Topline results from the MOMENTUM Phase 2 obesity trial of pemvidutide has shown at week 48, subjects receiving pemvidutide achieved mean weight losses of 10.3%, 11.2%, 15.6% and 2.2% at the 1.2mg, 1.8mg and 2.4mg doses and placebo, respectively, with a near-linear trajectory of continued weight loss observed on the 2.4 mg dose at the end of treatment.
Pemvidutide is a novel, investigational, peptide-based GLP-1/glucagon dual receptor agonist in development for the treatment of obesity and metabolic dysfunction-associated steatohepatitis (MASH), formerly known as non-alcoholic steatohepatitis (NASH). Activation of the GLP-1 and glucagon receptors is believed to mimic the complementary effects of diet and exercise on weight loss, with GLP-1 suppressing appetite and glucagon increasing energy expenditure.
The trial enrolled 391 subjects with obesity or overweight with at least one co-morbidity and without diabetes. Subjects were randomised 1:1:1:1 to 1.2mg, 1.8mg, 2.4mg pemvidutide or placebo administered weekly for 48 weeks in conjunction with diet and exercise. The 1.2mg and 1.8mg doses were administered without dose titration, while a short four-week titration period was employed for the 2.4mg dose. At baseline, subjects had a mean age of approximately 50 years, mean body mass index (BMI) of approximately 37kg/m2 and mean body weight of approximately 104 kg. Approximately 75% of subjects were female.
“The level of weight loss achieved at 48 weeks in this trial has been shown to reverse the key complications of obesity. Moreover, the trajectory of weight loss at the end of treatment with the 2.4mg dose suggests the potential for greater weight loss with continued treatment,” said Dr Scott Harris, Chief Medical Officer of Altimmune. “It is also important to recognise the safety profile of pemvidutide observed to date, especially cardiac-related safety, considering that many obesity patients are at risk for cardiovascular events such as arrhythmias and major adverse cardiac events.”
Over 50% of subjects achieved at least 15% weight loss and over 30% of subjects achieved at least 20% weight loss on the 2.4mg dose. As in prior clinical trials, pemvidutide resulted in robust reductions in serum lipids and improvements in blood pressure without imbalances in cardiac events, arrhythmias or clinically meaningful increases in heart rate. Glucose homeostasis was maintained, with no significant changes in fasting glucose or HbA1c.
More subjects receiving pemvidutide stayed on study compared to those receiving placebo, with 74.1% of pemvidutide subjects completing the trial compared to 61.9% of placebo subjects. Nausea and vomiting comprised the majority of adverse events (AEs) and were predominantly mild to moderate in severity. Only one (1.0%) subject experienced a drug-related serious adverse event (SAE), a case of vomiting at the 2.4mg dose.
Rates of AEs leading to treatment discontinuation were 6.2% in subjects receiving placebo and 5.1%, 19.2%, and 19.6% in subjects receiving 1.2mg, 1.8mg and 2.4mg of pemvidutide, respectively. Study discontinuations related to study drug occurred in 2.1% of placebo subjects and 4.1%, 16.2% and 15.5% in subjects receiving 1.2mg, 1.8mg and 2.4mg of pemvidutide, respectively, with most discontinuations due to AEs in the pemvidutide groups occurring in the first 16 weeks of treatment. No AEs of special interest or major adverse cardiac events (MACE) were observed, and there were low rates of cardiac AEs, including arrhythmias, with no imbalance across pemvidutide or placebo groups.
“This is an important day for Altimmune and we couldn’t be more pleased with these results. To put these results in context, the 15.6% mean weight loss observed with the 2.4 mg dose was associated with a mean weight loss of 32.2 lbs at 48 weeks. The impact of this level of weight loss on patients can be significant. For example, 48% of subjects on the 2.4 mg dose with baseline obesity no longer had obesity at the end of the 48-week trial,” said Dr Vipin K Garg, President and Chief Executive Officer of Altimmune. “We believe the magnitude of weight loss, robust reductions in triglycerides, LDL cholesterol and blood pressure, together with the safety profile observed in this trial, could potentially differentiate pemvidutide from the other incretin-based therapies. If approved, we believe pemvidutide could offer an important option for obesity patients, including those with risk factors for cardiovascular disease.”