Investor Presentaiton
R&D investor presentation
20
Semaglutide showed encouraging phase 2 data across additional
important endpoints which are considered relevant by regulators
Regulatory guidelines on
non-invasive endpoints
FDA
Non-invasive, disease-specific biomarkers, and
imaging modalities that assess liver stiffness or
hepatic fat content are acceptable as POC study
endpoints as long as the sponsor can scientifically
justify them¹
Mean change in ELF
from baseline at 72 weeks
Relative mean change in liver
stiffness³ at 72 weeks
1.0
1
0.9
0.0
-0.02
-0.1
-0.2
-0.3
*
-0.4
-0.35
-0.5
*
-0.44
0.8
0.7
0.75*
0.69*
0.68*
-0.6
-0.7
0.6
*
-0.64
-0.8
0.5
Placebo
0.1mg 0.2mg
0.4mg
Placebo 0.1mg 0.2mg 0.4mg
Semaglutide once-daily
Semaglutide once-daily
EUROPEAN MEDICINES AGENCY
SCIENCE MEDICINES HEALTH
Due to the slow development of fibrotic stages and
the low prevalence of the disease, the difficulties for
the validation of the proposed intermediate endpoints
are acknowledged. Future applicants should therefore
also take care that a sufficient amount of supportive
evidence for long-term efficacy is available. This
should consist of standard evaluations such as
imaging modalities, other biomarkers (bilirubin,
transaminases, but also e.g. ELF-test and other
potential future biomarkers)²
* statistically significant at 72 weeks (p<0.05 vs placebo). Based on the on-treatment analysis using mixed-effect model repeated measure (MMRM)
1 FDA guidance on developing treatment for NASH: "Noncirrhotic Nonalcoholic Steatohepatitis With Liver Fibrosis: Developing Drugs for Treatment Guidance for Industry", link
2 EMA guidance on developing treatment for NASH: "Reflection paper on regulatory requirements for the development of medicinal products for chronic non-infectious liver diseases (PBC, PSC, NASH)"
3 % of baseline
POC: proof of concept; ELF: enhanced liver fibrosisView entire presentation