Ionis Innovation
Our antisense-powered pipeline
Our drug discovery platform has served as a springboard for drug discovery and realized hope for patients with unmet needs. Our broad, diverse pipeline has more than 40 first-in-class and/or best-in-class medicines designed to treat a broad range of diseases including cancer and cardiovascular, neurological, infectious and pulmonary diseases.
The result of 30 years of perfecting and advancing RNA targeted drug discovery and development, our proprietary platform now provides a fast and efficient path from genomic discovery to life-saving therapies.
Neurological
Severe & Rare
Generation 2.5 antisense drug
ION357, formerly known as IONIS-RHO-2.5Rx, is an antisense oligonucleotide (ASO) drug designed to selectively reduce the production of the rhodopsin P23H mutant protein in the eye while allowing normal protein to be expressed. The allele-selective targeting of the ASO to the single-base P23H mutation prevents degeneration of rod photoreceptor cells and preserves cone photoreceptor cell function. ION357 provides a novel approach to treating autosomal dominant retinitis pigmentosa, in which patients have limited therapeutic options.
About Retinitis Pigmentosa
Retinitis pigmentosa (RP) is a group of rare inherited eye disorders causing photoreceptor degeneration that leads to progressive vision loss. The disease is clinically and genetically heterogeneous and can have an autosomal recessive, autosomaldominant, or X-linked pattern of inheritance. Affected patients first experience defective dark adaptation during adolescence or young adulthood, followed by loss of peripheral visual field when rod photoreceptor function declines. Patients eventually have only a residual central island of vision, which ultimately leads to complete blindness around the age of sixty.
- Campochiaro PA, Mir TA. The mechanism of cone cell death in Retinitis Pigmentosa.Prog Retin Eye Res. 2018 Jan;62:24-37. doi: 10.1016/j.preteyeres.2017.08.004.
- Daiger SP,Bowne SJ,Sullivan LS. Genes and Mutations Causing Retinitis Pigmentosa.Clin Genet. 2013 Aug; 84(2): 10.1111/cge.12203 Hartong DT, Berson EL, Dyja RP. Retinitis pigmentosa. Lancet2006; 368(9549):1795 809 Murray SF, Jazayeri A, Matthes MT, Yasumura D, Yang H, Peralta R, et al. Allele-Specific Inhibition of Rhodopsin With an Antisense Oligonucleotide Slows Photoreceptor Cell Degeneration. Invest Ophthalmol Vis Sci. 2015; 56(11):6362-75
- Hartong DT, Berson EL. Dyja RP. Retinitis pigmentosa. Lancet 2006; 368(9549):1795 809
- Murray SF, Jazayeri A, Matthes MT, Yasumura D, Yang H, Peralta R, et al. Allele-Specific Inhibition of Rhodopsin With an Antisense Oligonucleotide Slows Photoreceptor Cell Degeneration. Invest Ophthalmol Vis Sci. 2015; 56(11):6362-75
* Safety and efficacy have not been evaluated by any regulatory authorities for the indications described.
Cardiometabolic & Renal
Generation 2+ LICA antisense drug
IONIS-DGAT2Rx is a Generation 2+ antisense drug designed to reduce the production of DGAT2, or diacylglycerol acyltransferase 2, to treat patients with NASH, or nonalcoholic steatohepatitis. NASH is a common liver disease characterized by excessive triglycerides in the liver with concurrent inflammation and cellular damage. DGAT2 is an enzyme that catalyzes the final step in triglyceride synthesis in the liver. Reducing the production of DGAT2 should therefore decrease triglyceride synthesis in the liver. In animal studies, antisense inhibition of DGAT2 significantly improved liver steatosis, lowered blood lipid levels and reversed diet-induced insulin resistance in animal models of obesity and fatty liver disease. [3,5]
NASH is sometimes considered a “silent” liver disease because people with early-stage NASH feel well, even though they are starting to accumulate fat in their livers, and may not be aware that they have the disease. However, NASH can develop into more severe diseases such as liver cirrhosis and liver failure. Currently, liver transplant is the only therapeutic option for patients with liver cirrhosis. In addition, NASH has been shown to be a major risk factor for the development of liver cancer.
About NASH
NASH is a liver disease characterized by the presence of excessive liver fat (steatosis) that is accompanied by inflammation and cellular damage. NASH is considered a “silent” liver disease because in the early stages of the disease, patients generally feel well and are unaware they have the disease. However, as NASH progresses, scarring, or fibrosis, begins to accumulate in the liver. Ultimately, cirrhosis of the liver develops and the liver can no longer function normally. About 20 percent of NASH patients are reported to develop cirrhosis, and 30 to 40 percent of patients with NASH cirrhosis experience liver-related death. [4] Currently, liver transplantation is the only treatment for advanced cirrhosis and liver failure. Because of the high prevalence of NASH, it has recently become the third most common indication for liver transplantation in the US. [2] The exact cause of NASH is not well understood but the development of fatty liver diseases has been linked to obesity. As the number of people with obesity continues to rise globally, a parallel increase in the incidence of NASH has also been observed. Currently, it is estimated that 2 to 3 percent of the general population have NASH. [1] However, with the growing obesity epidemic, it is likely that the number of patients with NASH will also continue to rise.
