Theranexus Announces Positive Data on Efficacy and Safety in the Phase I/II Trial of Batten-1

Stabilization of motor symptom progression in young adult patients suffering from juvenile Batten disease (CLN3) after 18 months of treatment

Lyon, France – Austin, Texas, United States – 17 April 2024 – 3pm CET – Theranexus, a biopharmaceutical company innovating in the treatment of rare neurological diseases and the Beyond Batten Disease Foundation (BBDF), today announce final positive data on efficacy and safety in the Phase I/II trial of its drug candidate Batten-1 in juvenile Batten disease (CLN3) after 18 months of treatment.

The 18-month safety and efficacy data confirm the 12-month results announced in September 2023. Batten-1 presented a good safety profile. On average, in the 6 young adult patients, treated with Batten-1, progression of motor symptoms was considerably slowed down and appeared stable compared to progression in untreated patients, as evaluated by the modified UBDRS Physical Assessment score. The mean change from baseline was +1,83 for the six subjects treated over 18 months vs +6,04 in untreated subjects from the natural history study conducted by the University of Rochester (n=46).

For Professor Gary Clark, the trial’s principal investigator and Chief of Child Neurology at Texas Children’s Hospital in Houston, “The data collected after 18 months of treatment with Batten-1 further reinforce its highly promising potential. We currently no longer observe a marked progression of motor symptoms in the 6 patients treated. These results support the prospect of a major benefit of Batten-1 for the children with this very severe disease and for their families”.

For Theranexus’ CEO, Mathieu Charvériat: “These positive results on efficacy and safety of Batten-1 are highly encouraging for the patients and their families. Together with BBDF and the investigators we are initiating an Expanded Access Program (EAP) to enable the 6 patients previously in the trial to continue receiving the treatment, considering its favorable risk-benefit profile. These results highlight the strong therapeutic potential Batten-1 on the clinical course of the disease. In this context, we are exploring different funding options to ensure we have the adequate resources to launch a phase 3 pivotal trial, which design has already received positive opinions by the FDA and the EMA”.

As a reminder, the Phase I/II trial conducted by Theranexus and BBDF to evaluate their drug candidate, Batten-1, included six patients with juvenile Batten disease (CLN3) aged 17 years and over. The patients were treated for 18 months. Following their participation in the trial, all patients are offered the possibility to continue receiving the treatment through a compassionate use program. 

About Batten-1
Batten-1 is a novel and exclusive proprietary drug containing the active ingredient miglustat. The mechanism of action of this substance blocks the accumulation of glycosphingolipids and neuroinflammation, thus significantly reducing neuronal death that contributes to a progressive loss of function in patients. For patients over 17 years of age in the Phase I/II trial, the product is administered in solid form. In the Phase III trial, it will be administered in a liquid form better suited to pediatric patients.

Phase I/II trial design: this is an open-label trial involving 6 patients over 17 years of age with CLN3 Batten disease, treated with miglustat up to 600 mg/day for an 18-month period. The primary endpoint is patient safety and tolerability, assessed using reports of adverse effects, biological tests and ECG, as well as the pharmacokinetics of miglustat. The secondary endpoints include biomarkers (NfL, glycosphingolipds), efficacy monitoring: Unified Batten Disease Rating Scale, visual acuity, measurement of brain volumes by MRI and measurement of the thickness of the neuronal layer of the retina by optical coherence tomography scans. Administration of Batten-1 in escalating doses with a maximum of 600 mg/day was well tolerated, with no severe side effects observed causing treatment discontinuation. The most commonly reported adverse events are reversible gastrointestinal effects of often light to moderate severity, thus demonstrating the good tolerability profile of Batten-1 in this population. Further information about the trial is available on https://clinicaltrials.gov/ct2/show/NCT05174039.

