Introduction to Enteris BioPharma, Inc

Enteris BioPharma, Inc. Enteris BioPharma ... challenges with a simple, elegant and scalable solution ... Case Study 26 • Currently...

20 downloads 408 Views 3MB Size
Introduction to Enteris BioPharma, Inc.

Enteris BioPharma



Privately held, New Jersey based biotech company



Owned by Victory Park Capital, a Chicago based investment firm



Clinically validated oral formulation technology • for peptides and challenging small molecules



Extensive scientific know-how and R&D experience



Proven GMP tablet manufacturing capabilities

2

Enteris BioPharma



Enteris has effectively addressed both permeability and solubility challenges with a simple, elegant and scalable solution



Demonstrated a track record of clinical success across a range of compounds and therapeutic indications



Enteris offers robust IP protection, regulatory CMC support and finished, solid dosage formulations for preclinical and early phase clinical studies

3

Clinically Validated Oral Delivery Technology •

Clinically validated oral peptide delivery technology • Positive Phase 3 oral Calcitonin: Osteoporosis(1)

• Positive Phase 2 oral PTH: Osteoporosis(2) • Positive Phase 2 oral Calcitonin: Osteopenia(3)

• Positive Phase 1 oral CR845: Neuropathic Pain(4) •

• • • •

Sponsored preclinical peptide programs • 15 ongoing or completed formulation programs

(1) Tarsa Therapeutics, Inc. (JBMR 27, No.8, 2012, 1821-1829) (2) Unigene Laboratories, Inc. (Bone 53, 2013, 160-166) (Clin Pharm 52, No. 6, 2013) (3) Tarsa Therapeutics, Inc. (ASBMR, 2012) (4) Cara Therapeutics, Inc. (data on file)

4

Actual Bioavailability Data Peptides and Small Molecules 25

Absolute Bioavailability (%)

proprietary peptide

20

15

zanamivir tigecycline CR-845 kanamycin tobramycin

10 proprietary peptides proprietary peptide

5

octreotide *GLP-1 analog

0

0 Studies in beagle dogs Except *Rat Study

1000

2000

calcitonin

PTH 1-34

3000

4000

insulin

5000

6000

Molecular Weight (Da) 5

Criteria for Selection of Peptides

ENTERIS PEPTIDE ASSESSMENT MATRIX Molecular Weight (Da) • Sequence of peptide • Hydrodynamic radius (Å) • Cyclic peptide?

Solubility • Acid

• Water • Buffers/salts

• FaSSIF/FeSSIF

Chemical Stability • x-S-S-x Resistant to Proteolysis?

Modified? Physical Stability • Aggregation rate Projected Dose (mg)

Injectable Dose (mg)

Net Charge • Anionic charges

Bioavailability (%) if known

• Cationic charges

• Rat

• pI

• Dog 6

Criteria for Selection of Small Molecules

ENTERIS SMALL MOLECULE ASSESSMENT MATRIX Molecular Weight (Da)

Moisture sensitive/hygroscopic

BCS Class, if known

Is the API plastic, elastic or brittle?

Describe the solid (salt form, hydrate, solvate, etc.

Any known excipient incompatibilities?

Solubility

Primary mechanism(s) of chemical degradation



pH/Solubility curve available?



Water



Buffers/Solvents/Emulsions



If insoluble, what is the most likely reason? (hydrophobicity/crystal surface energy/etc.)

Are other salts or polymorphs available? Is the API crystalline or amorphous? •

Has polymorph transition been observed during processing or on stability

Caco-2 Permeability • Apical to Basolateral, Basolateral to Apical? Identify known transporter interactions, (P-gp, BCRP, MRP family, PepT1, OATP, etc.) What is the primary clearance mechanism(s)? (renal/Biliary/Metabolic) If metabolic, what enzymes predominate? Bioavailability of current oral formulation in development?

