Fazirsiran

Fazirsiran is an investigational drug being studied in clinical trials for the treatment of liver disease associated with Alpha-1 Antitrypsin Deficiency (AATD). This article summarizes key information from ongoing clinical trials evaluating the safety and efficacy of fazirsiran in patients with AATD-related liver disease. The trials aim to assess how fazirsiran affects liver scarring, inflammation, and levels of the abnormal Z-AAT protein that accumulates in the livers of people with this condition.

Table of Contents

What is Fazirsiran?

Fazirsiran is an investigational medication that is being studied for the treatment of liver disease associated with Alpha-1 Antitrypsin Deficiency (AATD). It is also known by several other names, including TAK-999, ARO-AAT, and ADS-001[1]. This drug is currently undergoing clinical trials to evaluate its safety and effectiveness in patients with AATD-related liver problems.

How Does Fazirsiran Work?

Fazirsiran works by reducing the production of an abnormal protein called Z-alpha-1 antitrypsin (Z-AAT) in the liver. In people with AATD, the liver produces this abnormal version of the alpha-1 antitrypsin (AAT) protein, which can accumulate in liver cells and lead to various liver problems[2]. By decreasing the creation of Z-AAT, fazirsiran aims to reduce the buildup of this abnormal protein in the liver and potentially slow down or prevent liver damage.

What Conditions Does Fazirsiran Treat?

Fazirsiran is specifically being developed to treat Alpha-1 Antitrypsin Deficiency-Associated Liver Disease (AATD-LD). This condition occurs when the abnormal Z-AAT protein accumulates in the liver, leading to various liver problems, including:

  • Liver fibrosis: Scarring of the liver tissue
  • Cirrhosis: Advanced scarring that can lead to liver failure
  • End-stage liver disease: Severe liver damage that may require a liver transplant

The clinical trials are focusing on patients with different stages of liver fibrosis, ranging from mild (F1) to more advanced stages (F2-F4)[2][1].

Ongoing Clinical Trials

Several clinical trials are currently underway to evaluate fazirsiran’s effectiveness and safety:

  1. A study in patients with mild liver fibrosis (METAVIR stage F1)[2]
  2. A study in patients with more advanced liver fibrosis (METAVIR stages F2 to F4)[1]
  3. A long-term extension study for patients who have completed previous fazirsiran trials[3]
  4. A study to evaluate how the body processes fazirsiran in people with various degrees of liver problems[4]

These trials aim to assess the drug’s ability to reduce liver fibrosis, slow disease progression, and improve various markers of liver health.

Administration and Dosage

Fazirsiran is administered as a subcutaneous injection, which means it is injected under the skin. The typical dosing schedule in the clinical trials involves:

  • An initial dose on Day 1
  • A second dose at Week 4
  • Subsequent doses every 12 weeks (approximately every 3 months)[1]

The standard dose being studied is 200 milligrams (mg) per injection, although this may be adjusted based on safety and effectiveness data collected during the trials[4].

Potential Benefits

The clinical trials are investigating several potential benefits of fazirsiran, including:

  • Reduction in liver fibrosis[1]
  • Decrease in the amount of abnormal Z-AAT protein in the liver[5]
  • Improvement in liver function tests and other markers of liver health[5]
  • Slowing or prevention of liver disease progression[3]

These potential benefits could significantly improve the quality of life for patients with AATD-associated liver disease and potentially reduce the need for liver transplantation in the future.

Safety and Side Effects

As fazirsiran is still in clinical trials, its full safety profile is not yet established. The ongoing studies are closely monitoring for any side effects or adverse events. Some of the safety measures being evaluated include:

  • Changes in vital signs, such as blood pressure and heart rate[1]
  • Changes in laboratory tests, including liver function tests[1]
  • Effects on lung function, as AATD can also affect the lungs[1]
  • Any unexpected medical events that occur during treatment[5]

It’s important to note that as an investigational drug, fazirsiran is not yet approved for general use, and its safety and effectiveness are still being determined through these clinical trials.

Aspect Details
Drug Name Fazirsiran (also known as TAK-999, ARO-AAT, ADS-001)
Condition Studied Alpha-1 Antitrypsin Deficiency-Associated Liver Disease
Administration Method Subcutaneous injection
Dosing Schedule Typically every 12 weeks after initial loading doses
Primary Outcomes – Changes in liver Z-AAT levels
– Reduction in liver fibrosis
– Safety and tolerability
Secondary Outcomes – Changes in serum Z-AAT levels
– Liver inflammation and steatosis
– Liver function tests (ALT, GGT, etc.)
– Liver stiffness measurements
– Quality of life assessments
Study Durations Ranging from approximately 2 to 3+ years
Key Assessments – Liver biopsies
– Blood tests
– Imaging (FibroScan, MRI)
– Pulmonary function tests

Ongoing Clinical Trials on Fazirsiran

  • Study on Fazirsiran for Patients with Alpha-1 Antitrypsin Deficiency Liver Disease and Mild Fibrosis

    Recruiting

    3 1 1
    Investigated drugs:
    Austria Belgium France Germany Ireland Italy +4
  • Study on Fazirsiran for Patients with Alpha-1 Antitrypsin Deficiency-Related Liver Disease and Fibrosis

    Recruiting

    3 1 1
    Investigated drugs:
    Austria Belgium Czechia Denmark France Germany +7
  • Study on Long-Term Safety of Fazirsiran for Patients with Alpha-1 Antitrypsin Deficiency-Related Liver Disease

    Recruiting

    3 1 1
    Investigated drugs:
    Austria Germany Portugal

Glossary

  • Alpha-1 Antitrypsin Deficiency (AATD): A genetic condition where the body doesn't make enough of a protein called alpha-1 antitrypsin, or makes an abnormal version that can build up in the liver, potentially causing liver disease.
  • Fazirsiran: An investigational drug being studied to treat liver disease associated with Alpha-1 Antitrypsin Deficiency. It works by reducing the production of the abnormal Z-AAT protein.
  • Z-AAT: The abnormal version of the alpha-1 antitrypsin protein that can accumulate in the liver cells of people with AATD, potentially leading to liver damage.
  • Fibrosis: Scarring of the liver tissue, which can occur as a result of long-term liver damage or disease.
  • METAVIR score: A system used to assess the stage of liver fibrosis, ranging from F0 (no fibrosis) to F4 (cirrhosis).
  • Subcutaneous injection: A method of administering medication by injecting it under the skin.
  • Liver biopsy: A medical procedure where a small sample of liver tissue is removed and examined to assess liver health and disease progression.
  • FibroScan: A non-invasive test that uses ultrasound technology to measure liver stiffness, which can indicate the presence and severity of liver fibrosis.
  • Pulmonary function test: A group of tests that measure how well the lungs are working, including how much air they can hold and how quickly air moves in and out.
  • Adverse event: Any unfavorable and unintended sign, symptom, or disease that occurs during a clinical trial, whether or not it is related to the treatment being studied.

References

  1. https://clinicaltrials.eu/trial/study-on-fazirsiran-for-patients-with-alpha-1-antitrypsin-deficiency-related-liver-disease-and-fibrosis/
  2. https://clinicaltrials.gov/study/NCT06165341
  3. https://clinicaltrials.gov/study/NCT05899673
  4. https://clinicaltrials.gov/study/NCT05891158
  5. https://clinicaltrials.gov/study/NCT03946449