About Batten disease
Juvenile Batten disease, also known as Spielmeyer-Vogt or CLN3 disease, is a rare, fatal, inherited disorder of the nervous system for which there is no treatment or cure. Juvenile Batten disease belongs to a group of disorders referred to as neuronal ceroid lipofuscinoses (NCLs). Over 400 different errors in 13 genes have been attributed to various forms of NCL, which differ from one another primarily by when symptoms first appear. The first symptom in the juvenile form, progressive vision loss, appears between the ages of 4 and 6 and is followed by cognitive disorders, behavioral disorders, and motor disorders. Seizures commonly appear within 2-4 years of the onset of disease. Over time, patients continue to decline mentally and physically. Eventually, those affected become wheelchair-bound, are bedridden, and die prematurely.

Juvenile Batten disease is always fatal; usually by the late teens to early 20s. In the United States and Europe, the juvenile form is the most common of the NCLs, which together, affect nearly 2,000 patients[1]. In pathophysiological terms, interactions between neurons and glial cells play key roles in the emergence and progression of all the NCLs.

About Beyond Batten Disease Foundation
Beyond Batten Disease Foundation (BBDF) is the world’s largest nonprofit organization dedicated to funding research for a treatment and cure for juvenile (CLN3) Batten disease. Since its inception in 2008, over $35 million has been invested in research by leveraging donations, co-funding and strategic partnerships. BBDF is spearheading a unique, cohesive strategy, incorporating independent scientific resources and collaboration with related organizations to drive research in juvenile Batten Disease. Today there is a treatment in sight. BBDF funded research has discovered a drug – Batten-1 – that slows the progression of the disease in Batten models. More information can be found at www.beyondbatten.org.

About Theranexus
Theranexus is an innovative biopharmaceutical company that emerged from the French Alternative Energies and Atomic Energy Commission (CEA). The company has a unique platform for the identification and characterization of advanced therapy drug candidates targeting rare neurological disorders and an initial drug candidate in clinical development for Batten disease.

Theranexus is listed on the Euronext Growth market in Paris (FR0013286259- ALTHX).

[1] National Organization for Rare Disorders (NORD)/Orphanet

Lyon, France – Austin, Texas, United States – 29 September 2023 – 7.30am – CET – Theranexus, a biopharmaceutical company innovating in the treatment of rare neurological diseases, and the Beyond Batten Disease Foundation (BBDF), present very encouraging interim results for efficacy and safety after 12 months of treatment in their Phase I/II trial for Batten disease (CLN3) at NCL2023, the International Congress on Neuronal Ceroid Lipofuscinoses held in Hamburg (Germany) from 26 to 30 September 2023.

For Professor Gary Clark, the trial’s principal investigator and Chief of Child Neurology at Texas Children’s Hospital in Houston, “The Phase I/II results for Batten-1 are highly promising, as we have observed a reduction in neurofilaments and glycosphingolipids and no notable progression of motor symptoms after 12 months of treatment in our 6 patients aged 17 years and over. This is unprecedented in the indication, and Batten-1 is thus a source of great hope for children affected by the disease and for their families”. Professor Clark will be presenting the 12-month interim efficacy and safety results at the “Translational Research Clinical” session on Friday 29 September at 12.25pm (CEST).

The 12-month treatment results further support the 6-month results announced in mid-June 2023. The new results, achieved after 12 months of treatment, show an average 32% decline in neurofilament light chain (NfL) levels in patient serum (as a reminder, 17% after 6 months’ treatment). Neurofilaments are a recognized biomarker of neurodegeneration. A 64% reduction in this biomarker is also observed in the cerebrospinal fluid (CSF). After twelve months of treatment, in line with preclinical data the results also confirmed a reduction in the glycosphingolipids involved in the disease (Gb3 reduction of 45%) which, when they accumulate, are toxic to neurons. Clinically, there was notably less worsening of motor symptoms evaluated by the modified UBDRS physical assessment subscale after 12 months than what is expected in this naturally progressive disease.

For Theranexus’ CEO, Mathieu Charvériat: “We are delighted with these 12-month results which confirm and complement our initial 6-month results. The decrease of biomarker levels confirms the effect of Batten-1 on neuronal death, and the clinical course did not worsen. These consistent results represent a significant endorsement of the mechanism of action and demonstrate the strong therapeutic potential of Batten-1 in Batten disease (CLN3)”.