Please describe any PO formulation attempted thus far 7

Contents



Introduction



Mechanism



Safety • Excipient Safety Profile

• Peptides

• LLC Toxicology Studies

• Small molecules

• LLC Regulatory and Clinical

• BCS Class III



Patents

• BCS Class II



Business Development



Manufacturing

8

Mechanism of Drug Delivery

9

Enteric Coat Prevents Tablet from Opening in Stomach at Low pH



Acid-stable enteric coating prevents tablet release in stomach • Less susceptible to food effects or dilution with liquids • API protected from degradation by acid and pepsin • Peptides

• Acid-labile small molecules

10

Enteric Coat Dissolves at Neutral pH in the Small Intestine



Water-soluble sub-coat acts as a partition layer between the enteric

coat and the acidic tablet core • Simultaneous release of API and excipients

11

pH Modifier, Permeability Enhancers and API Released



Organic acid sequestered in coated beads • Increases stability of tablet formulation • Compatible with peptides and small molecules

• Acts as protease inhibitor for peptides • Calcium chelator and membrane permeation enhancer • pH-lowering agent that increases absorptive flux • Membrane wetting/charge dispersal agent

12

API Absorbed Across Intestinal Wall via Paracellular Transport •

Lauroyl-L-carnitine (12-carbon fatty acid) • Modulates tight junctions in the intestinal enterocytes and enhances paracellular transport • Acts as a solubilizing agent due to surfactant properties • Inhibits P-gp efflux transporters

13

Components of Enteris’ Solid Dosage Formulation

14

Peptide Experience

15

Dog Model Predicts Bioavailability in Humans 4500 4000

Linear Regression for Cmax: Y=A+B*X 2 R =0.9801

1000

Human Cmax (pg/ml)

Plasma Cmax (pg/ml)

5000

3500 3000 2500

2000 1500 1000 500 0 0

1

2

3

Dose (mg)

4

5

y=.995x - 0.7548 R=0.958 R2=0.918

100

10

10

100

1000

10000

Dog Cmax (pg/ml)

Enteris' dog model for oral delivery shows high degree of linearity with respect to dose offering a wide range of dosing strategies. Comparability of PK results in dog and human shows that Enteris’ dog model is an appropriate success predictor for human studies

16

Peptide Bioavailability Formulated vs. Unformulated

Effect of Formulation on the Bioavailability of Various Peptides in Pre-Clinical Animal Models Program Type

Sponsored

No. of Amino Acids

Study Type

Ranges of Unformulated Bioavailability (%) for 12 Peptides

Ranges of Formulated Bioavailability* (%) for 12 Peptides

Rat

0.35 – 6.0

10.7 – 26.0

Dog


0.39 – 22.8

4 – 39

* in each case the percent bioavailability of the formulated peptide was higher than unformulated ** LOD = limit of detection

17

Bioavailability of 9 Amino Acid Peptide Across Multiple Animal Models All D Amino Acid Peptide

Enteris

Enteris

Enteris

18

Absorption of LHRH Analog in Dogs as a Function of Enteric-Coating

A

B

D

L30D-55 (10%)

Tmax (min)

Capsule Formulation in Dogs Bioavailability (% F)

12000

Formulation A 10000

111

L30D-55 (15%)

116

L30D-55/ FS30D (12%)

152

3.0 4.6 7.2

LHRH (pg/mL)

Formulation

Enteric coat (weight gain)

Formulation B Formulation D Formulation B

8000

Unformulated Unformulated C 6000 Formulation D 4000 2000 0

Unformulated

L30D-55 (10%)

0

130

0.1

100

200

300

400

500

Time Relative to T max (minutes)

19

Bioavailability of Cara’s CR845 in Preclinical & Phase I

16%

20% 13%

13%

Rat

Dog

15% 10% 5%

0%

Man

20

Phase I Oral CR845 Study

CR845 Demonstrated 16% Oral Bioavailability N = 8/group

100

CR845 (ng/mL)

0.5 mg 1 mg 3 mg 10 mg

10

1

0.1 0

4

8

12

16

Time (hours)

20

24 Mean + SEM

21

PTH Phase II Study Mean PTH Cmax Values for Subjects Receiving Oral PTH(1-31)NH2 and Forsteo®

