The Rho kinase (ROCK) inhibitor NRL-1049, a potential treatment for people with cerebral cavernous malformations (CCM), a condition marked by abnormally enlarged capillary cavities in the brain and spinal cord, was dosed in the first two cohorts of the investigational clinical trial, according to Neurelis, Inc., a commercial-stage neuroscience company. This first-in-human study aims to determine NRL-1049’s safety, tolerability, and pharmacokinetic properties. “This trial will build on the preclinical activity and tolerance seen in preclinical studies, so we are delighted to begin it. According to Craig Chamblis, founder and CEO of Neurelis, people with CCMs have few treatment choices, which include managing seizures with anti-seizure drugs and, in a small number of cases, surgical intervention to remove lesions. NRL-1049 may become the first CCMs treatment to receive FDA approval if it is successful.
In transgenic mice with the familial CCM mutations treated with NRL-1049, there was a significant dose-dependent reduction in lesion volume and a reduction in haemorrhage (iron deposition) near lesions at all doses after treatment compared with placebo, according to an analysis of NRL-1049 preclinical data. The safety, tolerability, and pharmacokinetic parameters of NRL-1049 will be established in a randomised, dose-escalation, double-blind, single ascending dose study in healthy volunteers. The study’s main goals are to gather information on clinical safety and tolerability as well as the maximum tolerated dose (MTD) of a single oral dose of NRL-1049.
Stuart Madden, PHD, CCHEM, FRSC, chief scientific officer, stated that the NRL-1049 phase 1 research was “based on solid preclinical evidence, both offering deeper insight into its potential, which helped explain our choice to launch this clinical programme.” We are enthusiastic about what NRL-1049 may imply for patients and value the trial participants’ and researchers’ contributions. NRL-1049, an investigational pre-clinical stage small molecule Rho kinase (ROCK) inhibitor intended to potentially lessen the buildup of new lesions as well as relieve neurological symptoms related to CCMs, was licenced by Neurelis from BioAxone BioSciences, Inc. in June 2021. NRL-1049’s application for an investigational new drug (IND) to the US Food and Drug Administration (FDA) was approved earlier this year.
The cerebral cortex, brainstem, and spinal cord are the most often affected areas of the brain by cerebral cavernous malformations (CCMs), a condition marked by abnormally expanded capillary cavities. CCMs can show up as one or more lesions, or they can show up as both. CCMs can be “clinically quiet” or show clinical signs such headaches, focal neurological impairments, seizures, and cerebral haemorrhage, depending on the size and location of the lesion. There are few treatment options available for people with CCMs, which only involve surgical intervention to remove lesions and managing seizures with anti-seizure drugs (e.g., microsurgical resection, stereotactic radiosurgery). With CCMs, there are no FDA-approved therapy options. The majority of cavernous malformations are treated conservatively by keeping an eye out for physical changes, recent haemorrhages, or other clinical signs. Dedicated to the research and commercialization of therapies for the treatment of epilepsy and other neurologic illnesses with significant unmet medical needs, Neurelis, Inc. is a commercial-stage neuroscience firm.
