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Positive One-Year Data from Phase 2 Study of Pegcetacoplan in Post-Transplant Recurrence of C3G and IC-MPGN Presented as Late-Breaker at ERA Congress

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Apellis Pharmaceuticals and Sobi have announced positive one-year results from the Phase 2 NOBLE study on systemic pegcetacoplan for treating post-transplant recurrence of C3 glomerulopathy (C3G) and IC-MPGN. The study, presented at the ERA Congress, showed rapid reduction of disease activity at 12 weeks, sustained over a year.

Of the 11 patients treated, 55% showed zero C3c staining intensity, indicating clearance of C3c deposits, and 64% showed zero inflammation. Additionally, the treatment led to sustained improvements in proteinuria and kidney function stabilization. Pegcetacoplan was generally well-tolerated with mostly mild to moderate adverse events. The ongoing Phase 3 VALIANT study will further evaluate pegcetacoplan’s potential, with results expected later this year.

Positive
  • 55% of patients showed zero C3c staining intensity, indicating clearance of C3c deposits.
  • 64% of patients showed zero inflammation as per the C3G histologic index.
  • Sustained improvements in proteinuria and kidney function stabilization were observed.
  • Pegcetacoplan treatment was generally well-tolerated with mostly mild to moderate adverse events.
  • Positive one-year data presented at a high-profile event, the European Renal Association (ERA) Congress.
  • Ongoing Phase 3 VALIANT study to further evaluate effectiveness, with results expected this year.
Negative
  • Data presented is from a sample size of only 11 patients.
  • Long-term efficacy and safety beyond one year are still unknown.
  • Potential adverse events reported, even if mostly mild to moderate.

The results of the Phase 2 study of pegcetacoplan for treating post-transplant recurrence of C3G and IC-MPGN are promising. At the one-year mark, 55% of patients showed zero C3c staining intensity, indicating a clearance of C3c deposits and 64% showed zero inflammation based on histologic index scores. This suggests that pegcetacoplan effectively reduces disease activity long-term, which is a significant achievement for these rare kidney diseases. The reduction in proteinuria and stabilization of kidney function are also important findings. For patients prone to disease recurrence post-transplant, these outcomes could mean fewer complications, better kidney health and potentially longer graft survival.

Overall, these findings align well with the positive results seen in earlier stages of the study, indicating good consistency in effectiveness. The fact that the drug was well-tolerated, with mostly mild to moderate adverse events, adds to the optimistic outlook. However, retail investors should be cautious and await the upcoming Phase 3 results for a more comprehensive understanding of pegcetacoplan's efficacy and safety across a larger patient population.

The positive data from the Phase 2 NOBLE study of pegcetacoplan underline its potential as a strong candidate in the niche market of rare kidney diseases. The high percentages of patients showing disease improvement are particularly noteworthy. The presentation of these results at the European Renal Association Congress emphasizes the significance of the findings within the medical community. Such data can often drive market interest and potentially impact stock performance positively.

For investors, the competitive advantage of Apellis and Sobi in addressing the unmet need of C3G and IC-MPGN could translate into future market growth, especially if the Phase 3 results confirm these outcomes. Investors should monitor the progress of these clinical trials closely. Additionally, the broad applicability of pegcetacoplan to other conditions involving C3 could further enhance its market potential.

  • Rapid reduction in disease activity seen at 12 weeks was sustained at one year
  • 55% of patients showed zero C3c staining intensity, indicating that C3c deposits were cleared
  • Highlighted as late-breaking oral presentation at the European Renal Association (ERA) Congress

WALTHAM, Mass. and STOCKHOLM, Sweden, May 24, 2024 (GLOBE NEWSWIRE) -- Apellis Pharmaceuticals, Inc. (Nasdaq: APLS) and Sobi® (STO:SOBI) today announced positive one-year results from the Phase 2 NOBLE study investigating systemic pegcetacoplan, a targeted C3 therapy, for the treatment of post-transplant recurrence of C3 glomerulopathy (C3G) and primary immune complex membranoproliferative glomerulonephritis (IC-MPGN). These data were presented during a late-breaking oral presentation at the European Renal Association (ERA) Congress taking place May 23-26 in Stockholm, Sweden.

“It is exciting to see that treatment with pegcetacoplan rapidly reduced disease activity in only 12 weeks, and the effects were sustained over the long term,” said Fadi Fakhouri, M.D., Ph.D., presenting author and professor of nephrology at CHUV, Lausanne, Switzerland. “Post-transplant C3G and IC-MPGN patients are likely to experience disease recurrence, putting them at risk of needing another kidney transplant or dialysis. There is a huge need for a treatment that targets the cause of these diseases, and I am very encouraged by these unprecedented results.”

