Therapeutics

Exidavnemab

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Overview

Name: Exidavnemab
Synonyms: BAN0805, ABBV-0805
Therapy Type: Immunotherapy (passive) (timeline)
Target Type: alpha-synuclein
Condition(s): Parkinson's Disease
U.S. FDA Status: Parkinson's Disease (Inactive)
Company: AbbVie, BioArctic AB

Background

This is a humanized monoclonal antibody targeting α-synuclein originally developed by the Swedish company BioArctic. Genetic and pathology evidence implicate aggregated forms of α-synuclein in the molecular pathogenesis of Parkinson’s disease and other α-synucleinopathies such as dementia with Lewy bodies (DLB). In 2018, AbbVie licensed this and similar antibodies from BioArctic, and until 2022 developed it for the treatment of PD.

BioArctic has engineered several antibodies that bind oligomeric/protofibrillar α-synuclein with nanomolar affinity and high selectivity over monomeric protein. BioArctic engineered several antibodies that bind oligomeric/protofibrillar α-synuclein with nanomolar affinity and high selectivity over monomeric protein (Lindström et al, 2014; Kallab et al., 2018). Preclinical work with ABBV-0805 showed protection against α-synuclein toxicity, as well as clearance of pathological aggregates and prolonged survival in α-synuclein transgenic mice (Nordström et al., 2021).

ABBV-0805 is one of several α-synuclein antibodies being investigated for PD. Others include BIIB054, TAK-341, LU AF82422, and prasinezumab.

Findings

In March 2019, AbbVie began a Phase 1 study of ABBV-0805 in healthy volunteers in the United States (press release). Data presented at the September 2021 International Congress of Parkinson’s Disease and Movement Disorders reported pharmacokinetic, safety and tolerability data that warranted continuing into Phase 2, with once-monthly dosing. A second Phase 1 study was conducted. An intravenous and a subcutaneous formulation were evaluated in a total of 98 healthy Caucasian, Japanese, and Han Chinese volunteers. Results, including exploratory target engagement data, were published after peer review (Boström et al., 2024).

In March 2020, AbbVie started what was going to be a multicenter, placebo-controlled Phase 1 study in 32 people with idiopathic, mild to moderate Parkinson’s. It was going to randomize them to three escalating doses of antibody or placebo, delivered by intravenous infusion every 28 days, with a fourth dose being added pending initial results. Primary outcomes were going to be adverse events and antibody pharmacokinetics in blood and cerebrospinal fluid. In July 2020, the company withdrew this trial, citing strategic reasons.

On April 20 2022, BioArctic announced that AbbVie had terminated its collaboration on α-synuclein antibodies, including ABBV-0805 (press release). BioArctic said it is looking for ways to continue development.

For details on ABBV-0805 trials, see clinicaltrials.gov.

Last Updated: 10 Sep 2024

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References

Therapeutics Citations

  1. TAK-341
  2. LU AF82422
  3. Prasinezumab

Paper Citations

  1. . Safety, Tolerability, and Pharmacokinetics of Single Doses of Exidavnemab (BAN0805), an Anti-α-Synuclein Antibody, in Healthy Western, Caucasian, Japanese, and Han Chinese Adults. J Clin Pharmacol. 2024 Aug 6; PubMed.
  2. . Immunotherapy targeting α-synuclein protofibrils reduced pathology in (Thy-1)-h[A30P] α-synuclein mice. Neurobiol Dis. 2014 Sep;69:134-43. Epub 2014 May 20 PubMed.
  3. . Region-Specific Effects of Immunotherapy With Antibodies Targeting α-synuclein in a Transgenic Model of Synucleinopathy. Front Neurosci. 2018;12:452. Epub 2018 Jul 4 PubMed.
  4. . ABBV-0805, a novel antibody selective for soluble aggregated α-synuclein, prolongs lifespan and prevents buildup of α-synuclein pathology in mouse models of Parkinson's disease. Neurobiol Dis. 2021 Dec;161:105543. Epub 2021 Nov 1 PubMed.

Other Citations

  1. BIIB054

External Citations

  1. press release
  2. press release
  3. clinicaltrials.gov

Further Reading

Papers

  1. . Cellular Uptake of α-Synuclein Oligomer-Selective Antibodies is Enhanced by the Extracellular Presence of α-Synuclein and Mediated via Fcγ Receptors. Cell Mol Neurobiol. 2016 Mar 10; PubMed.
  2. . Mapping of Surface-Exposed Epitopes of In Vitro and In Vivo Aggregated Species of Alpha-Synuclein. Cell Mol Neurobiol. 2016 Dec 27; PubMed.
  3. . Alpha-synuclein oligomer-selective antibodies reduce intracellular accumulation and mitochondrial impairment in alpha-synuclein exposed astrocytes. J Neuroinflammation. 2017 Dec 11;14(1):241. PubMed.