Eidos Therapeutics has commenced a pivotal Phase III clinical trial of its investigational small molecule AG10 for the treatment of transthyretin (TTR) amyloid cardiomyopathy (ATTR-CM).

ATTR is caused by tetrameric transthyretin (TTR) destabilisation due to inherited mutations or aging. AG10 is designed to stabilise TTR and prevent the molecular events leading to amyloidosis (ATTR).

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The global Phase III trial is dubbed ATTRibute-CM and will compare 800mg AG10 with placebo in a total of 510 patients suffering from symptomatic ATTR-CM associated with either wild-type or mutant TTR.

ATTRibute-CM will include two potentially registrational primary endpoints.

“The trial is designed to evaluate preservation of function and quality of life on an accelerated timeframe.”

Part A will measure the benefit of a change from baseline in six-minute walk distance (6MWD) at 12 months, while Part B will evaluate the decrease in all-cause mortality and the frequency of cardiovascular-related hospitalisations at 30 months.

The trial will also involve secondary endpoints such as quality of life assessment, safety parameters, serum TTR levels, and TTR stabilisation.

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Eidos Therapeutics president and chief medical officer Jonathan Fox said: “ATTRibute-CM aims to generate registrational evidence that AG10 provides meaningful benefit to ATTR-CM patients.

“The trial is designed to evaluate preservation of function and quality of life on an accelerated timeframe in addition to evaluating longer-term benefit on mortality and cardiovascular-related hospitalisations.

Positive data from the trial is expected to support the approval of AG10 in ATTR-CM treatment.

A previous Phase II trial involving symptomatic ATTR-CM patients demonstrated that AG10 was generally well-tolerated and significantly increased serum transthyretin in a dose-dependent manner.

Participants who received AG10 experienced normal serum transthyretin levels within 28 days of treatment.

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