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![Page 1: DUR DUR-928, an endogenous regulatory molecule, exhibits ...€¦ · 10 mg/kg 50 mg/kg * Score (0-3) Effect of DUR-928 on Liver Fibrosis Phase I Phase II e g e 0.0 0.5 1.0 1.5 2.0](https://reader036.vdocuments.us/reader036/viewer/2022062605/5fca0aec385fb80b88494318/html5/thumbnails/1.jpg)
Hepatic Gene ExpressionPhase I
Phase II
*p<0.05, **p<0.01
AASLD’s Emerging Trends in NAFLD, Washington DC, March 17-18, 2017
DUR-928, an endogenous regulatory molecule, exhibits anti-inflammatory and antifibrotic activity in a mouse model of NASH Mee J. Kim, WeiQi Lin, DURECT Corporation, Cupertino, CA, USA
INTRODUCTION RESULTSNon-alcoholic steatohepatitis (NASH) is marked by the presence offatty liver, inflammation and fibrosis
DUR-928 is an endogenous regulatory molecule that has beenpreviously shown to reduce hepatic lipid accumulation andinflammation in various animal models of non-alcoholic fatty liverdisease (NAFLD)
Phase I – Weeks 5-9 Four weeks of daily oral DUR-928 treatment during the earlystages of NAFLD/NASH exhibited dose-dependent effects:
Significant decrease in NAS
Trend of decrease of liver fibrosis was observed
Significant reduced hepatic expression of Tnfα and trend ofdecrease of Mcp-1
Phase II – Weeks 9-13 Four weeks of daily oral DUR-928 treatment when liver fibrosiswas established resulted in:
Significant decrease in liver fibrosis
Significant decrease in hepatocyte ballooning
Trend of reduced hepatic expression of fibrotic genes,Collagen 1a1 and 3a1
Hepatic nodule formation, which progresses to hepatocellularcarcinoma in this model, was also reduced in total number, sizeand incidence in DUR-928-treated mice
ConclusionsDUR-928 has the capability to improve liver morphology by itsanti-inflammatory and antifibrotic activity in STAMTM mice. Thesedata support the clinical development of DUR-928 for thetreatment of NASH and other inflammatory or fibrotic liverdiseases
The aim of this study was to investigate the efficacy of DUR-928 toameliorate the progression of NASH and liver fibrosis in theSTAMTM mouse model
STAMTM mouse model of NASH1
NASH was induced by a single subcutaneous injection of 200 ugstreptozotocin solution 2 days after birth in male C57BL/6J mice, followedby high fat diet (57 kcal % fat) feeding at 4 weeks of age until end of thestudy
Dosing regimen and schedule Phase I: Weeks 5–9, daily oral doses of 10 or 50 mg/kg DUR-928 orVehicle (n=8-9/treatment group) Phase II: Weeks 9–13, daily oral doses of 50 mg/kg DUR-928 or Vehicle(n=6-8/treatment group) Studies were terminated upon completion of dosing Baseline measurements were collected from untreated STAMTM mice at Week 9
Phenotypic analysis Hematoxylin & eosin (H&E) staining on liver sections andhistopathological analysis by a certified veterinary pathologist wereperformed to generate NAFLD activity scores (NAS) Percent (%) liver fibrosis as measured by presence of Sirius Red stainingand digital quantification Hepatic gene expression analyses by real-time reverse transcriptionquantitative polyermase chain reaction and normalized to Vehicle Statistical analysis: One-way ANOVA with Dunnett’s MultipleComparison
The STAMTM mouse model used in this study was developed and characterizedby SMC Laboratories (Tokyo, Japan)
We acknowledge Drs. Hongwei Wu, Andy Miksztal and Neil Verity for theirscientific contributions to this study
1. Fujii M, Shibazaki Y, Wakamatsu K, Honda Y, Kawauchi Y, et al. (2013) A murinemodel for non-alcoholic steatohepatitis showing evidence of association betweendiabetes and hepatocellular carcinoma. Med Mol Morphol 46: 141–152
SUMMARY & CONCLUSIONS
OBJECTIVE
MATERIALS & METHODS
ACKNOWLEDGEMENTS
DISCLOSURES Mee J. Kim and WeiQi Lin are employees of DURECT Corporation and may hold company stock/options
This presentation includes discussion of an investigational drug not approved for use in humans
REFERENCE
Phase II: DUR-928or Vehicle controlorally once daily
16151413121110987Week 654321
Birth
Fatty liver
NASH Fibrosis Noduledevelopment
Day 2 HCC
Manifestations of NASH pathology
Low-dose STZ
Phase I: DUR-928or Vehicle controlorally once daily
Begin HFD
Effect of DUR-928 on NAFLD Activity Score
Phase I Phase II
Vehi
cle
10 m
g/kg
50 m
g/kg
0
2
4
6
8**
NAF
LD A
ctiv
ity S
core
Vehi
cle
50 m
g/kg
Wee
k 9
Bas
elin
e
0
2
4
6
8
NAF
LD A
ctiv
ity S
core
Steatosis