As a reminder, the Phase I/II trial conducted by Theranexus and BBDF to evaluate their drug candidate, Batten-1, includes six patients with Batten disease (CLN3) aged 17 years and over. The patients are being treated over a 24-month period.

The presentation of the 12-month efficacy and safety results will be available online on 29 September after market closing.

For further information about NCL2023: https://ncl2023.de/

Read the full press release here.

Lyon, France – Austin, Texas, United States – 14 June 2023 – 7.30am CEST – Theranexus, a biopharmaceutical company innovating in the treatment of rare neurological diseases, and the Beyond Batten Disease Foundation (BBDF), have today announced encouraging preliminary results achieved with their drug candidate, Batten-1, in juvenile Batten disease as part of the Phase I/II ongoing trial after 6 months of treatment. These preliminary results suggest an effect of Batten-1 on neuronal death and initial signs of clinical efficacy.

Theranexus and BBDF are conducting a Phase I/II trial of their drug candidate in six patients with Batten disease (CLN3) aged 17 years and over who are due to receive treatment over a 24-month period. The first results of this Phase I/II trial after 9 weeks of treatment showed a good tolerability and pharmacokinetic profile for Batten-1. The new preliminary results, achieved after 6 months of treatment, show an average 17% decline in neurofilament light chain (NfL) levels in the blood of dosed patients. Neurofilaments are a recognized biomarker of neurodegeneration. Moreover, motor symptoms assessed by the modified physical subscale of the disease- specific UBDRS did not progress over the same period (mean score of 31.8 after 6 months of treatment as against 32.4 at baseline), whereas according to data available describing the natural course of the disease, this clinical score should have progressedby around one point in these patients. Lastly, the drug candidate continues to show a good tolerability profile after six months of treatment.

Read the full press release here.

Lyon, France – Austin, Texas, United States – 7 June 2023 – 7.30 am CEST – Theranexus, a biopharmaceutical company innovating in the treatment of rare neurological diseases, and the Beyond Batten Disease Foundation (BBDF), have today announced receipt of a positive opinion from the European Medicines Agency (EMA) for the design of the pivotal Phase III trial to evaluate their Batten-1 drug candidate for Batten disease.

Read the full press release here.

Theranexus and BBDF win FDA approval on efficacy endpoints for the Phase III trial to evaluate Batten-1 in CLN3 Batten disease

• Phase III’s primary endpoint will be visual acuity, with secondary endpoints including assessment of cognitive and motor functions,
• The FDA confirmed that this sole Phase III trial would secure Batten-1 approval for Batten CLN3 disease.

Lyon, France – Austin, Texas, United States – 9 May 2023 – 7.30am CEST – Theranexus, a biopharmaceutical company innovating in the treatment of neurological diseases, and the Beyond Batten Disease Foundation (BBDF), have today announced receipt of approval from the Food and Drug Administration (FDA) for the design and primary and secondary endpoints of the pivotal Phase III trial for Batten disease CLN3, at a meeting with the Division of Rare Diseases and Medical Genetics (DRDMG) held in mid-April.

“We are delighted with the constructive discussions we had with the FDA on defining the endpoints of Batten-1 and the design of our pivotal Phase III trial. Its valuable guidance allows us to get fully prepared for the trial launch,” explained Theranexus’ Chief Medical Officer Marie Sebille.

“We would like to thank the FDA for its support, which is fundamental to the development of our Batten-1 drug candidate, the only asset in active clinical development for Batten disease (CLN3). Our pivotal Phase III trial will enable us to gain approval for Batten-1, and also deliver rich news flow throughout the duration of the Phase III trial thanks to the parallel open-label patient cohort. More generally, we have no doubt that we can deliver a therapeutic response for patients suffering from Batten disease,” added Theranexus’ CEO Mathieu Charvériat.