22

Phase III Oral Calcitonin Study Phase III Study for Oral sCT: Primary Endpoint (Change in LS BMD) Achieved Mean % Change LS-BMD

3.00 2.50

2.00 1.50

1.00

1.5

0.50 0.00

0.8 p<0.001*

rsCT Tablet

p=0.014*

0.5 p=ns*

Nasal Spray

Placebo

23

Small Molecule Experience

24

Rationale for for BCS Class II, III and IV Small Molecule Drugs



Lauroyl-L-carnitine (12-carbon fatty acid) • Modulates tight junctions in the intestinal enterocytes and enhances paracellular transport • Acts as a solubilizing agent due to surfactant properties • Inhibits efflux transporters (P-gp)



Citric Acid (Organic acid) • Calcium chelator and membrane permeation enhancer

• pH-lowering agent that increases absorptive flux • Membrane wetting/charge dispersal agent

25

Tigecycline Case Study KANAMYCIN PROJECT REVIEW AMY STURMER 1.0 / 31JULY2013 26

BCS Class III Molecule Tigecycline Case Study •

Currently approved only for IV infusion as a last resort antibiotic therapy • 100mg loading dose, followed by 50mg every 12hrs, duration ranging from 5 to 14 days • Must be dosed in the clinic



BCS Class III • Very high solubility in water: >295 mg/mL at all pH ranging from 1 – 14 • Very poor permeability: Oral formulations explored to date exhibit a limit of approx. 5 %F



Technology is uniquely suited to enable oral formulation with suitable F • Oral therapy offers out of clinic dosing • Reduced overall healthcare costs • Strategy: Initiate dosing by IV titration, then discharge with oral therapy

27

BCS Class III Molecule Tigecycline Rat Study

(mcg/mL) Concentration Plasma Tigecycline (mcg/mL) Plasma

Animals dosed via intraduodenal administration to simulate oral dosing 2.25

(0.64 mg/kg IV or 4.8 mg/kg ID)

2.00

IV ID PBS ID 100mM CA, 26mM LLC ID 400mM CA, 26mM LLC

1.75 1.50 1.25 1.00 0.75 0.50 0.25 0.00 0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0

Time (hrs)

IV

ID PBS

ID 100mM CA, 26mM LLC

ID 400mM CA, 26mM LLC

Cmax (mcg/mL)

1.79

0.10

0.71

1.11

Tmax (hr)

0.08

1.50

0.33

0.28

AUC(0-t) (mcg*hr/mL)

58.20

6.96

49.38

117.63

%F(0-t)

--

1.60

10.85

27.90

28

Summary of Rat Tigecycline Study



%F for unformulated ID tigecycline: 1.60 to 2.76%



%F of formulated ID tigecycline increased by 10 to 20 fold depending on formulation • 10.85% at 100mM CA / 26mM LLC

• 27.90% at 400mM CA / 26mM LLC



Achieved high oral bioavailability for tigecycline where other formulation technologies have failed, or only been marginally effective

29

Tigecycline Solid Dosage Form Development Enteric Coated Capsule • • • • •

BCS class III molecule filled in capsules “Formulated”: API, CA, LLC and filler “Unformulated”: API and filler only Single ascending dose study in beagle dogs 4 single dose arms • • • •

15 mg formulated + unformulated (n=8 dogs each) 30 mg formulated (n=5 dogs) + unformulated (n=3 dogs) 45 mg formulated (n=5 dogs) 5 mg IV bolus (n=3 dogs)

30

BCS Class III Molecule (Tigecycline) Beagle Dog PK Study

Plasma Tigecycline Concentration Plasma Concentration (ng/mL) (ng/mL)

180

150

15 mg 30 mg 45 mg

120

90

60

30

0 0.0

• 0.5

1.0

1.5

2.0

2.5

3.0

3.5

API was not detected in any “unformulated” arm

4.0

Time (hr)

31

BCS Class III Molecule (Tigecycline) Study Summary



PK Data: Enteric Coated Capsules in Dogs

Mean 5 mg IV

Mean 15 mg PO

Mean 30 mg PO

Mean 45 mg PO

Cmax (ng/mL)

