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Amyloid
The Journal of Protein Folding Disorders
Volume 26, 2019 - Issue 2
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Original Articles

Transthyretin stabilization activity of the catechol-O-methyltransferase inhibitor tolcapone (SOM0226) in hereditary ATTR amyloidosis patients and asymptomatic carriers: proof-of-concept study#

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Pages 74-84 | Received 12 Jul 2018, Accepted 18 Mar 2019, Published online: 23 May 2019
 

Abstract

Objective: To assess the transthyretin (TTR) stabilization activity of tolcapone (SOM0226) in patients with hereditary ATTR amyloidosis, asymptomatic carriers and healthy volunteers.

Methods: A phase IIa proof-of-concept trial included two phases separated by a 6-week washout period. Phase A: single 200 mg dose of tolcapone; phase B: three 100 mg doses taken at 4 h intervals. The primary efficacy variable was TTR stabilization.

Results: Seventeen subjects were included (wild type, n = 6; mutation TTR Val30Met, n = 11). TTR stabilization was observed in all participants. Two hours after dosing, 82% of participants in phase A and 93% of those in phase B reached a TTR stabilization value of at least 20%. In phase A, there was an increase of 52% in TTR stabilization vs baseline values 2 h after dosing, which decreased to 22.9% at 8 h. In phase B, there was a significant increase of 38.8% in TTR stabilization 2 h after the first 100 mg dose. This difference was maintained after 10 h and decreased after 24 h. No serious adverse events were observed.

Conclusions: The ability of tolcapone for stabilizing TTR supports further development and repositioning of the drug for the treatment of ATTR amyloidosis.

Trial registration: EudraCT identifier: 2014-001586-27

Trial registration: ClinicalTrials.gov identifier: NCT02191826.

Disclosure statement

This study was sponsored by SOM Innovation Biotech, S.L., Barcelona, Spain, but the sponsor was not involved in interpretation of the data or drafting of the manuscript.

Additional information

Funding

JG is the recipient of FIS-FEDER PI16/01673 and FIS-FEDER PI19/00593. JG, MS, RI and NR are recipients of RETOS-Ministerio de Economia y Competitividad [RTC-2014–1931-1] grants.

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