Lobular In
flammati
on
Hepato
cyte
Ballooning
0.0
0.5
1.0
1.5
2.0
2.5 Vehicle50 mg/kgWeek 9Baseline
*
Scor
e (0
-3)
Steatosis
Lobular In
flammati
on
Hepato
cyte
Ballooning
0.0
0.5
1.0
1.5
2.0
2.5 Vehicle10 mg/kg50 mg/kg
*
Scor
e (0
-3)
Effect of DUR-928 on Liver Fibrosis
Phase I Phase II
Vehicl
e
50 m
g/kg
Week 9
Bas
eline
0.0
0.5
1.0
1.5
2.0
2.5
*
Siriu
s R
ed-p
ositi
ve A
rea
(%)
Vehicl
e
10 m
g/kg
50 m
g/kg0.0
0.5
1.0
1.5
2.0
2.5 NS
Siriu
s R
ed-p
ositi
ve A
rea
(%)
Sirius Red Staining for Collagen (fibrosis)
Phase I Phase II
Vehicle
10 mg/kg
50 mg/kg
Vehicle
x200
50 mg/kg
x200
x200
Week 9 Baseline
H&E Staining
Phase I Phase II
Vehicle
10 mg/kg
50 mg/kg
Vehicle
50 mg/kg
Week 9 Baseline
Hepatic Nodule FormationBy Week 12, nodule formation starts to occur in STAMTM
mice. Four weeks of 50 mg/kg DUR-928 treatment thatwas concluded at the end of Week 13 (Phase II) wasassociated with reduced size and incidence of nodules
Vehicle DUR-928
Total Number of Nodules
Vehicl
e
DUR-928
0
2
4
6
# N
odul
es O
bser
ved
Total Area of Nodules
Vehicl
e
DUR-928
0
100
200
300
400
500
600
700
Area
(mm
2 )
Incidence of Nodules
Vehicl
e
DUR-928
0
15
30
45
60
Perc
ent (
%)
Tnf
Vehicl
e
10 m
g/kg
50 m
g/kg0.0
0.5
1.0
1.5*
**
Rel
ativ
e Ex
pres
sion
(nor
mal
ized
to V
ehic
le)
Mcp-1
Vehicl
e
10 m
g/kg
50 m
g/kg0.0
0.5
1.0
1.5
2.0
Rel
ativ
e Ex
pres
sion
(nor
mal
ized
to V
ehic
le)
Collagen Type 1a1
Vehicl
e
10 m
g/kg
50 m
g/kg0.0
0.5
1.0
1.5
2.0
Rel
ativ
e Ex
pres
sion
(nor
mal
ized
to V
ehic
le)
Collagen Type 3a1
Vehicl
e
10 m
g/kg
50 m
g/kg0.0
0.5
1.0
1.5
2.0
Rel
ativ
e Ex
pres
sion
(nor
mal
ized
to V
ehic
le)
Tnf
Vehicl
e
DUR-928
Baseli
ne0.0
0.5
1.0
1.5
Rel
ativ
e Ex
pres
sion
(nor
mal
ized
to V
ehic
le)
Tgf
Vehicl
e
DUR-928
Baseli
ne0.0
0.5
1.0
1.5
Rel
ativ
e Ex
pres
sion
(nor
mal
ized
to V
ehic
le)
Collagen Type 1a1
Vehicl
e
DUR-928
Baseli
ne0.0
0.5
1.0
1.5
Rel
ativ
e Ex
pres
sion
(nor
mal
ized
to V
ehic
le)
Collagen Type 3a1
Vehicl
e
DUR-928
Baseli
ne0.0
0.5
1.0
1.5
Rel
ativ
e Ex
pres
sion
(nor
mal
ized
to V
ehic
le)
Hepatic Gene ExpressionPhase I
Phase II
*p<0.05, **p<0.01
AASLD’s Emerging Trends in NAFLD, Washington DC, March 17-18, 2017
DUR-928, an endogenous regulatory molecule, exhibits anti-inflammatory and antifibroticactivity in a mouse model of NASH MeeJ. Kim, WeiQi Lin, DURECT Corporation, Cupertino, CA, USA
INTRODUCTIONRESULTSNon-alcoholicsteatohepatitis(NASH)ismarkedbythepresenceoffattyliver,inflammationandfibrosis
DUR-928isanendogenousregulatorymoleculethathasbeenpreviouslyshowntoreducehepaticlipidaccumulationandinflammationinvariousanimalmodelsofnon-alcoholicfattyliverdisease(NAFLD)
PhaseI–Weeks5-9FourweeksofdailyoralDUR-928treatmentduringtheearlystagesofNAFLD/NASHexhibiteddose-dependenteffects:
SignificantdecreaseinNAS
Trendofdecreaseofliverfibrosiswasobserved
SignificantreducedhepaticexpressionofTnfαandtrendofdecreaseofMcp-1
PhaseII–Weeks9-13FourweeksofdailyoralDUR-928treatmentwhenliverfibrosiswasestablishedresultedin:
Significantdecreaseinliverfibrosis
Significantdecreaseinhepatocyteballooning
Trendofreducedhepaticexpressionoffibroticgenes,Collagen1a1and3a1
Hepaticnoduleformation,whichprogressestohepatocellularcarcinomainthismodel,wasalsoreducedintotalnumber,sizeandincidenceinDUR-928-treatedmice
ConclusionsDUR-928hasthecapabilitytoimprovelivermorphologybyitsanti-inflammatoryandantifibroticactivityinSTAMTMmice.ThesedatasupporttheclinicaldevelopmentofDUR-928forthetreatmentofNASHandotherinflammatoryorfibroticliverdiseases
TheaimofthisstudywastoinvestigatetheefficacyofDUR-928toamelioratetheprogressionofNASHandliverfibrosisintheSTAMTMmousemodel
STAMTMmousemodelofNASH1
NASHwasinducedbyasinglesubcutaneousinjectionof200ugstreptozotocinsolution2daysafterbirthinmaleC57BL/6Jmice,followedbyhighfatdiet(57kcal%fat)feedingat4weeksofageuntilendofthestudy
DosingregimenandschedulePhaseI:Weeks5–9,dailyoraldosesof10or50mg/kgDUR-928orVehicle(n=8-9/treatmentgroup)PhaseII:Weeks9–13,dailyoraldosesof50mg/kgDUR-928orVehicle(n=6-8/treatmentgroup)Studies were terminated upon completion of dosingBaseline measurements were collected from untreated STAMTMmice at Week 9
PhenotypicanalysisHematoxylin&eosin(H&E)stainingonliversectionsandhistopathologicalanalysisbyacertifiedveterinarypathologistwereperformedtogenerateNAFLDactivityscores(NAS)Percent(%)liverfibrosisasmeasuredbypresenceofSiriusRedstaininganddigitalquantificationHepaticgeneexpressionanalysesbyreal-timereversetranscriptionquantitativepolyermasechainreactionandnormalizedtoVehicleStatisticalanalysis:One-wayANOVAwithDunnett’sMultipleComparison