From 22 to 26 February 2023 in Orlando, Florida 

▪ Presentation of preclinical data demonstrating how Batten-1 drastically reduces the buildup of toxic glycosphingolipids in Batten disease and a poster describing for the first time the burden of Batten disease. 

Lyon, France – Austin, Texas, United States – Cardiff, UK – 20 February 2023 – 6pm CET – Theranexus, a biopharmaceutical company innovating in the treatment of neurological diseases and pioneer in the development of drug candidates modulating the interaction between neurons and glial cells, and its partners Beyond Batten Disease Foundation (BBDF) and Cardiff University, today announced several presentations at WORLDSymposium 2023, an international scientific event focused on lysosomal diseases (22 to 26 February in Orlando, Florida – United States). 

Lyon, France – Austin, Texas, United States – 6 September 2022 – 6 pm CEST – Theranexus, a biopharmaceutical company innovating in the treatment of neurological diseases and pioneer in the development of drug candidates modulating the interaction between neurons and glial cells, and the Beyond Batten Disease Foundation (BBDF), have today announced finalization of recruitment of the last patient for the Phase I/II clinical trial to evaluate the tolerability, pharmacokinetics of the Batten-1 drug candidate in juvenile (CLN3) Batten disease.

A total of six patients with juvenile Batten disease aged 17 and over are enrolled in the Phase I/II clinical trial. The Batten-1 drug candidate containing the active ingredient miglustat is administered in escalating doses. The initial tolerability and pharmacokinetic data for miglustat obtained after the first 9 weeks of treatment in this population will serve to initiate Phase III, and Phase I/II patients are being treated and evaluated over a 24-month period.

Franck Mouthon, Chairman of Theranexus, said: “Finalization of recruitment for our Phase I/II trial is an important milestone in the development of Batten-1, a drug candidate that aims to significantly slow progression of juvenile Batten disease for which there is currently no available treatment. Our goal for the next stages in the development process is to launch an international pivotal Phase II/III trial in 2023.”

Craig Benson, Chair of the Beyond Batten Disease Foundation, added: “As parents and representatives of patients with juvenile Batten disease and their families, we are delighted with the enrollment of the last patient in the Phase I/II trial. This new Batten-1 treatment offers tremendous hope for our children affected by the disease.”

The Phase I/II trial is being conducted by referral centers for Batten disease in the United States, with Dr. Gary Clark, Chief of Child Neurology at Texas Children’s Hospital in Houston, as principal investigator.

About Batten-1
Batten-1 is a novel and exclusive proprietary drug containing the active ingredient miglustat. The mechanism of action of this substance blocks the accumulation of glycosphingolipids and neuroinflammation to prevent brain cell death. In the Phase I/II trial, Batten-1 is administered to patients over 17 years of age in solid form, and in Phase III it will be administered in a liquid form better suited to children.

About Batten disease
Juvenile Batten disease, also known as Spielmeyer-Vogt or CLN3 disease, is a rare, fatal, inherited disorder of the nervous system for which there is no treatment or cure. Juvenile Batten disease belongs to a group of disorders referred to as neuronal ceroid lipofuscinoses (NCLs). Over 400 different errors in 13 genes have been attributed to various forms of NCL, which differ from one another primarily by when symptoms first appear. The first symptom in the juvenile form, progressive vision loss, appears between the ages of 4 and 6 which is followed by personality changes, behavioral problems, and slowed learning. Seizures commonly appear within 2-4 years of the onset of disease. Over time, patients continue to decline mentally and physically. Eventually, those affected become wheelchair-bound, are bedridden, and die prematurely. Psychiatric symptoms or psychosis can appear at any time.