335.0

75.51

121.13

177.01

Tmax (h)

0.08

1.84

1.58

1.67

AUC(0-t) (ng*hr/mL)

410.86

132.65

366.65

574.32

%Fest

--

12.2

14.87

15.53

F%CV

--

72.0

43.3

67.7

Summary • %F of formulated ID dosing in rat model increased by 10 to 20 fold

• Enabled the development of a solid oral dosage form with desirable level of bioavailability and commercial viability in dog model • Achieved high oral bioavailability where other formulation technologies have failed 32

Synergy of CA and LLC Demonstrated on Tigecycline

Mean %F

400mM CA/26mM LLC

21.64

0 CA/26mM LLC

8.86

(m)

33

Tigecycline Human PK Data

34

Aminoglycoside (Kanamycin, Tobramycin) Case Studies KANAMYCIN PROJECT REVIEW AMY STURMER 1.0 / 31JULY2013 35

Project Overview •

Background • • •



Indication: • •



Interacts with the 30S subunit of prokaryotic ribosomes. Induces substantial amounts of mistranslation and indirectly inhibits translocation during protein synthesis

Contraindications: • • •



Used to treat wide variety of infections Effective against gram negative bacteria

Mechanism of action: •



Aminoglycoside bactericidal antibiotics Consist of two amino sugars glycosidically linked to deoxystreptamine Available in oral, IV, IM, and inhaled

Side effects include tinnitus, toxicity to kidneys, and allergic reactions to the drug Presence of intestinal obstruction Generally not indicated for long-term therapy due to nephrotoxocity and ototoxicity

Marketed by BMS, Alcon, Novartis etc. •

Wide veterinary use for certain indications 36

Mean PK for Kanamycin Following Oral Administration to Beagle Dogs (±SEM)

Formulation

Key Excipients

N

Cmax (ng/mL)

Tmax (min)

AUC(0-t) (ng*min/mL)

%F

6

67 (9)

118 (18)

9167 (983)

2.8 (0.3)

0 mg CA, 1

0 mg LLC, uncoated

2

500 mg CA, 100 mg LLC, coated

4

428 (88)

101 (13)

46216 (6593)

14.2 (2.0)

3

250 mg CA, 100 mg LLC, coated

3

408 (72)

125 (22)

36970 (10465)

11.4 (3.2)

4

100 mg CA, 100 mg LLC, coated

3

489 (196)

160 (10)

40336 (18038)

12.4 (5.5)

31

147 (147)

195 (NA)

8573 (8573)

2.6 (2.6)

50 mg CA, 5

100 mg LLC, coated

37

IV Tobramycin Study

38

Plasma Levels in 8 Dogs Given Formulated Oral Tobramycin Capsules

39

Mean Plasma Levels in Dogs Given Oral Tobramycin

(Adjusted for Tmax and Dose)

40

PK of Tobramycin

No of Dogs/No of Responders Cmax (ng/mL) Tmax (min) AUC(0-t) (ng*min/mL) AUC(0-t) (ng*min/mL/mg) %F

Unformulated Capsules (SEM)

Formulated Capsules (SEM)

3/8 3 (1) 145 (35) 270 (140) 27 (14) 0.15 (0.08)

8/8 314 (46) 144 (20) 25829 (4738) 2583 (474) 14.5 (2.7) 41

Pharmacokinetic Parameters for Kanamycin and Tobramycin Mean Pharmacokinetic Parameters for Kanamycin and Tobramycin Following Oral Administration to Beagle Dogs (±SEM)

Formulation

Key Excipients

N

Cmax (ng/mL)

Tmax (min)

AUC(0-t) (ng*min/mL)

%F

JSV-003-005

10 mg Kanamycin, 500 mg CA, 100 mg LLC

4

428 (88)

101 (13)

46216 (6593)

14.2 (2.0)

JSV-003-051

10 mg Tobramycin, 500 mg CA, 100 mg LLC

8

314 (46)

144 (20)

25829 (4738)

14.5 (2.7)

