Ensifentrine combines bronchodilator and anti-inflammatory properties in one compound and has the potential to be an effective treatment for COPD and other respiratory diseases, including asthma and cystic fibrosis.
Ensifentrine has been well tolerated in clinical trials involving over 1250 people. It is designed to maximize its effectiveness and reduce adverse events through:
high selectivity for PDE3 and PDE4 over other enzymes and receptors to minimize off-target effects;
direct delivery to the lungs by inhalation to maximize pulmonary exposure to ensifentrine while minimizing systemic distribution and potential adverse events.
Unique mechanism of action
Ensifentrine is a first-in-class, inhaled, dual inhibitor of the phosphodiesterase 3 (PDE3) and phosphodiesterase 4 (PDE4) enzymes. This dual inhibition enables it to combine bronchodilator and anti-inflammatory properties in one compound, differentiating it from existing drug classes used to treat COPD, including corticosteroids, beta2-agonists and anti-muscarinics.
Ensifentrine also activates the Cystic Fibrosis Transmembrane Conductance Regulator (CFTR), which is beneficial in reducing mucous viscosity and improving mucociliary clearance. This potentially makes it an attractive therapy for the treatment of cystic fibrosis.
Ensifentrine has the potential to substantially improve both lung function and quality of life of respiratory patients who are not satisfactorily treated with available drugs. We are developing three formulations of ensifentrine in Phase 2 trials for the treatment of COPD: nebulized, dry powder inhaler (DPI), and pressurized metered-dose inhaler (pMDI).
In Phase 2 studies in patients with moderate-to-severe COPD, our lead formulation, nebulized ensifentrine, has demonstrated significant and clinically meaningful improvements in both lung function and COPD symptoms, including breathlessness. In addition, nebulized ensifentrine has further improved lung function and reduced residual lung volumes (air trapping) in COPD patients taking standard of care, short- and long-acting bronchodilator therapy, including maximum bronchodilator treatment with dual/triple therapy (LABA/LAMA +/- ICS). Nebulized ensifentrine is currently in a Phase 2b clinical study evaluating its effect as an add-on to treatment with a long-acting bronchodilator in patients with moderate-to-severe COPD, which is expected to be completed around year-end 2019.
We reported positive results from a Phase 2 study of the DPI formulation of ensifentrine in August 2019. The pMDI formulation is currently in a Phase 2 study, with single dose data expected in the first quarter of 2020 and final data around the middle of 2020. Ensifentrine also has potential applications in cystic fibrosis, asthma and other respiratory diseases.
This range of Verona Pharma-supported publications provide further pharmacologic background to the research that we are engaged in.
Tara Rheault and Margot Macdonald-Berko
MedNous, July/August 2019
Leif Bjermer, Katharine Abbott-Banner, Kenneth Newman
Pulmonary Pharmacology & Therapeutics, 14 June 2019, 101814
David Singh, Katharine Abbot-Banner, Thomas Bergtsson, Kenneth Newman
Eur. Respir. J. 2018
Lui G Franciosi, PhD, Prof. Zuzana Diamant, MD, Katharine H Banner, PhD, Rob Zuiker, MD, Nicoletta Morelli, MD, Ingrid M C Kamerling, PhD, Marieke L de Kam, MSc, Prof. Jacobus Burggraaf, MD, Prof. Adam F Cohen, MD, Prof. Mario Cazzola, et al.
The Lancet Respiratory Medicine, October 25, 2013, http://dx.doi.org/10.1016/S2213- 2600(13)70187-5
Katharine H. Abbott-Banner and Clive P. Page
Basic & Clinical Pharmacology & Toxicology Doi: 10.1111/bcpt.12209
Franciosi L, Diamant Z, Morelli N, de Kam M, Cohen A, Walker M, Page CP.
Clin Transl Allergy. 2013; 3 (Suppl 1): O13