cells.
About FibroGen
FibroGen, Inc., is a biotechnology-based drug discovery company using its
expertise in the fields of tissue fibrosis and hypoxia-inducible factor
(HIF) biology to discover, develop, and commercialize novel therapeutics
for fibrotic disorders, anemia, ischemic disease, cancer, and other areas
of unmet medical need. FibroGen also develops and produces recombinant
human collagens and gelatins using unique production technology that
provides the basis for FibroGen's proprietary cosmetic dermal filler
and biomaterials supply business.
For more information about FibroGen, Inc., please visit
www.fibrogen.com.
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Contact:
Laura Hansen, Director of Corporate Communications
E-Mail: lhansen@fibrogen.com
Phone: 650-866-7828