TheSTAMTMmousemodelusedinthisstudywasdevelopedandcharacterizedbySMCLaboratories(Tokyo,Japan)
WeacknowledgeDrs.HongweiWu,AndyMiksztalandNeilVerityfortheirscientificcontributionstothisstudy
1.FujiiM,ShibazakiY,WakamatsuK,HondaY,KawauchiY,etal.(2013)Amurinemodelfornon-alcoholicsteatohepatitisshowingevidenceofassociationbetweendiabetesandhepatocellularcarcinoma.MedMolMorphol46:141–152
SUMMARY & CONCLUSIONS
OBJECTIVE
MATERIALS & METHODS
ACKNOWLEDGEMENTS
DISCLOSURESMeeJ. Kim and WeiQi Lin are employees of DURECT Corporation and may hold company stock/options
This presentation includes discussion of an investigational drug not approved for use in humans
REFERENCE
Phase II: DUR-928or Vehicle controlorally once daily
16 15 14 13 12 11 10 9 8 7 Week6 5 4 3 2 1
Birth
Fatty liver
NASHFibrosisNoduledevelopment
Day 2HCC
Manifestations of NASH pathology
Low-dose STZ
Phase I: DUR-928or Vehicle controlorally once daily
Begin HFD
Effect of DUR-928 on NAFLD Activity Score
Phase IPhase II
Vehicle
10 mg/kg
50 mg/kg
0
2
4
6
8**
NAFLD Activity Score
Vehicle
50 mg/kg
Week 9 Baseline
0
2
4
6
8
NAFLD Activity Score
Steatosis
Lobular In
flammati
on
Hepato
cyte
Ballooning
0.0
0.5
1.0
1.5
2.0
2.5Vehicle50 mg/kgWeek 9Baseline
*
Score (0-3)
Steatosis
Lobular In
flammati
on
Hepato
cyte
Ballooning
0.0
0.5
1.0
1.5
2.0
2.5Vehicle10 mg/kg50 mg/kg
*
Score (0-3)
Effect of DUR-928 on Liver Fibrosis
Phase I Phase II
Vehicl
e
50 m
g/kg
Week 9
Bas
eline
0.0
0.5
1.0
1.5
2.0
2.5
*
Sirius Red-positive Area (%)
Vehicl
e
10 m
g/kg
50 m
g/kg0.0
0.5
1.0
1.5
2.0
2.5NS
Sirius Red-positive Area (%)
Sirius Red Staining for Collagen (fibrosis)
Phase IPhase II
Vehicle
10 mg/kg
50 mg/kg
Vehicle
x200
50 mg/kg
x200
x200
Week 9 Baseline
H&E Staining
Phase IPhase II
Vehicle
10 mg/kg
50 mg/kg
Vehicle
50 mg/kg
Week 9 Baseline
Hepatic Nodule FormationByWeek12,noduleformationstartstooccurinSTAMTM
mice.Fourweeksof50mg/kgDUR-928treatmentthatwasconcludedattheendofWeek13(PhaseII)wasassociatedwithreducedsizeandincidenceofnodules
VehicleDUR-928
Total Number of Nodules
Vehicl
e
DUR-928
0
2
4
6
# Nodules Observed
Total Area of Nodules
Vehicl
e
DUR-928
0
100
200
300
400
500
600
700
Area (mm
2)
Incidence of Nodules
Vehicl
e
DUR-928
0
15
30
45
60
Percent (%)
Tnf
Vehicl
e
10 m
g/kg
50 m
g/kg0.0
0.5
1.0
1.5*
**
Relative Expression
(normalized to Vehicle)
Mcp-1
Vehicl
e
10 m
g/kg
50 m
g/kg0.0
0.5
1.0
1.5
2.0
Relative Expression
(normalized to Vehicle)
Collagen Type 1a1
Vehicl
e
10 m
g/kg
50 m
g/kg0.0
0.5
1.0
1.5
2.0
Relative Expression
(normalized to Vehicle)
Collagen Type 3a1
Vehicl
e
10 m
g/kg
50 m
g/kg0.0
0.5
1.0
1.5
2.0
Relative Expression
(normalized to Vehicle)
Tnf
Vehicl
e
DUR-928
Baseli
ne0.0
0.5
1.0
1.5
Relative Expression
(normalized to Vehicle)
Tgf
Vehicl
e
DUR-928
Baseli
ne0.0
0.5
1.0
1.5
Relative Expression
(normalized to Vehicle)
Collagen Type 1a1
Vehicl
e
DUR-928
Baseli
ne0.0
0.5
1.0
1.5
Relative Expression
(normalized to Vehicle)
Collagen Type 3a1
Vehicl
e
DUR-928
Baseli
ne0.0
0.5
1.0
1.5
Relative Expression
(normalized to Vehicle)
Hepatic Gene ExpressionPhase I
Phase II
*p<0.05, **p<0.01
AASLD’s Emerging Trends in NAFLD, Washington DC, March 17-18, 2017
DUR-928, an endogenous regulatory molecule, exhibits anti-inflammatory and antifibrotic activity in a mouse model of NASH Mee J. Kim, WeiQi Lin, DURECT Corporation, Cupertino, CA, USA
INTRODUCTION RESULTSNon-alcoholic steatohepatitis (NASH) is marked by the presence offatty liver, inflammation and fibrosis
DUR-928 is an endogenous regulatory molecule that has beenpreviously shown to reduce hepatic lipid accumulation andinflammation in various animal models of non-alcoholic fatty liverdisease (NAFLD)
Phase I – Weeks 5-9 Four weeks of daily oral DUR-928 treatment during the earlystages of NAFLD/NASH exhibited dose-dependent effects:
Significant decrease in NAS
Trend of decrease of liver fibrosis was observed
Significant reduced hepatic expression of Tnfα and trend ofdecrease of Mcp-1
Phase II – Weeks 9-13 Four weeks of daily oral DUR-928 treatment when liver fibrosiswas established resulted in:
Significant decrease in liver fibrosis
Significant decrease in hepatocyte ballooning
Trend of reduced hepatic expression of fibrotic genes,Collagen 1a1 and 3a1