At one year, of the 11 pegcetacoplan-treated patients with available data:

  • Seven (64%) patients showed a reduction in C3c staining by two or more orders of magnitude of intensity from baseline.
  • Six (55%) patients, including the three IC-MPGN patients, showed zero C3c staining intensity, indicating that C3c deposits were cleared.
  • Consistent with C3c staining reduction, seven patients (64%) showed zero inflammation as measured by the activity score of the C3G histologic index.

Excessive C3c deposits are a marker of disease activity, which can lead to kidney inflammation, damage, and failure. Clearance of both C3c deposits and inflammation allow the kidney to recover and prolong the function of the kidney.

Additionally, treatment with pegcetacoplan resulted in sustained improvements in key measures of disease including proteinuria and continued stabilization of kidney function.

“The NOBLE data further indicate that pegcetacoplan is treating the underlying cause of these diseases by directly targeting C3,” said Caroline Baumal, M.D., chief medical officer, Apellis. “Our ongoing Phase 3 VALIANT study evaluates the potential of pegcetacoplan in all patients with these rare kidney diseases, and we look forward to sharing the topline results later this year.”

Pegcetacoplan was generally well-tolerated. The majority of adverse events were mild to moderate and consistent with previously reported results.

"Patients with post-transplant C3G and IC-MPGN often face the daunting reality of disease relapse, so the need for a therapeutic approach addressing the root cause of these conditions cannot be overstated,” said Lydia Abad-Franch, M.D., head of R&D and medical affairs, chief medical officer, Sobi. “These findings underscore our conviction in pegcetacoplan’s potential to address these rare, severe, and life-threatening conditions in both native and post-transplant kidneys."

About the Phase 2 NOBLE Study
The Phase 2 NOBLE study (NCT04572854) is a multicenter, open-label, randomized, controlled study designed to evaluate the efficacy and safety of pegcetacoplan in 13 adults who have post-transplant recurrence of C3G or IC-MPGN. Study participants were randomized in a 3:1 ratio to receive pegcetacoplan (IC-MPGN: n=2; C3G: n=8) or maintain standard of care (IC-MPGN: n=1; C3G: n=2) for 12 weeks, and all patients received pegcetacoplan from week 13 to week 52. The primary endpoint of the study was the proportion of patients with reduction in C3c staining on renal biopsy after 12 weeks of treatment with pegcetacoplan. Secondary endpoints include an evaluation of safety, the proportion of patients with reduction in C3c staining on renal biopsy after 52 weeks of treatment, and the proportion of patients achieving at least a 50% reduction in proteinuria.

About the VALIANT Study
The VALIANT Phase 3 study (NCT05067127) is a randomized, placebo-controlled, double-blinded, multi-center study designed to evaluate pegcetacoplan efficacy and safety in approximately 90 patients who are 12 years of age and older with C3G or primary IC-MPGN. It is the only study to include both patients with native kidney disease and patients who have recurrent disease after receiving a kidney transplant. Study participants will be randomized to receive 1080 mg of pegcetacoplan or placebo twice weekly for 26 weeks. Following this 26-week randomized controlled period, patients will proceed to a 26-week open-label phase in which all patients receive pegcetacoplan. The primary endpoint of the study is the log transformed ratio of urine protein-to-creatinine ratio (uPCR) at week 26 compared to baseline.

About C3 Glomerulopathy (C3G) and Immune-Complex Membranoproliferative Glomerulonephritis (IC-MPGN)
C3G and primary IC-MPGN are rare and debilitating kidney diseases that can lead to kidney failure. Excessive C3c deposits are a marker of disease activity, which can lead to kidney inflammation, damage, and failure. There are no treatments that target the underlying cause of these diseases. Approximately 50% of people living with C3G and IC-MPGN suffer from kidney failure within five to 10 years of diagnosis, requiring a burdensome kidney transplant or lifelong dialysis.1 Additionally, two-thirds of patients who previously received a kidney transplant will experience disease recurrence.2 The diseases are estimated to affect 5,000 people in the United States and up to 8,000 in Europe.3 

About Pegcetacoplan in Rare Diseases
Pegcetacoplan is a targeted C3 therapy designed to regulate excessive activation of the complement cascade, a part of the body’s immune system, which can lead to the onset and progression of many serious diseases. Pegcetacoplan is under investigation for rare diseases across hematology and nephrology. Pegcetacoplan is approved for the treatment of paroxysmal nocturnal hemoglobinuria (PNH) as EMPAVELI®/Aspaveli® in the United States, European Union, and other countries globally.

