China approves world’s first new Alzheimer’s drug in 20 years

A new seaweed-based drug could be used for treatment of mild to moderate Alzheimer’s, according to authorities in China.  This is the worlds first new drug to be approved in two decades.

The seaweed-based drug, called Oligomannate, can be used for the treatment of mild to moderate Alzheimer’s, according to a statement from China’s drug safety agency. The approval is conditional however, meaning that while it can go on sale during additional clinical trials, it will be strictly monitored and could be withdrawn should any safety issues arise.

Alzheimer’s disease, which starts with memory loss and escalates to severe brain damage, is believed to cause 60% to 70% of the cases of dementia reported worldwide, according to the World Health Organization. Dementia affects an estimated 50 million people worldwide.
Named after Alois Alzheimer, the neuropathologist who discovered the disease in 1906, it has so far confounded researchers and pharmaceutical companies.

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NMPA granted Oligomannate for fast-track review in November 2018.  It is the first novel drug approved for Alzheimer’s disease globally since 2003.  Oligomannate will provide a new treatment option to fight Alzheimer’s disease for patients and is expected to be available in China by the end of 2019.

Here are the study results

The Phase 3 clinical trial is a multicenter, randomized, double-blind, placebo-controlled, parallel-group 36 week study led by Peking Union Hospital and Shanghai Jiaotong University Medical School Mental Health Center. The study was conducted in 34 Tier-1 hospitals across China. A total of 818 patients with the diagnosis of mild to moderate Alzhemer’s disease  completed the study. The trial was conducted in collaboration with IQVIA (formally Quintiles) and Signant Health (formerly Bracket) among other partners.

Trial results demonstrated that Oligomannate statistically improve cognitive function in mild-to-moderate AD patients as early as week 4 and the benefit was sustained at each follow-up assessment visit. The mean difference between Oligomannate and placebo groups in ADAS-Cog12 Score (a standard cognitive measure commonly used in AD studies) was 2.54 (p< 0.0001), with sustained efficacy from first month of treatment to the end of 9 months of treatment. Oligomannate was safe and well tolerated with side effects comparable to the placebo.

“I have been doing research on Alzheimer’s disease for 50 years, participated in multiple global multi-center studies of multiple drugs, and have never found a satisfactory treatment for Alzheimer’s disease,” said Professor Zhang Zhenxin, MD, a leading principal investigator of the phase 3 trial of Oligomannate and professor of Neurology at Peking Union Medical College Hospital in Beijing. “The result of the 9-month trial of Oligomannate is exciting. We finally see hope and dawn. I am sincerely happy for the patients and their families.”

“There are only few drugs available to treat Alzheimer’s disease, and none can delay or prevent progression of the disease,” said Professor Xiao Shifu, a leading principal investigator of the phase 3 trial of Oligomannate at Center for Mental Health at Shanghai Jiaotong University Medical College. “The results of the Phase 3 clinical study showed rapid onset of efficacy of Oligomannate within 4 weeks, and that patients’ cognitive function continued to improve. The treatment was safe during the 36-week clinical trial.”

The cause of AD is not yetfully understood . Deposition of amyloid plaques and neurofibrillary tangles are among the proposed underlying etiologies; these are the common targets of many current investigational drugs.  Oligomannate has a mechanism of action distinct from other agents currently on the martet and in clinical trials.  As described by Professor Geng Meiyu, the leading inventor of the drug at the Chinese Academy of Sciences Shanghai Institute of Materia Medica, the preclinical studies show that Oligomannate reconditions dysbiosis of gut microbiota, inhibits the abnormal increase of intestinal flora metabolites,modulates  peripheral and central inflammation, reduces amyloid protein deposition and tau hyperphosphorylation, and improves cognitive function.

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In the Research Highlight1 about the preclinical study of Oligomannate recently published in Cell Research2, Professor David M. Holtzman, chairmen of Department of Neurology and director of Hope Center for Neurological Diseases at Washington University in St. Louis and his colleagues wrote that the preclinical data “supports the emerging idea that modulation of the gut microbiome via treatments such as GV-971 or other strategies should be further explored as novel strategies to slow the progression of AD”.