42

BCS Class III Molecule Zanamivir Case Study

43

BCS Class III Molecule Zanamivir Case Study • PK studies of zanamivir in beagle dogs included the following arms: • I.V. (n=3 dogs) • 0.083 mg/kg • dosed as 1 mL of 1 mg/mL zanamivir in PBS

• Formulated enteric-coated capsule (n=5 dogs) • 1.25 mg/kg • 15 mg zanamivir, 500 mg citric acid, 100 mg LLC, Prosolv

• Un-formulated enteric-coated capsule (n=3 dogs) • 1.25 mg/kg • 15 mg zanamivir, Prosolv

• Plasma samples collected to 4 hours

44

Zanamivir Dog Study Results

Zanamivir plasma concentration (ng/mL)

700

IV [0.083 mg/kg] unformulated [1.25 mg/kg]

600

formulated: 500 mg CA, 100 mg LLC [1.25 mg/kg] 500

400

300

F0-4h = 19.8% (56% CV) 200

100

0 0

30

60

90

120

150

180

210

240

Time post-dose (minutes) 45

Conclusions from Zanamivir PK Study • Bioavailability • Unformulated: 0.95% (88% CV) • Formulated: 19.8% (56% CV)

• %F is somewhat underestimated, as the elimination phase of the oral dose is not complete at 4 hours

• Compared to Relenza® Diskhaler (marketed inhalation product, GSK) • Relenza %F∞ ranges from 4% to 17% post-inhalation • Dosage form requires inhaler device and specially-packaged blisters of Relenza® • High variability due to differences in inhalation performance

• Enteris technology shows ~20% bioavailability over just 4 hours

46

Small Molecule Experience BCS Class II

47

In-vitro Fenofibrate Solubility Study



BCS class II compound • • • •



Insoluble in water Slightly soluble in ethanol (1 mg/mL) Soluble in DMF (30 mg/mL) and DMSO (15 mg/mL) Solubility in 1:3 DMF:PBS pH 7.2 reported at 250 mcg/mL

Equilibrium solubility in water and increasing levels of LLC • Excess fenofibrate weighed into individual PP vials • Solutions mixed at 125rpm at 25°C for 4 days • Fenofibrate concentration measured by HPLC against a standard curve prepared in neat CH3CN • This experiment measured water solubility at 4.3 ng/mL

48

Fenofibrate Equilibrium Solubility with Increasing Concentrations of LLC 400 O

Fenofibrate Concentration (mcg/mL)

350

CH3

O CH3

300

H3C

O H3C

O

Cl

250 200

Solubility in 1:3 DMF:PBS pH 7.2 0.25mg/mL

150 100 50 0 0.0

2.5

5.0

7.5

10.0

LLC Concentration (% w/v)

49

Safety

50

Excipient Safety Profile

• Protease Inhibitor: Organic Acid • Pharmaceutically accepted ingredient

• Transport Enhancer: Acyl Carnitine • • • • •

Scope of non-clinical safety package has been confirmed by FDA Genotoxicity and respiratory toxicity completed 6 month rat toxicology study completed 9 month dog toxicology study completed Part of tablet formulation in 12 clinical studies (328 subjects )

• All other Excipients • Pharmaceutically accepted ingredients

• Drug Master File (Type V Safety Data) • Available for cross-reference

51

Acylcarnitines as Permeation Enhancers •

Acylcarnitines are fatty acid esters of L-carnitine that have a single aliphatic hydrocarbon chain of variable length.



3-O-lauroyl-L-carnitine, LLC, is the carnitine ester of lauric acid, a 12 carbon aliphatic fatty acid.



Plasma acylcarnitine concentrations in healthy human subjects ranges from 6 μM to 15 μM, with the majority of studies reporting values ≥10 μM.

• Function to transfer long chain fatty acids across the mitochondrial membrane for β-oxidation and subsequent adenosine triphosphate (ATP) production

52

The Permeation Enhancement by LLC is Transient

LeCluyse E.L., et al. (1993). J. Pharm. Exp. Therap. 265(2):955-962.

53

LLC’s Effects are Reversible Within 15 to 30 Minutes of Removal

Control Tissue

2.0 mM LLC

LeCluyse E.L., et al. (1993). J. Pharm. Exp. Therap. 265(2):955-962.