Hepatic nodule formation, which progresses to hepatocellularcarcinoma in this model, was also reduced in total number, sizeand incidence in DUR-928-treated mice
ConclusionsDUR-928 has the capability to improve liver morphology by itsanti-inflammatory and antifibrotic activity in STAMTM mice. Thesedata support the clinical development of DUR-928 for thetreatment of NASH and other inflammatory or fibrotic liverdiseases
The aim of this study was to investigate the efficacy of DUR-928 toameliorate the progression of NASH and liver fibrosis in theSTAMTM mouse model
STAMTM mouse model of NASH1
NASH was induced by a single subcutaneous injection of 200 ugstreptozotocin solution 2 days after birth in male C57BL/6J mice, followedby high fat diet (57 kcal % fat) feeding at 4 weeks of age until end of thestudy
Dosing regimen and schedule Phase I: Weeks 5–9, daily oral doses of 10 or 50 mg/kg DUR-928 orVehicle (n=8-9/treatment group) Phase II: Weeks 9–13, daily oral doses of 50 mg/kg DUR-928 or Vehicle(n=6-8/treatment group) Studies were terminated upon completion of dosing Baseline measurements were collected from untreated STAMTM mice at Week 9
Phenotypic analysis Hematoxylin & eosin (H&E) staining on liver sections andhistopathological analysis by a certified veterinary pathologist wereperformed to generate NAFLD activity scores (NAS) Percent (%) liver fibrosis as measured by presence of Sirius Red stainingand digital quantification Hepatic gene expression analyses by real-time reverse transcriptionquantitative polyermase chain reaction and normalized to Vehicle Statistical analysis: One-way ANOVA with Dunnett’s MultipleComparison
The STAMTM mouse model used in this study was developed and characterizedby SMC Laboratories (Tokyo, Japan)
We acknowledge Drs. Hongwei Wu, Andy Miksztal and Neil Verity for theirscientific contributions to this study
1. Fujii M, Shibazaki Y, Wakamatsu K, Honda Y, Kawauchi Y, et al. (2013) A murinemodel for non-alcoholic steatohepatitis showing evidence of association betweendiabetes and hepatocellular carcinoma. Med Mol Morphol 46: 141–152
SUMMARY & CONCLUSIONS
OBJECTIVE
MATERIALS & METHODS
ACKNOWLEDGEMENTS
DISCLOSURES Mee J. Kim and WeiQi Lin are employees of DURECT Corporation and may hold company stock/options
This presentation includes discussion of an investigational drug not approved for use in humans
REFERENCE
Phase II: DUR-928or Vehicle controlorally once daily
16151413121110987Week 654321
Birth
Fatty liver
NASH Fibrosis Noduledevelopment
Day 2 HCC
Manifestations of NASH pathology
Low-dose STZ
Phase I: DUR-928or Vehicle controlorally once daily
Begin HFD
Effect of DUR-928 on NAFLD Activity Score
Phase I Phase II
Vehicle
10 mg/kg
50 mg/kg
0
2
4
6
8**
NAFLD Activity Score
Vehicle
50 mg/kg
Week 9 Baseline
0
2
4
6
8
NAFLD Activity Score
Steatosis
Lobular Inflammation
Hepatocyte Ballooning0.0
0.5
1.0
1.5
2.0
2.5 Vehicle50 mg/kgWeek 9Baseline *
Score (0-3)
Steatosis
Lobular Inflammation
Hepatocyte Ballooning0.0
0.5
1.0
1.5
2.0
2.5 Vehicle10 mg/kg50 mg/kg
*
Score (0-3)
Effect of DUR-928 on Liver Fibrosis
Phase I Phase II
Vehicle
50 mg/kg
Week 9 Baseline 0.0
0.5
1.0
1.5
2.0
2.5
*
Sirius Red-positive Area (%)
Vehicle
10 mg/kg
50 mg/kg0.0
0.5
1.0
1.5
2.0
2.5 NS
Sirius Red-positive Area (%)
Sirius Red Staining for Collagen (fibrosis)
Phase I Phase II
Vehicle
10 mg/kg
50 mg/kg
Vehicle
x200
50 mg/kg
x200
x200
Week 9 Baseline
H&E Staining
Phase I Phase II
Vehicle
10 mg/kg
50 mg/kg
Vehicle
50 mg/kg
Week 9 Baseline
Hepatic Nodule FormationBy Week 12, nodule formation starts to occur in STAMTM
mice. Four weeks of 50 mg/kg DUR-928 treatment thatwas concluded at the end of Week 13 (Phase II) wasassociated with reduced size and incidence of nodules
Vehicle DUR-928
Total Number of Nodules
Vehicle
DUR-9280
2
4
6
# Nodules Observed
Total Area of Nodules
Vehicle
DUR-9280
100
200
300
400
500
600
700
Area (mm
2 )
Incidence of Nodules
Vehicle
DUR-9280
15
30
45
60
Percent (%)
Tnf
Vehicle
10 mg/kg
50 mg/kg0.0
0.5
1.0
1.5*
**
Relative Expression
(normalized to Vehicle)
Mcp-1
Vehicle
10 mg/kg
50 mg/kg0.0
0.5
1.0
1.5
2.0
Relative Expression
(normalized to Vehicle)
Collagen Type 1a1
Vehicle
10 mg/kg
50 mg/kg0.0
0.5
1.0
1.5
2.0
Relative Expression
(normalized to Vehicle)
Collagen Type 3a1
Vehicle
10 mg/kg
50 mg/kg0.0
0.5
1.0
1.5
2.0
Relative Expression
(normalized to Vehicle)
Tnf
Vehicle
