The IMPAHCT Study is a Phase 2b/Phase 3, randomized, double-blinded, placebo-controlled study of AV-101 (dry powder inhaled imatinib) in patients with PAH. Most approved therapies for PAH do not address the proliferation of cells in the pulmonary vasculature and the subsequent vascular remodeling that cause PAH. Despite the availability of multiple approved therapies, functional limitations and survival of patients with PAH remain unsatisfactory. Therefore, there is a critical unmet need for alternative PAH treatments that directly target the underlying disease process.
PAH is a disease that disproportionately affects women (65–80%), and often strikes in the prime of life, with the average age of those affected now being 50. People with PAH experience a narrowing and blockage of the blood vessels in the lungs resulting in an increased resistance to blood flow into the lungs from the right side of the heart.
This forces the heart to work harder to meet this abnormal demand, and over time the heart weakens and ultimately may fail.
Existing therapies, known as vasodilators, while effective at providing symptomatic relief, fail to treat the underlying cellular proliferation causing disease progression.
Our lead program, AV-101, an investigational proprietary dry powder inhaled formulation of imatinib, is intended to address the underlying hyper-proliferation at the source: within the narrowed arteries of the lungs.
Imatinib is an antiproliferative agent that selectively targets the kinase signaling that has been implicated in causing aberrant cell growth in the pulmonary vasculature, while not interfering with signals needed for healthy cellular function.
AV-101 has been designed to deliver high concentrations of imatinib throughout the airways where it can permeate into the lung parenchyma and immediately reach the surrounding tissue and blood vessels–efficiently delivering a therapeutic medicine straight to diseased blood vessels.
By targeting hyperproliferation in the pulmonary vasculature and limiting systemic exposure, AV-101 has the potential to make a meaningful difference for PAH patients.
Imatinib is the first anti proliferative to have demonstrated clinical efficacy in phase 2 and phase 3 trials of PAH when administered orally. However, systemic side effects limited its therapeutic use and imatinib was never approved for the treatment of PAH.
AV-101 is a novel, investigational dry powdered form of imatinib for inhalation that is designed to deliver anti-proliferative therapy directly to the lungs, allowing more of the drug to access the diseased tissues directly while simultaneously reducing systemic exposure.
AV-101 has been designed to deliver high concentrations of imatinib throughout the airways where it can permeate throughout the lung and immediately reach the surrounding tissue and blood vessels–with a goal of efficiently delivering AV-101 straight to diseased blood vessels.
Most of the currently available therapies for PAH help to relieve the symptoms but do not significantly reverse the damage caused to the blood vessels in the lungs associated with PAH.
The IMPAHCT Study will include about 462 patients. Participation will last for about 7 months and involve at least 8 study visits. The study includes:
For the Phase 2b and Intermediate parts, eligible participants will be randomized 1:1:1:1 to receive AV-101 (at 10 mg, 35 mg, or 75 mg) or placebo. For the Phase 3 part, eligible participants will be randomized 1:1 to receive either AV-101 (at its optimal dose, based on results of the Phase 2b part) or placebo. The study drug (AV-101 or placebo) will be administered as capsules twice daily using a dry powder inhaler.
A safety follow-up phone call will be done 4 weeks after the last dose of study drug. Alternatively, participants may join a long-term extension study, during which they will receive AV-101 until it is commercially available.