Juvenile Batten disease is always fatal; usually by the late teens to early 20s. In the United States and Europe, the juvenile form is the most common of the NCLs, which together, affect nearly 3,000 patients. In pathophysiological terms, interactions between neurons and glial cells play key roles in the emergence and progression of all the NCLs.
About Beyond Batten Disease Foundation

Beyond Batten Disease Foundation (BBDF) is the world’s largest nonprofit organization dedicated to funding research for a treatment and cure for juvenile (CLN3) Batten disease. Since its inception in 2008, over $35 million has been invested in research by leveraging donations, co-funding and strategic partnerships. BBDF is spearheading a unique, cohesive strategy, incorporating independent scientific resources and collaboration with related organizations to drive research in juvenile Batten Disease . Today there is a treatment in sight. BBDF funded research has discovered a drug – Batten-1 – that slows the progression of the disease in Batten models. More information can be found at www.beyondbatten.org

About Theranexus
Theranexus is an innovative biopharmaceutical company that emerged from the French Alternative Energies and Atomic Energy Commission (CEA). It specializes in the treatment of central nervous system disorders and is a pioneer in the development of drug candidates targeting both neurons and glial cells.

The company has a unique platform for the identification and characterization of advanced therapy drug candidates targeting rare neurological disorders and an initial drug candidate in clinical development for Batten disease.
Theranexus is listed on the Euronext Growth market in Paris (FR0013286259- ALTHX).

Next financial publication:
Tuesday 27 September 2022: First half 2022 financial results

More information at http://www.theranexus.com

Contacts
THERANEXUS
Thierry Lambert
Chief Financial Officer
contact@theranexus.com

NEWCAP
Théo Martin/Pierre Laurent
Investor Relations
+33 (0)1 44 71 94 97
theranexus@newcap.eu

FP2COM
Florence Portejoie
Media Relations
+ 33 (0)6 07 76 82 83
fportejoie@fp2com.fr

Disclaimer
This press release contains certain forward-looking statements concerning Theranexus and its business, including its prospects and product candidate development. Such forward-looking statements are based on assumptions that Theranexus considers to be reasonable. However, there can be no assurance that the estimates contained in such forward-looking statements will be verified, which estimates are subject to numerous risks including the risks set forth in the universal registration document of Theranexus filed with the AMF on 28 April 2021 under number D.21-0379 (a copy of which is available on www.theranexus.com) and to the development of economic conditions, financial markets and the markets in which Theranexus operates. The forward-looking statements contained in this press release are also subject to risks not yet known to Theranexus or not currently considered material by Theranexus. The occurrence of all or part of such risks could cause actual results, financial conditions, performance or achievements of Theranexus to be materially different from such forward-looking statements. Theranexus expressly declines any obligation to update such forward-looking statements.

[1] National Organization for Rare Disorders (NORD)/Orphanet
[2] Settembre et al, TFEB links autophagy to lysosomal biogenesis, Science 2011

Lyon, France – Austin, TX, USA – 3 February 2022 – Theranexus, a biopharmaceutical company innovating in the treatment of neurological diseases and pioneer in the development of drug candidates modulating the interaction between neurons and glial cells, and the Beyond Batten Disease Foundation (BBDF), are starting recruitment for Phase I/II clinical trial to evaluate BBDF-101 in Batten disease.

Franck Mouthon, Chairman of Theranexus, said: “The launch of recruitment is a key step in the development of our drug candidate BBDF-101. This trial will be conducted with BBDF and in collaboration with leading North American referral centers for Batten Disease, a rare, fatal, genetic disorder of the nervous system. Our ambition is to demonstrate the full potential of BBDF-101 in this disease for which there are currently no therapeutic options for patients.”

Following on from the award of Investigational New Drug (IND) approval from the Food and Drug Administration (FDA) for its BBDF-101 program in 2021, Theranexus is now actively recruiting patients for its Phase I/II clinical trial. During the 2-year trial, six patients 17-year-old or older will receive BBDF-101 in escalating doses during the first 4.5 months to establish tolerability and pharmacokinetics of trehalose, miglustat and a combination of trehalose/miglustat. The results of the titration phase will be available at the start of the second half of 2022.

After consulting with the FDA, at the end of 2022 Theranexus plans to start a pivotal Phase III trial involving a pediatric cohort of 30 patients with regular measurements to assess disease progression and safety. The aim will be to compare the development of various signs and symptoms in these patients, as rated on the Unified Batten Disease Rating Scale (UBDRS, neurological and behavioral symptoms, activities of daily living, etc.), over a period of two years, to data from a study of disease progression in a cohort of untreated patients followed for many years at the University of Rochester.