DUR-928
Baseline0.0
0.5
1.0
1.5
Relative Expression
(normalized to Vehicle)
Tgf
Vehicle
DUR-928
Baseline0.0
0.5
1.0
1.5
Relative Expression
(normalized to Vehicle)
Collagen Type 1a1
Vehicle
DUR-928
Baseline0.0
0.5
1.0
1.5
Relative Expression
(normalized to Vehicle)
Collagen Type 3a1
Vehicle
DUR-928
Baseline0.0
0.5
1.0
1.5
Relative Expression
(normalized to Vehicle)
Hepatic Gene ExpressionPhase I
Phase II
*p<0.05, **p<0.01
AASLD’s Emerging Trends in NAFLD, Washington DC, March 17-18, 2017
DUR-928, an endogenous regulatory molecule, exhibits anti-inflammatory and antifibroticactivity in a mouse model of NASH MeeJ. Kim, WeiQi Lin, DURECT Corporation, Cupertino, CA, USA
INTRODUCTIONRESULTSNon-alcoholicsteatohepatitis(NASH)ismarkedbythepresenceoffattyliver,inflammationandfibrosis
DUR-928isanendogenousregulatorymoleculethathasbeenpreviouslyshowntoreducehepaticlipidaccumulationandinflammationinvariousanimalmodelsofnon-alcoholicfattyliverdisease(NAFLD)
PhaseI–Weeks5-9FourweeksofdailyoralDUR-928treatmentduringtheearlystagesofNAFLD/NASHexhibiteddose-dependenteffects:
SignificantdecreaseinNAS
Trendofdecreaseofliverfibrosiswasobserved
SignificantreducedhepaticexpressionofTnfαandtrendofdecreaseofMcp-1
PhaseII–Weeks9-13FourweeksofdailyoralDUR-928treatmentwhenliverfibrosiswasestablishedresultedin:
Significantdecreaseinliverfibrosis
Significantdecreaseinhepatocyteballooning
Trendofreducedhepaticexpressionoffibroticgenes,Collagen1a1and3a1
Hepaticnoduleformation,whichprogressestohepatocellularcarcinomainthismodel,wasalsoreducedintotalnumber,sizeandincidenceinDUR-928-treatedmice
ConclusionsDUR-928hasthecapabilitytoimprovelivermorphologybyitsanti-inflammatoryandantifibroticactivityinSTAMTMmice.ThesedatasupporttheclinicaldevelopmentofDUR-928forthetreatmentofNASHandotherinflammatoryorfibroticliverdiseases
TheaimofthisstudywastoinvestigatetheefficacyofDUR-928toamelioratetheprogressionofNASHandliverfibrosisintheSTAMTMmousemodel
STAMTMmousemodelofNASH1
NASHwasinducedbyasinglesubcutaneousinjectionof200ugstreptozotocinsolution2daysafterbirthinmaleC57BL/6Jmice,followedbyhighfatdiet(57kcal%fat)feedingat4weeksofageuntilendofthestudy
DosingregimenandschedulePhaseI:Weeks5–9,dailyoraldosesof10or50mg/kgDUR-928orVehicle(n=8-9/treatmentgroup)PhaseII:Weeks9–13,dailyoraldosesof50mg/kgDUR-928orVehicle(n=6-8/treatmentgroup)Studies were terminated upon completion of dosingBaseline measurements were collected from untreated STAMTMmice at Week 9
PhenotypicanalysisHematoxylin&eosin(H&E)stainingonliversectionsandhistopathologicalanalysisbyacertifiedveterinarypathologistwereperformedtogenerateNAFLDactivityscores(NAS)Percent(%)liverfibrosisasmeasuredbypresenceofSiriusRedstaininganddigitalquantificationHepaticgeneexpressionanalysesbyreal-timereversetranscriptionquantitativepolyermasechainreactionandnormalizedtoVehicleStatisticalanalysis:One-wayANOVAwithDunnett’sMultipleComparison
TheSTAMTMmousemodelusedinthisstudywasdevelopedandcharacterizedbySMCLaboratories(Tokyo,Japan)
WeacknowledgeDrs.HongweiWu,AndyMiksztalandNeilVerityfortheirscientificcontributionstothisstudy
1.FujiiM,ShibazakiY,WakamatsuK,HondaY,KawauchiY,etal.(2013)Amurinemodelfornon-alcoholicsteatohepatitisshowingevidenceofassociationbetweendiabetesandhepatocellularcarcinoma.MedMolMorphol46:141–152
SUMMARY & CONCLUSIONS
OBJECTIVE
MATERIALS & METHODS
ACKNOWLEDGEMENTS
DISCLOSURESMeeJ. Kim and WeiQi Lin are employees of DURECT Corporation and may hold company stock/options
This presentation includes discussion of an investigational drug not approved for use in humans
REFERENCE
Phase II: DUR-928or Vehicle controlorally once daily
16 15 14 13 12 11 10 9 8 7 Week6 5 4 3 2 1
Birth
Fatty liver
NASHFibrosisNoduledevelopment
Day 2HCC
Manifestations of NASH pathology
Low-dose STZ
Phase I: DUR-928or Vehicle controlorally once daily
Begin HFD
Effect of DUR-928 on NAFLD Activity Score
Phase IPhase II
Vehicle
10 mg/kg
50 mg/kg
0
2
4
6
8**
NAFLD Activity Score
Vehicle
50 mg/kg
Week 9 Baseline
0
2
4
6
8
NAFLD Activity Score
Steatosis
Lobular In
flammati
on
Hepato
cyte
Ballooning
0.0
0.5
1.0
1.5
2.0
2.5Vehicle50 mg/kgWeek 9Baseline
*
Score (0-3)
Steatosis
Lobular In
flammati
on
Hepato
cyte
Ballooning
0.0
0.5
1.0
1.5
2.0
2.5Vehicle10 mg/kg50 mg/kg
*
Score (0-3)
Effect of DUR-928 on Liver Fibrosis
Phase I Phase II
Vehicl
e
50 m
g/kg
Week 9
Bas
eline
0.0
0.5
1.0
1.5
2.0
2.5
*
Sirius Red-positive Area (%)
Vehicl
