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CCR9 Program
Overview
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Phase II Trial in Celiac Disease
Celiac Disease

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CCR9 Program

Our lead product candidate, Traficet-EN™, or CCX282, targeting the CCR9 chemokine receptor, is currently in a Phase II/III clinical trial in moderate-to-severe Crohn's disease, a chronic inflammatory condition of the gastrointestinal tract and one of two forms of inflammatory bowel disease (IBD). Inflammatory bowel disease refers to two diseases - Crohn's disease and ulcerative colitis. We are currently evaluating a Phase II clinical trial to explore the safety and efficacy Traficet-EN in patients with ulcerative colitis. In addition, Traficet-EN is currently being studied in a Phase II clinical trial in patients with celiac disease.

Traficet-EN is intended to control the inappropriate immune system response underlying Crohn's disease by inhibiting the CCR9 chemokine receptor. In adults, CCR9 is a highly specific receptor expressed predominately by T-cells, a subset of the body's immune cells that migrate selectively to the digestive tract. Studies have shown that when CCR9, or its chemokine ligand CCL25 (previously known as TECK), are over-expressed, the migration of T-cells to the small and large intestine causes persistent inflammation. CCR9 positive T-cells have been shown to play a role in Crohn's disease and other gastrointestinal tract inflammatory disorders such as ulcerative colitis and celiac disease.

Traficet-EN Advantages
We believe that Traficet-EN may provide the following advantages over existing therapeutic approaches for the treatment of patients with Crohn's disease:

  • Reduced side effects, as it is designed to avoid the broad immunosuppressive effects of existing therapies by selectively targeting the CCR9 chemokine receptor.
  • Oral administration as a more convenient option relative to injectable or infusible therapeutics such as TNF-α; inhibitors as well as certain steroids and immunosuppressants. Improved patient compliance is particularly important in controlling chronic conditions such as Crohn's disease.
  • Lower manufacturing costs, relative to TNF-α; inhibitors, as a small molecule.

We believe Traficet-EN, if approved for marketing by the FDA, will provide physicians with a new and attractive option for the first-line treatment of patients with moderate-to-severe Crohn's disease.

We have completed six clinical trials to date, and have two ongoing clinical trials with Traficet-EN. These trials include five Phase I clinical trials of Traficet-EN among healthy volunteers to evaluate safety and pharmacokinetics with single-dose and multiple-dose administration. In these trials, Traficet-EN was well tolerated and was found to be appropriate for once- or twice-daily oral dosing. We subsequently conducted a 28-day Phase II clinical trial in 74 patients with moderate-to-severe Crohn's disease, in which Traficet-EN was demonstrated safe and well tolerated. In this trial, we observed indications of clinical activity based on a reduction in Crohn's Disease Activity Index (CDAI) scores and lower C-reactive protein (CRP) levels in patients treated with Traficet-EN.

In 2006, we initiated a multinational, multi-center Phase II/III clinical trial, called PROTECT-1, to further assess the safety and efficacy of Traficet-EN for the induction of clinical response or remission in patients with moderate-to-severe Crohn's disease. Following the completion of a 12-week induction phase during which all subjects will receive either a placebo or one of three doses of Traficet-EN and a four-week open label phase during which all subjects will receive doses of Traficet-EN, the study will include a separate 36-week phase to evaluate Traficet-EN's utility as maintenance therapy for the response or remission in patients with Crohn's disease, which will be assessed by re-randomizing all patients with a 70-point-or-greater drop in CDAI scores at the end of the active treatment period to either Traficet-EN or placebo.

We also initiated a Phase II proof-of-concept trial to evaluate the safety and efficacy of Traficet-EN in patients with celiac disease in October 2007. This trial is designed to evaluate the effect of Traficet-EN on the inflammatory response in the digestive tract caused by the ingestion of gluten-containing foods (i.e., those containing wheat, rye and barley). We are currently evaluating a Phase II clinical trial to explore the safety and efficacy of Traficet-EN in patients with ulcerative colitis.

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