Fulcrum therapeutics announces results of phase 1 clinical trial of losmapimod in fshd

Fulcrum therapeutics, inc. announced preliminary results of a phase 1 clinical trial of losmapimod to treat the root cause of facioscapulohumeral dystrophy (fshd). losmapimod is a selective p38a/ss mitogen activated protein kinase inhibitor. fulcrum exclusively in-licensed losmapimod following fulcrum’s discovery that the inhibition of p38a/ss reduced expression of the dux4 gene in muscle cells derived from patients with fshd, a disease which is caused by the mis-expression of dux4 in skeletal muscle. results were presented by michelle mellion, md, medical director at fulcrum therapeutics, in an oral presentation during the 24th international annual congress of the world muscle society in copenhagen, denmark. the primary objective of the trial was to investigate the safety and tolerability of losmapimod in healthy volunteers and in fshd patients. the secondary objective was to evaluate repeated dose pharmacokinetics (pk) and target engagement (te) in fshd patients. in the first cohort, 10 healthy volunteers were randomized to a single oral dose of losmapimod (n=8) 7.5 mg followed by a single oral dose of 15 mg after a wash out period or to single oral dose placebo (n=2) in both dosing periods. in the second cohort, 15 fshd patients were randomized and treated with placebo (n=3) or losmapimod 7.5 mg (n=6) or 15 mg (n=6) taken orally twice daily for 14 days. losmapimod was well tolerated with no serious adverse events (saes) reported. similar tolerability, safety and pk were observed in healthy volunteers and patients with fshd. treatment with losmapimod demonstrated dose-dependent pk and te in blood. this was consistent with previously reported data from more than 3,500 patients treated with losmapimod across multiple other indications. fshd patients treated with losmapimod also achieved dose-dependent concentrations in skeletal muscle, with a muscle to plasma exposure ratio of approximately 1:1. the losmapimod 15 mg dose taken orally twice daily demonstrated sustained drug concentrations that in preclinical models with human fshd myotubes resulted in a robust reduction of dux4-driven gene expression. analysis of target engagement in muscle is ongoing. these data support the selection of the 15 mg dose of losmapimod taken orally twice daily in the company’s ongoing phase 2b placebo-controlled 24-week clinical trial, referred to as redux4, as well as its ongoing phase 2 open label-study of losmapimod for the treatment of patients with fshd.
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