e
10 m
g/kg
50 m
g/kg0.0
0.5
1.0
1.5
2.0
2.5NS
Sirius Red-positive Area (%)
Sirius Red Staining for Collagen (fibrosis)
Phase IPhase II
Vehicle
10 mg/kg
50 mg/kg
Vehicle
x200
50 mg/kg
x200
x200
Week 9 Baseline
H&E Staining
Phase IPhase II
Vehicle
10 mg/kg
50 mg/kg
Vehicle
50 mg/kg
Week 9 Baseline
Hepatic Nodule FormationByWeek12,noduleformationstartstooccurinSTAMTM
mice.Fourweeksof50mg/kgDUR-928treatmentthatwasconcludedattheendofWeek13(PhaseII)wasassociatedwithreducedsizeandincidenceofnodules
VehicleDUR-928
Total Number of Nodules
Vehicl
e
DUR-928
0
2
4
6
# Nodules Observed
Total Area of Nodules
Vehicl
e
DUR-928
0
100
200
300
400
500
600
700
Area (mm
2)
Incidence of Nodules
Vehicl
e
DUR-928
0
15
30
45
60
Percent (%)
Tnf
Vehicl
e
10 m
g/kg
50 m
g/kg0.0
0.5
1.0
1.5*
**
Relative Expression
(normalized to Vehicle)
Mcp-1
Vehicl
e
10 m
g/kg
50 m
g/kg0.0
0.5
1.0
1.5
2.0
Relative Expression
(normalized to Vehicle)
Collagen Type 1a1
Vehicl
e
10 m
g/kg
50 m
g/kg0.0
0.5
1.0
1.5
2.0
Relative Expression
(normalized to Vehicle)
Collagen Type 3a1
Vehicl
e
10 m
g/kg
50 m
g/kg0.0
0.5
1.0
1.5
2.0
Relative Expression
(normalized to Vehicle)
Tnf
Vehicl
e
DUR-928
Baseli
ne0.0
0.5
1.0
1.5
Relative Expression
(normalized to Vehicle)
Tgf
Vehicl
e
DUR-928
Baseli
ne0.0
0.5
1.0
1.5
Relative Expression
(normalized to Vehicle)
Collagen Type 1a1
Vehicl
e
DUR-928
Baseli
ne0.0
0.5
1.0
1.5
Relative Expression
(normalized to Vehicle)
Collagen Type 3a1
Vehicl
e
DUR-928
Baseli
ne0.0
0.5
1.0
1.5
Relative Expression
(normalized to Vehicle)
Hepatic Gene ExpressionPhase I
Phase II
*p<0.05, **p<0.01
AASLD’s Emerging Trends in NAFLD, Washington DC, March 17-18, 2017
DUR-928, an endogenous regulatory molecule, exhibits anti-inflammatory and antifibroticactivity in a mouse model of NASH MeeJ. Kim, WeiQi Lin, DURECT Corporation, Cupertino, CA, USA
INTRODUCTIONRESULTSNon-alcoholicsteatohepatitis(NASH)ismarkedbythepresenceoffattyliver,inflammationandfibrosis
DUR-928isanendogenousregulatorymoleculethathasbeenpreviouslyshowntoreducehepaticlipidaccumulationandinflammationinvariousanimalmodelsofnon-alcoholicfattyliverdisease(NAFLD)
PhaseI–Weeks5-9FourweeksofdailyoralDUR-928treatmentduringtheearlystagesofNAFLD/NASHexhibiteddose-dependenteffects:
SignificantdecreaseinNAS
Trendofdecreaseofliverfibrosiswasobserved
SignificantreducedhepaticexpressionofTnfαandtrendofdecreaseofMcp-1
PhaseII–Weeks9-13FourweeksofdailyoralDUR-928treatmentwhenliverfibrosiswasestablishedresultedin:
Significantdecreaseinliverfibrosis
Significantdecreaseinhepatocyteballooning
Trendofreducedhepaticexpressionoffibroticgenes,Collagen1a1and3a1
Hepaticnoduleformation,whichprogressestohepatocellularcarcinomainthismodel,wasalsoreducedintotalnumber,sizeandincidenceinDUR-928-treatedmice
ConclusionsDUR-928hasthecapabilitytoimprovelivermorphologybyitsanti-inflammatoryandantifibroticactivityinSTAMTMmice.ThesedatasupporttheclinicaldevelopmentofDUR-928forthetreatmentofNASHandotherinflammatoryorfibroticliverdiseases
TheaimofthisstudywastoinvestigatetheefficacyofDUR-928toamelioratetheprogressionofNASHandliverfibrosisintheSTAMTMmousemodel
STAMTMmousemodelofNASH1
NASHwasinducedbyasinglesubcutaneousinjectionof200ugstreptozotocinsolution2daysafterbirthinmaleC57BL/6Jmice,followedbyhighfatdiet(57kcal%fat)feedingat4weeksofageuntilendofthestudy
DosingregimenandschedulePhaseI:Weeks5–9,dailyoraldosesof10or50mg/kgDUR-928orVehicle(n=8-9/treatmentgroup)PhaseII:Weeks9–13,dailyoraldosesof50mg/kgDUR-928orVehicle(n=6-8/treatmentgroup)Studies were terminated upon completion of dosingBaseline measurements were collected from untreated STAMTMmice at Week 9
PhenotypicanalysisHematoxylin&eosin(H&E)stainingonliversectionsandhistopathologicalanalysisbyacertifiedveterinarypathologistwereperformedtogenerateNAFLDactivityscores(NAS)Percent(%)liverfibrosisasmeasuredbypresenceofSiriusRedstaininganddigitalquantificationHepaticgeneexpressionanalysesbyreal-timereversetranscriptionquantitativepolyermasechainreactionandnormalizedtoVehicleStatisticalanalysis:One-wayANOVAwithDunnett’sMultipleComparison
TheSTAMTMmousemodelusedinthisstudywasdevelopedandcharacterizedbySMCLaboratories(Tokyo,Japan)
WeacknowledgeDrs.HongweiWu,AndyMiksztalandNeilVerityfortheirscientificcontributionstothisstudy
1.FujiiM,ShibazakiY,WakamatsuK,HondaY,KawauchiY,etal.(2013)Amurinemodelfornon-alcoholicsteatohepatitisshowingevidenceofassociationbetweendiabetesandhepatocellularcarcinoma.MedMolMorphol46:141–152
