OP0241 SAFETY AND EFFICACY OF LENABASUM IN AN OPEN-LABEL EXTENSION OF A PHASE 2 STUDY OF LENABASUM IN REFRACTORY SKIN-PREDOMINANT DERMATOMYOSITIS (DM) SUBJECTS
Authors: Victoria Werth, David Pearson, Joyce Owaka, Rui Feng, Josef Simon Concha, Basil Patel, Emily Hejazi, Caitlin Cornwall, Scott Constantine, Nancy Dgetluck, Barbara White
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Lenabasum is a synthetic, non-immunosuppressive, selective cannabinoid receptor type 2 agonist that activates resolution of innate immune responses. Lenabasum had acceptable safety and tolerability and improved efficacy outcomes in the initial 16-week double-blinded, randomized, placebo-controlled Part A of Phase 2 trial JBT101-DM-001 (NCT02466243) in dermatomyositis (DM) subjects with refractory, skin-predominant involvement. <h3>Objectives</h3> To provide long-term safety and efficacy data in DM subjects in this study. <h3>Methods</h3> Subjects who completed Part A were eligible to receive oral lenabasum 20 mg BID in an open-label extension (OLE) that assessed safety and efficacy at 4 weeks, then every 8 weeks. <h3>Results</h3> 20/22 (90.9%) eligible subjects received open-label lenabasum, following a mean interval of 31 weeks from end of Part A, during which when they received only standard-of care, to start of OLE during which lenabasum 20 mg BID was added. 17/20 (85.0%) subjects were on stable baseline immunosuppressive drugs. At the time of data cut-off, all subjects who entered OLE completed 12 months of dosing. Nineteen/20 (95%) of subjects experienced at least 1 AE, with 59 AEs occurring among the subjects during the OLE to date. The majority of AEs were mild (n = 16, 80%), with 1 severe AE (fatigue) considered unrelated to lenabasum reported. AEs occurring in ≥ 2 subjects were: dermatomyositis worsening, dizziness, fatigue, herpes zoster, nasopharyngitis, nausea, upper respiratory tract infection, and urinary tract infection. No serious AEs related to lenabasum have been reported. Improvement was seen in multiple physician- and patient-reported efficacy outcomes; selected outcomes are presented in Figure 1. Mean (SE) changes from study start at Week 52 in the OLE were: CDASI activity score = -17.6 (SD), Patient Skin Activity VAS = -2.6 (SD); Skindex-29 Symptoms Domain = -21.6 (SD); Patient Itch VAS = -2.8 (SD); Physician Overall Disease VAS = -3.0 (SD); and Patient Pain VAS = - 2.3 (SD). Improvements were seen in other efficacy outcomes. 12 subjects had no changes in immunosuppressive drugs during the OLE, 3 reduced chronic steroids, 2 reduced mycophenolate, 3 were switched from methotrexate to mycophenolate, 1 started methotrexate, and 1 had a burst and taper of steroids. <h3>Conclusion:&nbsp;</h3> Lenabasum continues to have a favorable safety and tolerability profile in the OLE of the Phase 2 trial JBT101-DM-001 with no serious AEs or study discontinuations related to lenabasum. The CDASI activity score and multiple other physician and patient-reported outcomes improved, although limitations of attributing efficacy to lenabasum in the setting of open-label dosing is acknowledged. These data support further testing of lenabasum for the treatment of DM, and a Phase 3 study of lenabasum in DM has started.&nbsp; <h3>Disclosure of Interests:&nbsp;&nbsp;</h3> Victoria Werth: None declared, David Pearson: None declared, Joyce Owaka: None declared, Rui Feng: None declared, Josef Simon Concha: None declared, Basil Patel: None declared, Emily Hejazi: None declared, Caitlin Cornwall Shareholder of: Corbus Pharmaceuticals, Inc., Employee of: Corbus Pharmaceuticals, Inc., Scott Constantine Shareholder of: Corbus Pharmaceuticals, Inc., Employee of: Corbus Pharmaceuticals, Inc., Nancy Dgetluck Employee of: Corbus Pharmaceuticals, Inc., Barbara White Shareholder of: Corbus Pharmaceuticals, Inc., Employee of: Corbus Pharmaceuticals, Inc.&nbsp;&nbsp;