Matinas BioPharma Holdings, Inc., a clinical-stage biopharmaceutical company, announced topline results from the ENHANCE-IT study (Pharmacodynamic Effects of a Free-fatty Acid Formulation of Omega-3 Pentaenoic Acids to ENHANCE Efficacy in Adults with Hypertriglyceridemia), the second head-to-head comparative study of LYPDISO vs. Vascepa.
In ENHANCE-IT, the key parameters evaluated included triglycerides (TGs), other lipoprotein and inflammatory markers, and blood levels of omega-3 fatty acids. The primary endpoint was the percent change from baseline to end-of-treatment in TG and superiority vs. Vascepa.
Analyses were performed on a Pharmacodynamic (PD) population (n=94; all subjects with evaluable measurements in the two-treatment period, regardless of compliance with study drug treatment), and a Per Protocol (PP) population (n=82; those subjects in the PD population where overall compliance in both treatment periods was at least 80% with no clinically important protocol violations or deviations).
Plasma eicosapentaenoic acid (EPA) concentrations were statistically significantly higher with LYPDISO, with a 46% relative percentage improvement in EPA blood level concentrations over Vascepa.
In the PD population there was a greater reduction in TGs with LYPDISO (21.9%) as compared with Vascepa (15.7%); this 39% relative improvement did not achieve statistical significance. In the PP population, there were statistically significant superior reductions in TGs, total cholesterol (TC), VLDL cholesterol (VLDL-C) and high sensitivity C-reactive protein (hsCRP), a well-established inflammatory marker.
“In this ENHANCE-IT study, LYPDISO achieved significantly higher EPA levels, and lowered triglycerides as well as hsCRP levels to a greater extent than Vascepa,” said John J.P. Kastelein, M.D., Ph.D., Matinas Scientific Advisory Board member and Professor of Medicine at the Department of Vascular Medicine at the Academic Medical Center of the University of Amsterdam, The Netherlands. “The REDUCE-IT outcomes trial with Vascepa has shown that achieved EPA levels drive the cardiovascular protection conferred by omega-3 fatty acids. The impressive biomarker changes in ENHANCE-IT with LYPDISO support a potential robust protection against cardiovascular disease in a pivotal phase 3 outcome programme.”
lood fatty acids levels increased with both LYPDISO and Vascepa, with similar findings in both the PD and the PP populations. In the PD population the change in fatty acid level with LYPDISO was 46% greater for EPA, 26% greater for DPA, and 38% greater for total omega-3 levels than with Vascepa – all highly statistically significant. DHA levels did not change meaningfully with either therapy but increased slightly with LYPDISO.
These findings highlight and further confirm the greater bioavailability of LYPDISO’s free fatty acid formulation in delivering substantially higher blood levels of EPA.
In the PD population LYPDISO reduced TGs by 21.9%, compared to a 15.7% reduction with Vascepa; this difference (a relative improvement of 39%) did not achieve statistical significance.
There were similar numerical trends for all other lipid parameters. Of note, LYPDISO did not raise LDL cholesterol, as has been noted with other omega-3 formulations containing DHA.
With regard to changes in hs-CRP, there were statistically significant and superior differences between groups – LYPDISO was associated with reductions in hs-CRP, while Vascepa was associated with increases in hs-CRP.
In the prespecified PP population, there were similar numerical trends as seen within the PD population; however, given the more stringent compliance requirements for this population, with less inter-individual variability, some of the differences between groups now emerged as statistically significant.
In the PP population, LYPDISO reduced TGs by 20.9%, compared to a 13.8% reduction with Vascepa; this difference was significant with a P-value of 0.04 (a relative improvement of 51%).
There were additional statistically significant superior reductions with LYPDISO in total cholesterol (5.5% vs 2.3%) and VLDL-C (16.0% vs 10.9%), with similar non-significant numerical trends for the other lipid parameters.
In the PP population, there were again significant differences between groups in hs-CRP response.
“We are very grateful for all the hard work and dedication on the part of the study team, the investigators, and most importantly, the study subjects, especially during a pandemic,” commented James J. Ferguson, M.D, FACC, FAHA, Chief Medical Officer of Matinas. “These results have advanced our understanding of the potential role of LYPDISO in the management of patients with elevated triglycerides and cardiovascular disease. Bioavailability is clearly an important consideration in achieving higher EPA levels. Even when Vascepa is given the advantage of being dosed with meals, LYPDISO provides TG lowering that is better than with Vascepa, with no increase in LDL-C, and with the added advantage of substantially higher blood levels of EPA, total omega-3 and significant impact on hs-CRP.”
“We are very pleased with the topline data from ENHANCE-IT,” said Jerome D. Jabbour, chief executive officer of Matinas. “The statistically significant superior EPA levels achieved with LYPDISO are an important differentiator vs. Vascepa. Although we did not achieve statistical significance on the primary endpoint of triglycerides in the prespecified population, these data point to the potential for robust cardiovascular risk reduction with LYPDISO. We further believe that these data could position LYPDISO to potentially become the best-in-class prescription omega-3 for the reduction of cardiovascular risk and we will begin a process to identify a partner with which to collaborate on a cardiovascular outcomes study.”
ENHANCE-IT was an open-label, randomized, 28-day crossover study assessing the pharmacodynamic effects of LYPDISO vs. Vascepa. The study enrolled 100 adult men and women with elevated triglycerides (150-499 mg/dL), with approximately 58% of study subjects with TGs = 200 mg/dL. The study protocol involved two 28-day treatment periods, with a washout period of at least 28 days in between treatments and was conducted at eight sites in the US LYPDISO and Vascepa were each administered as 2g twice daily with food in accordance with currently approved Vascepa labeling. Lipid parameters (triglycerides, Total-, LDL-, VLDL-, HDL-, and non-HDL cholesterol, apolipoproteins A1, B and C3, and PCSK9), a key inflammatory marker (hs-CRP), and omega-3 blood levels were measured at each baseline and at the end of each treatment period. The primary endpoint measured the percent change from baseline to end-of-treatment in plasma triglycerides.
Analysis of the safety database for ENHANCE-IT remains ongoing. There were no serious adverse events reported for this study and no dropouts related to study drug adverse events.
Further analyses of additional clinical data from the study are continuing and the company expects to present the full data from this study at upcoming scientific congresses and in peer-reviewed journals over the course of the year.
Matinas BioPharma is a clinical-stage biopharmaceutical company focused on developing next generation therapeutics to advance standards of care for patients in areas of significant unmet medical need.
