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Gene Therapy Appears To Reduce Symptoms Of Parkinson's By 40 Percent
Ceregene, Inc., has announced that CERE-120, a gene therapy product in
development for the treatment of Parkinson's disease, was well tolerated and
appeared to reduce symptoms by approximately 40% (p<0.001), as measured by
the Unified Parkinson's Disease Rating Scale (UPDRS) motor "off" score, in
an open-label Phase 1 study in 12 patients with advanced disease.  Initial
results of the study were presented by Dr. William J. Marks Jr., principal
investigator of the study and associate professor of Neurology at the
University of California, San Francisco (UCSF) today at the American
Neurological Association annual meeting in Chicago.
The study was authored by: Dr. Jill Ostrem, UCSF neurologist; Dr. Philip
Starr, PhD, and Dr. Paul Larson, who conducted the neurosurgery at UCSF;
neurologist Dr. Leo Verhagen, with neurosurgeon Dr. Roy Bakay, at Rush
University Medical Center.
The study was supported in part by a grant from The Michael J. Fox
Foundation for Parkinson's Research.  Based on the initial results, the
Foundation today announced plans to partially fund a Phase 2 study with a
$1.9 million grant
"We were encouraged by the results of the Phase 1 trial," said Deborah W.
Brooks, president and CEO of The Michael J. Fox Foundation. "Based on these
and on the intriguing efficacy observations, we're eager to continue to
support research in Phase 2 that will more definitively assess the potential
of CERE-120 to treat PD."
CERE-120 is comprised of an adeno-associated virus (AAV) vector carrying the
gene for neurturin (NTN), a naturally occurring protein, whose role is to
keep dopamine-secreting neurons alive and functioning normally.  All 12
patients enrolled in the study underwent stereotactic neurosurgery to
deposit CERE-120 into their putamen.  The putamen is a region of the brain
that undergoes degeneration and reduced dopamine production in Parkinson's
disease patients and this has been closely linked to the major motor
deficits in these patients.
All patients entered in the trial were judged to have inadequate control of
their disease with standard levadopa therapy and were otherwise potential
candidates for additional treatment interventions such as deep brain
stimulation (DBS) surgery.
CERE-120 was delivered at 2 different doses, with patients receiving the low
dose demonstrating approximately 40% improvement in UPDRS motor "off" scores
by 9 months and patients receiving the 4-fold higher dose showing a similar
effect 3 months sooner.  Patients also demonstrated a 50% reduction in hours
of "off" time (i.e., time when normal Parkinson's medication was ineffective
and symptoms were troubling to the patient) and a doubling of good quality
"on" time without dyskinesias (i.e., time when a patient is functioning
well) according to self-reported diaries.
NTN (neurturin) is a member of the same protein family as glial cell-derived
neurotrophic factor (GDNF) and the two molecules have similar
pharmacological properties.  GDNF has previously been tested in Parkinson's
disease patients.  Ceregene owns exclusive technology and product rights to
CERE-120.
"Targeted delivery of the trophic factor neurturin is a compelling approach
to treating Parkinson's disease," said Dr. Marks.  "The safety data and
preliminary efficacy data that we have seen in this Phase 1 study are
encouraging.  Clearly, a larger-scale study is warranted."
According to Dr. Marks, existing treatments for Parkinson's disease treat
symptoms only, and for only a limited period of time.  "Patients with
Parkinson's disease urgently need therapeutic approaches that not only
improve symptoms and function, but also have the ability to modify the
underlying disease itself in a favorable manner," he said.
In addition to Dr. Marks, the study was authored by: Dr. Jill Ostrem, UCSF
neurologist; Dr. Philip Starr, and Dr. Paul Larson, who conducted the
neurosurgery at UCSF; neurologist    Dr. Leo Verhagen with neurosurgeon Dr.
Roy Bakay, at Rush University Medical Center in Chicago; and Raymond T.
Bartus, PhD, who led the clinical and preclinical development of CERE-120 at
Ceregene.
"The planned Phase 2 trial will be a randomized controlled trial involving
approximately 50 patients, and is designed to test if the efficacy we have
seen in our initial Phase 1 trial will hold up in a controlled study,"
stated Jeffrey M. Ostrove, PhD, president and CEO of Ceregene.
Eight medical centers will participate in the Phase 2 study: Baylor College
of Medicine, Duke University, Orgeon Health Sciences University, University
of Alabama at Birmingham, University of Pennsylvania and Mount Sinai College
of Medicine.  UCSF and Rush will also be participating.
"The Phase 1 data reported today affirms that the functioning of CERE-120
closely resembled its performance in preclinical studies both in terms of
its overall safety as well as its possible efficacy," noted Raymond T.
Bartus, PhD, Ceregene's chief operating officer.  "The development of growth
factors as a treatment for neurodegenerative diseases has been hampered by
the difficulty of delivering them specifically to the targeted areas that
need their neuroprotective properties. We believe our programs increasingly
demonstrate that gene transfer may represent a safe and effective means of
solving this age-old problem," said Raymond Bartus.

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