SUMMARY & CONCLUSIONS
OBJECTIVE
MATERIALS & METHODS
ACKNOWLEDGEMENTS
DISCLOSURESMeeJ. Kim and WeiQi Lin are employees of DURECT Corporation and may hold company stock/options
This presentation includes discussion of an investigational drug not approved for use in humans
REFERENCE
Phase II: DUR-928or Vehicle controlorally once daily
16 15 14 13 12 11 10 9 8 7 Week6 5 4 3 2 1
Birth
Fatty liver
NASHFibrosisNoduledevelopment
Day 2HCC
Manifestations of NASH pathology
Low-dose STZ
Phase I: DUR-928or Vehicle controlorally once daily
Begin HFD
Effect of DUR-928 on NAFLD Activity Score
Phase IPhase II
Vehicle
10 mg/kg
50 mg/kg
0
2
4
6
8**
NAFLD Activity Score
Vehicle
50 mg/kg
Week 9 Baseline
0
2
4
6
8
NAFLD Activity Score
Steatosis
Lobular In
flammati
on
Hepato
cyte
Ballooning
0.0
0.5
1.0
1.5
2.0
2.5Vehicle50 mg/kgWeek 9Baseline
*
Score (0-3)
Steatosis
Lobular In
flammati
on
Hepato
cyte
Ballooning
0.0
0.5
1.0
1.5
2.0
2.5Vehicle10 mg/kg50 mg/kg
*
Score (0-3)
Effect of DUR-928 on Liver Fibrosis
Phase I Phase II
Vehicl
e
50 m
g/kg
Week 9
Bas
eline
0.0
0.5
1.0
1.5
2.0
2.5
*
Sirius Red-positive Area (%)
Vehicl
e
10 m
g/kg
50 m
g/kg0.0
0.5
1.0
1.5
2.0
2.5NS
Sirius Red-positive Area (%)
Sirius Red Staining for Collagen (fibrosis)
Phase IPhase II
Vehicle
10 mg/kg
50 mg/kg
Vehicle
x200
50 mg/kg
x200
x200
Week 9 Baseline
H&E Staining
Phase IPhase II
Vehicle
10 mg/kg
50 mg/kg
Vehicle
50 mg/kg
Week 9 Baseline
Hepatic Nodule FormationByWeek12,noduleformationstartstooccurinSTAMTM
mice.Fourweeksof50mg/kgDUR-928treatmentthatwasconcludedattheendofWeek13(PhaseII)wasassociatedwithreducedsizeandincidenceofnodules
VehicleDUR-928
Total Number of Nodules
Vehicl
e
DUR-928
0
2
4
6
# Nodules Observed
Total Area of Nodules
Vehicl
e
DUR-928
0
100
200
300
400
500
600
700
Area (mm
2)
Incidence of Nodules
Vehicl
e
DUR-928
0
15
30
45
60
Percent (%)
Tnf
Vehicl
e
10 m
g/kg
50 m
g/kg0.0
0.5
1.0
1.5*
**
Relative Expression
(normalized to Vehicle)
Mcp-1
Vehicl
e
10 m
g/kg
50 m
g/kg0.0
0.5
1.0
1.5
2.0
Relative Expression
(normalized to Vehicle)
Collagen Type 1a1
Vehicl
e
10 m
g/kg
50 m
g/kg0.0
0.5
1.0
1.5
2.0
Relative Expression
(normalized to Vehicle)
Collagen Type 3a1
Vehicl
e
10 m
g/kg
50 m
g/kg0.0
0.5
1.0
1.5
2.0
Relative Expression
(normalized to Vehicle)
Tnf
Vehicl
e
DUR-928
Baseli
ne0.0
0.5
1.0
1.5
Relative Expression
(normalized to Vehicle)
Tgf
Vehicl
e
DUR-928
Baseli
ne0.0
0.5
1.0
1.5
Relative Expression
(normalized to Vehicle)
Collagen Type 1a1
Vehicl
e
DUR-928
Baseli
ne0.0
0.5
1.0
1.5
Relative Expression
(normalized to Vehicle)
Collagen Type 3a1
Vehicl
e
DUR-928
Baseli
ne0.0
0.5
1.0
1.5
Relative Expression
(normalized to Vehicle)Hepatic Gene Expression
Phase I
Phase II
*p<0.05, **p<0.01
AASLD’s Emerging Trends in NAFLD, Washington DC, March 17-18, 2017
DUR-928, an endogenous regulatory molecule, exhibits anti-inflammatory and antifibrotic activity in a mouse model of NASH Mee J. Kim, WeiQi Lin, DURECT Corporation, Cupertino, CA, USA
INTRODUCTION RESULTSNon-alcoholic steatohepatitis (NASH) is marked by the presence offatty liver, inflammation and fibrosis
DUR-928 is an endogenous regulatory molecule that has beenpreviously shown to reduce hepatic lipid accumulation andinflammation in various animal models of non-alcoholic fatty liverdisease (NAFLD)
Phase I – Weeks 5-9 Four weeks of daily oral DUR-928 treatment during the earlystages of NAFLD/NASH exhibited dose-dependent effects:
Significant decrease in NAS
Trend of decrease of liver fibrosis was observed
Significant reduced hepatic expression of Tnfα and trend ofdecrease of Mcp-1
Phase II – Weeks 9-13 Four weeks of daily oral DUR-928 treatment when liver fibrosiswas established resulted in:
Significant decrease in liver fibrosis
Significant decrease in hepatocyte ballooning
Trend of reduced hepatic expression of fibrotic genes,Collagen 1a1 and 3a1
Hepatic nodule formation, which progresses to hepatocellularcarcinoma in this model, was also reduced in total number, sizeand incidence in DUR-928-treated mice
ConclusionsDUR-928 has the capability to improve liver morphology by itsanti-inflammatory and antifibrotic activity in STAMTM mice. Thesedata support the clinical development of DUR-928 for thetreatment of NASH and other inflammatory or fibrotic liverdiseases