Generation 2.5 antisense drug
ION532, formerly known as IONIS-AZ5-2.5Rx and AZD2373.
About Chronic Kidney Disease
Chronic kidney disease (CKD) is a worldwide public health problem, affecting about 10% of the population. Within United States, over 37 million adults have CKD and millions of others are at increased risk. CKD may be caused by diabetes, high blood pressure and other disorders. Without treatment, CKD may progress and eventually lead to kidney failure, which requires dialysis or a kidney transplant to maintain life.
Select Publication
https://www.cdc.gov/kidneydisease/pdf/2019_National-Chronic-Kidney-Disease-Fact-Sheet.pdf
Cancer
Generation 2.5 antisense drug
ION251, formerly known as IONIS-IRF4-2.5Rx.
Interferon Regulatory Factor 4 (IRF4) is a transcription factor expressed in lymphocytes, where it directs terminal differentiation of B-cells to plasma cells and also has roles in T cell functions such as T cell exhaustion. IRF4 has emerged as a key regulator of multiple genes controlling the survival of multiple myeloma (MM) tumor cells as well as other B-cell malignancies. IRF4 is overexpressed in MM as a result of several mechanisms including activating mutations in the DNA binding domain and translocations. Even limited depletion of IRF4 leads to rapid cell death of MM tumor cells, and as such MM is considered to be “addicted” to IRF4. Taken together, selective inhibition of IRF4 with a therapeutic antisense oligonucleotides (ASO) is an attractive strategy for the treatment of MM with the potential for potent MM cell kill with limited effects on normal cells.
About Multiple Myeloma
Multiple Myeloma (MM) is an incurable cancer characterized by uncontrolled proliferation of bone marrow plasma cells. Despite their initial responses to current therapies, almost all MM patients eventually relapse with a median overall survival time of 13 months following relapse, presenting a strong need for new treatments. Interferon Regulatory Factor 4 (IRF4) is a transcription factor involved in immune cell development and is essential for plasma cell differentiation. IRF4 has emerged as a key regulator of multiple genes controlling the survival of MM and other B-cell malignancy such as c-Myc and is aberrantly expressed in MM as a result of activating mutations and translocations.
- Mittrucker HW, Matsuyama T, Grossman A, et al. Requirement for the transcription factor LSIRF/IRF4 for mature B and T lymphocyte function. Science 1997;275:540-3.
- Shaffer AL, Emre NC, Lamy L, et al. IRF4 addiction in multiple myeloma. Nature 2008;454:226-31.
* Safety and efficacy have not been evaluated by any regulatory authorities for the indications described.
Generation 2.5 antisense drug
ION674, formerly known as IONIS-EZH2-2.5Rx, is an epigenetic modulator as the catalytic subunit of the polycomb repressive complex 2 (PRC2). It functions as a histone methyltransferase which catalyzes the mono- through tri-methylation of lysine 27 residue of histone 3 (H3K27me3) and suppresses the transcription of specific genes. It is involved in early embryogenesis, self-renewal and proliferation of embryo and adult stem cells. Increased expression or activity of EZH2 has been reported in multiple solid tumors as well as hematological malignancies, which associates with poor prognosis. Aberrant expression of ION674 can be caused by multiple mechanisms in a variety of cancer types. For example, activating mutations leading to enhanced catalytic activity of ION674 are found in certain types of B-cell lymphoma including GCB-DLBCL and follicular lymphoma. There is also evidence that solid tumors with a loss of function in tumor suppressor genes such as SWI/SNF complex, BAP1, and UTX are highly dependent on ION674 for their growth. Finally, ION674 can promote tumor growth by creating immune-suppressive tumor microenvironment such as T cell exhaustion. Collectively, selective depletion of ION674 by ASO is expected to be highly efficacious in treating tumors with aberrant expression of ION674.
GCB-DLBCL and Follicular Lymphoma
GCB-DLBCL and follicular lymphoma belong to B-cell non-Hodgkin lymphoma (NHL), a lymphoproliferative disorder originating in B lymphocytes. Even though the initial response rate to the standard of care treatment composed of chemotherapy in combination with anti-CD20 antibody (R-CHOP) is relatively good, the disease either relapses or becomes refractory to the therapy. Heterozygous somatic mutations leading to increased ION674 activity have been found in approximately 20% of patients with GCB-DLBCL and follicular lymphoma, where ION674 plays a driver role in promoting tumor growth, suggesting that these tumor types might be highly sensitive to ION674 inhibition by EZH2 ASO.
- Morin RD, Johnson NA et al. Somatic mutations altering EZH2 (Tyr641) in follicular and diffuse large B-cell lymphomas of germinal-center origin. Nat. Genet 2010; 42:181-15
- McCabe MT, Ott HM et al. EZH2 inhibition as a therapeutic strategy for lymphoma with EZH2-activating mutations. Nature 2012; 492:108-12
- Galaznick A, Huelin R et al. ,Systematic review of therapy used in relapsed or refractory diffuse large B-cell lymphoma and follicular lymphoma Future Sci OA 2018; 4:FSO322
* Safety and efficacy have not been evaluated by any regulatory authorities for the indications described.
Other
Future-creating, antisense medicines
