The Nonclinical Safety Profile of GalNAc-conjugated RNAi Therapeutics in Subacute Studies

• Published in: Toxicologic pathology Vol. 46; no. 7; pp. 735 - 745
• Main Authors: Janas, Maja M., Harbison, Carole E., Perry, Victoria K., Carito, Brenda, Sutherland, Jessica E., Vaishnaw, Akshay K., Keirstead, Natalie D., Warner, Garvin
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.10.2018
• Subjects: Acetylgalactosamine - chemistry; Acetylgalactosamine - pharmacology; Acetylgalactosamine - toxicity; Animals; CHO Cells; Chromosome Aberrations - chemically induced; Cricetulus; Dose-Response Relationship, Drug; Drug Evaluation, Preclinical; Liver - drug effects; Liver - pathology; Lymphocytes - drug effects; Lymphocytes - pathology; Macaca fascicularis; Mutagenicity Tests; Rats, Sprague-Dawley; RNA, Small Interfering - chemistry; RNA, Small Interfering - genetics; RNA, Small Interfering - pharmacology; RNA, Small Interfering - toxicity; Species Specificity; Toxicity Tests, Subacute; rat pathology; liver; preclinical safety assessment/risk management; drug development; cell(ular) pathology; monkey pathology; preclinical research and development
• ISSN: 0192-6233; 1533-1601
• DOI: 10.1177/0192623318792537

Short interfering RNAs (siRNAs) and antisense oligonucleotides (ASOs) are the most clinically advanced oligonucleotide-based platforms. A number of N-acetylgalactosamine (GalNAc)-conjugated siRNAs (GalNAc-siRNAs), also referred to as RNA interference (RNAi) therapeutics, are currently in various stages of development, though none is yet approved. While the safety of ASOs has been the subject of extensive review, the nonclinical safety profiles of GalNAc-siRNAs have not been reported. With the exception of sequence differences that confer target RNA specificity, GalNAc-siRNAs are largely chemically uniform, containing limited number of phosphorothioate linkages, and 2’-O-methyl and 2’-deoxy-2’-fluoro ribose modifications. Here, we present the outcomes of short-term (3–5 week) rat and monkey weekly repeat-dose toxicology studies of six Enhanced Stabilization Chemistry GalNAc-siRNAs currently in clinical development. In nonclinical studies at supratherapeutic doses, these molecules share similar safety signals, with histologic findings in the organ of pharmacodynamic effect (liver), the organ of elimination (kidney), and the reticuloendothelial system (lymph nodes). The majority of these changes are nonadverse, partially to completely reversible, correlate well with pharmacokinetic parameters and tissue distribution, and often reflect drug accumulation. Furthermore, all GalNAc-siRNAs tested to date have been negative in genotoxicity and safety pharmacology studies.