The aim of this study was to investigate the efficacy of DUR-928 toameliorate the progression of NASH and liver fibrosis in theSTAMTM mouse model
STAMTM mouse model of NASH1
NASH was induced by a single subcutaneous injection of 200 ugstreptozotocin solution 2 days after birth in male C57BL/6J mice, followedby high fat diet (57 kcal % fat) feeding at 4 weeks of age until end of thestudy
Dosing regimen and schedule Phase I: Weeks 5–9, daily oral doses of 10 or 50 mg/kg DUR-928 orVehicle (n=8-9/treatment group) Phase II: Weeks 9–13, daily oral doses of 50 mg/kg DUR-928 or Vehicle(n=6-8/treatment group) Studies were terminated upon completion of dosing Baseline measurements were collected from untreated STAMTM mice at Week 9
Phenotypic analysis Hematoxylin & eosin (H&E) staining on liver sections andhistopathological analysis by a certified veterinary pathologist wereperformed to generate NAFLD activity scores (NAS) Percent (%) liver fibrosis as measured by presence of Sirius Red stainingand digital quantification Hepatic gene expression analyses by real-time reverse transcriptionquantitative polyermase chain reaction and normalized to Vehicle Statistical analysis: One-way ANOVA with Dunnett’s MultipleComparison
The STAMTM mouse model used in this study was developed and characterizedby SMC Laboratories (Tokyo, Japan)
We acknowledge Drs. Hongwei Wu, Andy Miksztal and Neil Verity for theirscientific contributions to this study
1. Fujii M, Shibazaki Y, Wakamatsu K, Honda Y, Kawauchi Y, et al. (2013) A murinemodel for non-alcoholic steatohepatitis showing evidence of association betweendiabetes and hepatocellular carcinoma. Med Mol Morphol 46: 141–152
SUMMARY & CONCLUSIONS
OBJECTIVE
MATERIALS & METHODS
ACKNOWLEDGEMENTS
DISCLOSURES Mee J. Kim and WeiQi Lin are employees of DURECT Corporation and may hold company stock/options
This presentation includes discussion of an investigational drug not approved for use in humans
REFERENCE
Phase II: DUR-928or Vehicle controlorally once daily
16151413121110987Week 654321
Birth
Fatty liver
NASH Fibrosis Noduledevelopment
Day 2 HCC
Manifestations of NASH pathology
Low-dose STZ
Phase I: DUR-928or Vehicle controlorally once daily
Begin HFD
Effect of DUR-928 on NAFLD Activity Score
Phase I Phase II
Vehi
cle
10 m
g/kg
50 m
g/kg
0
2
4
6
8**
NAF
LD A
ctiv
ity S
core
Vehi
cle
50 m
g/kg
Wee
k 9
Bas
elin
e
0
2
4
6
8
NAF
LD A
ctiv
ity S
core
Steatosis
Lobular In
flammati
on
Hepato
cyte
Ballooning
0.0
0.5
1.0
1.5
2.0
2.5 Vehicle50 mg/kgWeek 9Baseline
*
Scor
e (0
-3)
Steatosis
Lobular In
flammati
on
Hepato
cyte
Ballooning
0.0
0.5
1.0
1.5
2.0
2.5 Vehicle10 mg/kg50 mg/kg
*
Scor
e (0
-3)
Effect of DUR-928 on Liver Fibrosis
Phase I Phase II
Vehicl
e
50 m
g/kg
Week 9
Bas
eline
0.0
0.5
1.0
1.5
2.0
2.5
*
Siriu
s R
ed-p
ositi
ve A
rea
(%)
Vehicl
e
10 m
g/kg
50 m
g/kg0.0
0.5
1.0
1.5
2.0
2.5 NS
Siriu
s R
ed-p
ositi
ve A
rea
(%)
Sirius Red Staining for Collagen (fibrosis)
Phase I Phase II
Vehicle
10 mg/kg
50 mg/kg
Vehicle
x200
50 mg/kg
x200
x200
Week 9 Baseline
H&E Staining
Phase I Phase II
Vehicle
10 mg/kg
50 mg/kg
Vehicle
50 mg/kg
Week 9 Baseline
Hepatic Nodule FormationBy Week 12, nodule formation starts to occur in STAMTM
mice. Four weeks of 50 mg/kg DUR-928 treatment thatwas concluded at the end of Week 13 (Phase II) wasassociated with reduced size and incidence of nodules
Vehicle DUR-928
Total Number of Nodules
Vehicl
e
DUR-928
0
2
4
6
# N
odul
es O
bser
ved
Total Area of Nodules
Vehicl
e
DUR-928
0
100
200
300
400
500
600
700
Area
(mm
2 )
Incidence of Nodules
Vehicl
e
DUR-928
0
15
30
45
60
Perc
ent (
%)
Tnf
Vehicl
e
10 m
g/kg
50 m
g/kg0.0
0.5
1.0
1.5*
**
Rel
ativ
e Ex
pres
sion
(nor
mal
ized
to V
ehic
le)
Mcp-1
Vehicl
e
10 m
g/kg
50 m
g/kg0.0
0.5
1.0
1.5
2.0
Rel
ativ
e Ex
pres
sion
(nor
mal
ized
to V
ehic
le)
Collagen Type 1a1
Vehicl
e
10 m
g/kg
50 m
g/kg0.0
0.5
1.0
1.5
2.0
Rel
ativ
e Ex
pres
sion
(nor
mal
ized
to V
ehic
le)
Collagen Type 3a1
Vehicl
e
10 m
g/kg
50 m
g/kg0.0
0.5
1.0
1.5
2.0
Rel
ativ
e Ex
pres
sion
(nor
mal
ized
to V
ehic
le)
Tnf
Vehicl
e
DUR-928
Baseli
ne0.0
0.5
1.0
1.5
Rel
ativ
e Ex
pres
sion
(nor
mal
ized
to V
ehic
le)
Tgf
Vehicl
e
DUR-928
Baseli
ne0.0
0.5
1.0
1.5
Rel
ativ
e Ex
pres
sion
(nor
mal
ized
to V
ehic
le)
Collagen Type 1a1
Vehicl
e
DUR-928
Baseli
ne0.0
0.5
1.0
1.5
Rel
ativ
e Ex
pres
sion
(nor
mal
ized
to V
ehic
le)
Collagen Type 3a1
Vehicl
e
DUR-928
Baseli
ne0.0
0.5
1.0
1.5
Rel
ativ
e Ex
pres
sion
(nor
mal
ized
to V
ehic
le)