Green Valley will launch Oligomannate very soon in China, and plan to submit the marketing authorization applications in selected countries following the China launch.  A multi-center global phase 3 clinical trial (GREEN MEMORY) with sites in the U.S., Europe and Asia is planned to be initiated in early 2020 to support global regulatory filing of Oligomannate.

“The phase 3 clinical trial of Oligomannate conducted in China showed a sustainable cognitive benefit. It was well tolerated. This is the first new therapy for Alzheimer’s disease approved in many years and we applaud this innovation,” said Jeffrey Cummings, MD, Vice Chair for Research and Research Professor of UNLV Department of Brain Health and Professor and director of Center for Neurodegeneration and Translational Neuroscience Cleveland Clinic, Lou Ruvo Center for Brain Health, and a scientific advisor to Green Valley. “We look forward to the global phase 3 trial of Oligomannate to investigate its clinical effects in larger and more diverse populations and to collect samples that will provide evidence of the agent’s biological effects.

“I am encouraged by the cognitive improvement, safety and tolerability associated with Oligommanate in this initial clinical trial, as well as the potential to diversify the portfolio of promising treatments for our affected patients and families,” said Eric Reiman, MD, Executive Director of Banner Alzheimer’s Institute and a scientific advisor to Green Valley. “I am also encouraged by the plan to further evaluate clinical and biological effects of this drug in global trials.”

905E8BB5-936C-4A74-A474-7A83D4809B07“The preclinical observation that Oligomannate suppresses gut dysbiosis and harnesses neuroinflammation has resulted in improvement of cognitive impairment, as evidenced by the trial results,” said Philip Scheltens, MD, PhD, professor of Neurologist and CEO of Alzheimer Center Amsterdam and a scientific advisor to Green Valley. “These results advance our understanding of the mechanisms that play a role in Alzheimer’s disease and implies that the gut microbiome is a valid target for development of AD therapies.”

“We are very excited that Oligomannate is the first new drug approved for treating Alzheimer’s patients in the past 17 years, we are grateful to our patients and families who are the real heroes in the fight against this debilitating disease,” said Mr. Lv Songtao, Chairman of Green Valley.  “At Green Valley, we are committed to the mission of ‘developing medicines that fulfill the biggest unmet medical needs for human health’ and have finally succeeded after 22 years of unremitting efforts. We look forward to continuing this journey to bring new treatment to all patients around the world.”

About Green Valley

Shanghai Green Valley Pharmaceuticals is an innovative Chinese pharmaceutical company that pioneers new treatment strategies in the area of chronic and complex diseases. The company upholds the sacred mission of “developing medicines that fulfill the biggest unmet medical needs for human health”, explores the pathogenesis of chronic and complex diseases with a holistic view of treatment, and focuses on breakthrough innovation in research and development of carbohydrate drugs. Green Valley is committed to becoming a global leader in carbohydrate drug innovation, providing safer and more effective drugs for patients with chronic and complex diseases, and providing better choice of treatment for diseases and improving the quality of life.

green valley

Green Valley Pharmaceuticals was founded in 1997 and is headquartered in Zhangjiang Science City in Shanghai, China. It is focused on advancing research programs in neuropsychiatric diseases, cancer, cardiovascular diseases, metabolic diseases and autoimmune diseases. It has 1,500 employees in China and operates a subsidiary in the United States. It has built the world’s first large-scale carbohydrate compound library, the first carbohydrate drug API and processing facility, and the world’s leading R&D pipeline for carbohydrate drug products.

References

1.      Seo DOBoros BD, and Holtzman DM (2019) The microbiome: A target for Alzheimer disease? Cell Res. 29(10):779-780

2.      Wang X and Sun G et. al. (2019) Sodium oligomannate therapeutically remodels gut microbiota and suppresses gut bacterial amino acids-shaped neuroinflammation to inhibit Alzheimer’s disease progression. Cell Res. 29(10):787-803

  1. World Alzheimer Report 2018, published by Alzheimer’s Disease International (ADI), London, 2018

 

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