This Phase III trial will be conducted in collaboration with the leading referral centers for Batten disease in the United States which include the Texas Children’s Hospital in Houston, TX, the fourth largest pediatric hospital in the United States, the National Institutes of Health, and the University of Rochester Batten Center in Rochester, NY.

“It is with great gratitude for our patients’ families and donors that we now see the launch of the BBDF-101 clinical program which aims to offer a therapeutic solution for patients suffering from this very rare genetic disease. Achieving this major milestone for the Foundation, in collaboration with Theranexus, is an exciting culmination of almost 12 years of research,” concludes Craig Benson, Chair of the BBDF Board of Directors. 

About Batten disease

Juvenile Batten disease, also known as Spielmeyer-Vogt or CLN3 disease, is a rare, fatal, inherited disorder of the nervous system for which there is no treatment or cure. Juvenile Batten disease belongs to a group of disorders referred to as neuronal ceroid lipofuscinoses (NCLs). Over 400 different errors in 13 genes have been attributed to various forms of NCL, which differ from one another primarily by when symptoms first appear. The first symptom in the juvenile form, progressive vision loss, appears between the ages of 4 and 6 which is followed by personality changes, behavioral problems, and slowed learning. Seizures commonly appear within 2-4 years of the onset of disease. Over time, patients continue to decline mentally and physically. Eventually, those affected become wheelchair-bound, are bedridden, and die prematurely. Psychiatric symptoms or psychosis can appear at any time. Juvenile Batten disease is always fatal; usually by the late teens to early 20s. In the United States and Europe, the juvenile form is the most common of the NCLs, which together, affect nearly 3,000 patients[1] In pathophysiological terms, interactions between neurons and glial cells play key roles in the emergence and progression of all the NCLs.

About Beyond Batten Disease Foundation

Beyond Batten Disease Foundation (BBDF) is the world’s largest nonprofit organization dedicated to funding research for a treatment and cure for juvenile (CLN3) Batten disease. Since its inception in 2008, over $35 million has been invested in research by leveraging donations, co-funding and strategic partnerships. BBDF is spearheading a unique, cohesive strategy, incorporating independent scientific resources and collaboration with related organizations to drive research in juvenile Batten Disease[2]. Today there is a treatment in sight. BBDF funded research has discovered a drug that slows the progression of the disease in Batten models. More information can be found at www.beyondbatten.org

About development of BBDF-101 for Batten disease and the partnership between BBDF and Theranexus

The research funded by BBDF and conducted by academics specializing in lysosomal storage disorders (particularly Baylor College of Medicine) led to the discovery of the drug candidate BBDF-101. Following a partnership agreement between BBDF and Theranexus concluded in late 2019 (see below), Theranexus supplemented preclinical development of BBDF-101 with research to establish product safety. Thanks to the research findings, BBDF-101 will now be able to enter the clinical phase following the grant of IND status by the FDA in September 2021.

The clinical development pathway includes:

• Phase I/II for which recruitment began today,
• Phase III due to start by the end of 2022 and to include 30 patients with the aim of achieving final results in the second half of 2025,

The development of BBDF-101 is the result of a partnership concluded between BBDF and Theranexus in late 2019. The exclusive, global license agreement between BBDF and Theranexus covers the clinical development of drug candidate BBDF-101 pending approval and its commercial use. Theranexus also plans to continue its research on the NeuroLead platform of drug candidates targeting neurological forms of other lysosomal disorders.

In consideration for this license, the agreement provides for Theranexus to pay BBDF fixed sums on signing, approval, and achievement of commercial objectives post-approval. Moreover, the agreement provides for payment of royalties calculated based on net sales of BBDF-101 once it is marketed by Theranexus

[1] National Organization for Rare Disorders (NORD)/Orphanet

[2] Settembre et al, TFEB links autophagy to lysosomal biogenesis, Science 2011