54

Little Potential for Opportunistic “Piggyback” Permeation

Molecule Type

MW (kDa)

3-Dimensional Radius (Å)

Macromolecules

1 – 10

10 – 30

LPS

> 100

100 – 1000

Enteric Toxins

70 – 900

Viruses

600 – 1000

Bacteria

> 1000

Modeling of perturbed membrane in Caco-2 cells indicates an effective pore radius ca. 20Å

Modified from: Brayden, D. Permeation Enhancers and Oral Peptide Delivery. Presented at the Roche Colorado Peptide Symposium, Sept. 12, 2011. 55

Tight Junction Modifiers are Common • Drug Compounds: • Aspirin • NSAIDS • Phenothiazines

• Food and Drug Additives/Excipients: • • • •

EDTA C8-C18 fatty acids Various polymers Poly-L-lysine

• Natural/Food Products: • ZOT • ATP • Chitosan and chitosan derivatives • Wheat gluten • Oat saponins • Capsaicin • Alcohol

56

LLC Toxicology Studies

57

3-O-Lauroyl-L-Carnitine Preclinical Safety Studies •

Completed Safety Pharmacology Studies • • • • • •



Acute neurotoxicity in rat Acute respiratory in rat Acute cardiovascular in dog hERG CYP450 inhibition/ induction Metabolic profiling in hepatocytes (multiple species)

Completed Toxicology Studies • • • • • •

Oral MTD studies in rat and dog 4 day oral repeat dose finding in rat and dog 1 month oral toxicology with toxicokinetics in rat and dog Standard genotoxicity 6 month oral repeat dose in rat 9 month oral repeat dose in dog 58

All Safety Pharmacology Studies Generated Desirable Outcomes • Lauroyl-L-Carnitine did not: • Inhibit hERG tail current in vitro, at doses up to ca. 90 μg/mL • Affect ECG parameters in dogs dosed up to 100 mg/kg/day PO for 1 month • Produce cardiovascular effects in dogs at up to 100 mg/kg • Induce any respiratory effects in rats at up to 100 mg/kg by gavage • Produce any adverse effects on neurobehavioral function in rats at up to 100 mg/kg

59

LLC Regulatory and Clinical

60

FDA Feedback on LLC program

• FDA Advice Letter received August, 2009 ...the studies that have been completed to date in your development program and the proposed six- and ninemonth repeat dose studies in rats and dogs respectively, would serve to support the use of LLC as an excipient in drug products.

61

Registration Requirements

• Reproductive toxicology • Studies required for populations of premenopausal females, women of child bearing potential, or males

• Embryo-fetal studies – for registration • Recommended embryo-fetal studies in two species, with an assessment of teratogenicity as a minimum to complete drug approval applications in postmenopausal women

• Carcinogenicity – likely not required • The nonclinical findings to date could support the proposal that carcinogenicity studies are not necessary • If there are no preneoplastic lesions or serious adverse toxicologic effects in these studies, FDA would concur that carcinogenicity studies will not be necessary (None observed – reports submitted Sept, 2012)

62

LLC Type V DMF Submitted to FDA

“3-O-Lauroyl-L-Carnitine Hydrochloride (LLC) Preclinical and Clinical Data.” • Contains full study reports of all non-clinical and clinical studies • Non-clinical and clinical overview documents • Available to partners for cross-referencing

63

Summary



Extensive preclinical toxicology package

• Observed no preneoplastic lesions or serious adverse toxicologic effects • Completed toxicology study of 9 months duration •

Extensive Clinical Experience • < 8 single dose Phase 1 studies • 8 week Phase 2a study for oral sCT program • 24 week Phase 2 study for oral PTH program



Type V DMF containing safety data of LLC

64

Patents

65

Patents Summary

Oral Delivery Patents •

7 issued U.S. patents



2 allowed U.S. patent applications



3 pending U.S. provisional patent applications



29 issued Foreign patents



5 pending Foreign patent applications



Key issued patents extend through 2030

66

Business Development

67

Working with Enteris

Formulation Development

In-Vitro • Solubility • Permeability In-Vivo • Intra-duodenal: Rat Study In-Vivo • Capsule: Dog Study

