title: Efficacy and safety of a new-class hemostatic drug candidate, AV513, in dogs with hemophilia A.
abstract: AV513 is a select fucoidan, a sulfated polysaccharide of botanical origin. It inhibits tissue factor pathway inhibitor (TFPI) activity and accelerates clotting of human hemophilia A and B plasma. In prior work, subcutaneous administration of AV513 to mice with hemophilia A improved hemostasis. The current studies were designed to evaluate potential efficacy and safety in dogs with hemophilia A (hemophilia A dogs) with minimally increased hemostasis after adenoassociated viral-FVIII gene transfer and in treatment-naive severe hemophilia A dogs. AV513 administered subcutaneously to low-FVIII dogs for multiple weeks improved hemostasis as exhibited in thromboelastography (TEG) and cuticle bleeding time (CBT) tests. Moreover, AV513 administered orally to AAV-FVIII dogs and treatment-naive severe hemophilia A dogs for a multiweek dose-escalating period yielded correction to normal ranges in both TEG and CBT end points at 5 to 15 mg/kg and 15 to 20 mg/kg dose levels, respectively. In all 3 separate studies, throughout their duration, AV513 was well tolerated by the dogs without any adverse events. Additional pharmacologic characterization of AV513 included intravenous pharmacokinetic analysis in rats. In summary, the combination of safety and efficacy in 2 global tests of hemostasis in the hemophilia A dog model indicate that further evaluation of AV513 as a hemostatic agent in hemophilia A patients is warranted.
authors.affiliation: Research and Development, Avigen, Alameda, CA 94502, USA. sprasad@avigen.com
authors.forename: Srinivasa
authors.initials: S
authors.lastname: Prasad
authors.forename: David
authors.initials: D
authors.lastname: Lillicrap
authors.forename: Andrea
authors.initials: A
authors.lastname: Labelle
authors.forename: Sabine
authors.initials: S
authors.lastname: Knappe
authors.forename: Tracy
authors.initials: T
authors.lastname: Keller
authors.forename: Erin
authors.initials: E
authors.lastname: Burnett
authors.forename: Sandra
authors.initials: S
authors.lastname: Powell
authors.forename: Kirk W
authors.initials: KW
authors.lastname: Johnson
mesh_terms: D000818:Animals; D001760:Bleeding Time; D000229:Dependovirus; D004195:Disease Models, Animal; D004283:Dog Diseases / Q000188:drug therapy / Q000235:genetics / Q000378:metabolism; D004285:Dogs; D004305:Dose-Response Relationship, Drug; D004353:Drug Evaluation, Preclinical; D005169:Factor VIII / Q000235:genetics / Q000378:metabolism; D006467:Hemophilia A / Q000188:drug therapy* / Q000235:genetics / Q000378:metabolism / Q000662:veterinary; D006487:Hemostasis / Q000187:drug effects*; D006490:Hemostatics / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology*; D006801:Humans; D007279:Injections, Subcutaneous; D008074:Lipoproteins / Q000378:metabolism; D051379:Mice; D011134:Polysaccharides / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology*; D051381:Rats; D013916:Thrombelastography; D013997:Time Factors
chemical_list: D006490:Hemostatics; D008074:Lipoproteins; D011134:Polysaccharides; C051928:lipoprotein-associated coagulation inhibitor; D005169:Factor VIII; C007789:fucoidan