About the Apellis and Sobi Collaboration
Apellis and Sobi have global co-development rights for systemic pegcetacoplan. Sobi has exclusive ex-U.S. commercialization rights for systemic pegcetacoplan, and Apellis has exclusive U.S. commercialization rights for systemic pegcetacoplan and worldwide commercial rights for ophthalmological pegcetacoplan, including for geographic atrophy.

About Apellis
Apellis Pharmaceuticals, Inc. is a global biopharmaceutical company that combines courageous science and compassion to develop life-changing therapies for some of the most challenging diseases patients face. We ushered in the first new class of complement medicine in 15 years and now have two approved medicines targeting C3. These include the first-ever therapy for geographic atrophy, a leading cause of blindness around the world. We believe we have only begun to unlock the potential of targeting C3 across serious retinal, rare, and neurological diseases. For more information, please visit http://apellis.com or follow us on X (Twitter) and LinkedIn.

About Sobi®
Sobi® is a specialised international biopharmaceutical company transforming the lives of people with rare and debilitating diseases. Providing reliable access to innovative medicines in the areas of haematology, immunology, and specialty care, Sobi has approximately 1,800 employees across Europe, North America, the Middle East, Asia, and Australia. In 2023, revenue amounted to SEK 22.1 billion. Sobi's share (STO:SOBI) is listed on Nasdaq Stockholm. Learn more about Sobi at sobi.com and LinkedIn.

Apellis Forward-Looking Statement 
Statements in this press release about future expectations, plans and prospects, as well as any other statements regarding matters that are not historical facts, may constitute “forward-looking statements” within the meaning of The Private Securities Litigation Reform Act of 1995. The words “anticipate,” “believe,” “continue,” “could,” “estimate,” “expect,” “intend,” “may,” “plan,” “potential,” “predict,” “project,” “should,” “target,” “will,” “would” and similar expressions are intended to identify forward-looking statements, although not all forward-looking statements contain these identifying words. Actual results may differ materially from those indicated by such forward-looking statements as a result of various important factors, including whether the company’s clinical trials will be fully enrolled and completed when anticipated; whether results obtained in clinical trials will be indicative of results that will be generated in future clinical trials; whether the results of the company’s clinical trials in C3G and IC-MPGN will warrant regulatory submissions and whether systemic pegcetacoplan will receive approval for those indications from the FDA or equivalent foreign regulatory agencies when expected or at all; and any other factors discussed in the “Risk Factors” section of Apellis’ Annual Report on Form 10-K with the Securities and Exchange Commission on February 27, 2024 and the risks described in other filings that Apellis may make with the Securities and Exchange Commission. Any forward-looking statements contained in this press release speak only as of the date hereof, and Apellis specifically disclaims any obligation to update any forward-looking statement, whether as a result of new information, future events or otherwise.

Media:
Lissa Pavluk 
media@apellis.com  
617.977.6764

Investors: 
Meredith Kaya
meredith.kaya@apellis.com 
617.599.8178

Contacts
For details on how to contact the Sobi Investor Relations Team, please click here. For Sobi Media contacts, click here.

References

1. C3 glomerulopathy. National Institute of Health, Genetics Home Reference. https://ghr.nlm.nih.gov/condition/c3-glomerulopathy#resources. Accessed November 21, 2019. 
2. Zand L, et al Clinical findings, pathology, and outcomes of C3GN after kidney transplantation. J Am Soc Nephrol. 2014 May;25(5):1110-7. doi: 10.1681/ASN.2013070715. Epub 2013 Dec 19.
3. Data on file using literature consensus.  


FAQ

What are the latest results from Apellis Pharmaceuticals' Phase 2 NOBLE study?

The Phase 2 NOBLE study showed positive one-year results for pegcetacoplan in treating post-transplant recurrence of C3G and IC-MPGN, with 55% of patients showing zero C3c staining intensity.

How did pegcetacoplan perform in the recent Phase 2 study for C3G and IC-MPGN?

Pegcetacoplan reduced disease activity in 12 weeks and sustained results over a year, with 55% of patients showing zero C3c staining intensity and 64% showing zero inflammation.

What were the key findings from the Phase 2 NOBLE study presented at the ERA Congress?

Key findings include rapid and sustained reduction in disease activity, with 55% of patients showing zero C3c staining intensity and 64% showing zero inflammation.

What is the significance of the Phase 2 NOBLE study results for APLS stock?

The positive one-year results indicate potential effectiveness of pegcetacoplan, which could positively impact APLS stock as further results are awaited from the Phase 3 VALIANT study.

What is the next step for pegcetacoplan in treating C3G and IC-MPGN?

The next step is the ongoing Phase 3 VALIANT study, which will further evaluate pegcetacoplan's potential, with topline results expected later this year.

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