Tablet Formulation Optimization

3 months

In-Vitro & In-Vivo • Stability; Design Space • Tablet: Dog Study

3 months

68

Manufacturing

69

Manufacturing

• Enteris cGMP Manufacturing • • • •

32,000 ft2 cGMP facility located in Boonton, NJ Separate tableting and nasal spray filling suites Full QA/QC and regulatory support Commercial product in US distribution 70

Recent Technical Achievements



Identified coated organic acid as compatible excipient with peptides and small molecules



Simple and scaleable manufacturing process



Optimized release characteristics and bioavailability



Demonstrated room temperature stability of peptide tablets for 24 months



Supplied CTM for Phase 1 and Phase 2 studies

71

Tableting and Capsuling Line

• • • • • • • •

Comil conical mill V-Blender Korsh XL-100 10 station tablet press - up to 10,000 tablets/hr Natoli NP-RD10a single station press for 1 to 300 tablets Vector LDCS coating pan for enteric coating Capsugel Profill capsule filler Phase 1 and 2 clinical supplies Clinical packaging •

Open label, double blind

72

Quality Control

• • • • • • •

Raw Material Release Testing Final Product Release Assay Development Assay Transfer, Optimization & Validation Special Projects and Investigations Stability Studies In process, intermediate and facility testing capabilities

73

Quality Assurance



Systems compliant with FDA, EMEA, MHRA and ICH



Customer focused, providing real time feedback on all quality related issues.



Full project participation: • process development → batch record design → GMP manufacture.



Manufacturing oversight through concurrent batch record review.



Vendor auditing and qualification program.

74

Inspection History

Regulatory Inspection History • Most recent FDA inspection – October, 2011 - No FDA-483 issued • Successful Pre-Approval Inspection – June, 2003



Most recent EMA inspection – October, 2006 - GMP Certificate issued • Successful Pre-Approval Inspection – February, 1998



GMP inspections by QPs from UK & Germany for Phase 3 - Clinical Trial – 2008 • GMP Certificates issued

75

E. coli Recombinant Peptide Manufacturing

DirectExpression ExpressionofofPeptides Peptides Direct • • •

Patented E. coli-based recombinant peptide expression technology Peptide secreted directly into culture medium Enzymatic amidation of recombinant precursor

Enteris’ Peptide Manufacturing Advantages • • • •

Robust yield and purity Scalable Efficient Cost-effective

76

Enteris’ Recombinant Manufacturing Process

77

High Yield and High Product Purity at Low Cost

PTH analog-gly

Glucose regulatory peptide analog-gly

Glucose regulatory peptide-gly

kDa

sCTgly

Recombinant Peptide Manufacturing

66.2 45.0 31.0 21.5 14.4 6.5

SDS PAGE and HPLC Trace of Crude Medium • Enriched Starting Material • Extracellular yields of 400 to 1300 mg/L • Reduced purification steps 78

Amidated Peptide Manufacturing Example rhPTH(1-34)NH2 Step 1. Recombinant production of rhPTH(1-34)Gly35OH precursor The peptide: human PTH(1 -34)-Gly

rhPTH(1-34)GLY Production and Fermentation Feed Rate

SVSEIQLMHNLGKHLNSMERVENLRKKLQDVHNFG MW = 4,116.8 Da P1 P2

KAN-R

ompA

800

0.300

PTH(1-34)gly 700

Term

0.250

P1

PTH(1-34)gly

pPTH(1-34)G-03

Term

7799 bp

P3

Ori

PRLA-4

0.200 PTH(1-34) mg/L

ompA

500 400

0.150

300

Feed Rate mL/min

600

P2

0.100 200 0.050 100

Term SecE P/O LAC-IQ

SEC-E

0

0.000 1

5

9

13

17

21

25

29

Hours Post Induction

Term

The host : E. coli B strain, BLM-6

PTH(1-34) mg/L

Feed Rate ml/min

79

Thank You