Form 8-K

 

 

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

FORM 8-K

CURRENT REPORT

Pursuant to Section 13 or 15(d) of the

Securities Exchange Act of 1934

Date of Report (Date of earliest event reported): January 12, 2009

MEDICINOVA, INC.

(Exact name of registrant as specified in its charter)

 

Delaware   001-33185   33-0927979

(State or other jurisdiction

of incorporation)

 

(Commission

File Number)

 

(IRS Employer

Identification No.)

4350 La Jolla Village Drive, Suite 950

San Diego, CA 92122

(Address of principal executive offices) (Zip Code)

Registrant’s telephone number, including area code: (858) 373-1500

Not Applicable

(Former name or former address, if changed since last report)

Check the appropriate box below if the Form 8-K filing is intended to simultaneously satisfy the filing obligation of the registrant under any of the following provisions:

 

¨ Written communications pursuant to Rule 425 under the Securities Act (17 CFR 230.425)

 

¨ Soliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR 240.14a-12)

 

¨ Pre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b))

 

¨ Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR 240.13e-4(c))

 

 

 


Item 7.01 Regulation FD Disclosure.

Representatives of MediciNova, Inc. (the “Registrant”) will be attending the 27th Annual JPMorgan Healthcare Conference commencing January 12, 2009. A copy of the slide presentation to be used by the Registrant at investor meetings during this conference is attached hereto as Exhibit 99.1 to this Current Report.

The information in this Current Report, including Exhibit 99.1 furnished herewith, is being furnished and shall not be deemed “filed” for any purpose, including for purposes of Section 18 of the Securities Exchange Act of 1934, as amended (the “Exchange Act”), or otherwise subject to the liabilities of that Section. The information in this Current Report shall not be deemed incorporated by reference into any filing under the Securities Act of 1933, as amended, or the Exchange Act, except as shall be expressly set forth by specific reference in such filing to this Current Report.

 

Item 9.01 Financial Statements and Exhibits.

 

(d) Exhibits.

 

Exhibit

  

Description

99.1    Slide presentation of the Registrant


SIGNATURES

Pursuant to the requirements of the Securities Exchange Act of 1934, the Registrant has duly caused this report to be signed on its behalf by the undersigned hereunto duly authorized.

 

    MEDICINOVA, INC.
Dated: January 12, 2009     By:   /s/ Shintaro Asako
       

Shintaro Asako

Vice President and Chief Financial Officer


EXHIBIT INDEX

 

Exhibit

  

Description

99.1    Slide presentation of the Registrant
Slide presentation of the Registrant
©
MediciNova, Inc. 2009
Accelerating
the global development
and commercialization of
innovative pharmaceuticals
Exhibit 99.1


©
MediciNova, Inc. 2009
Statements in this presentation that are not historical in nature constitute forward-looking statements within the
meaning of the safe harbor provisions of the Private Securities Litigation Reform Act of 1995. These forward-
looking
statements
include,
without
limitation,
statements
regarding
MediciNova’s
clinical
trials
supporting
safety
and efficacy of product candidates and the potential novelty of such product candidates as treatments for disease,
plans and objectives for clinical trials and product development, strategies, future performance, financial
condition,
liquidity
and
capital
resources.
These
forward-looking
statements
may
be
preceded
by,
followed
by
or
otherwise include the words "believes," "expects," "anticipates," "intends," "estimates," "projects," "can," "could,"
"may,"
"would,"
or
similar
expressions.
Actual
results
or
events
may
differ
materially
from
those
expressed
or
implied in any forward-looking statements due to various factors, including, without limitation, the risks and
uncertainties inherent in clinical trials and product development and commercialization, such as the uncertainty in
results of clinical trials for product candidates, the uncertainty of whether the results of clinical trials will be
predictive of results in later stages of product development, the risk of delays or failure to obtain or maintain
regulatory
approval,
the
risk
of
failure
of
the
third
parties
upon
whom
MediciNova
relies
to
conduct
its
clinical
trials
and manufacture its product candidates to perform as expected, the risk of increased cost and delays due to
delays in the commencement, enrollment, completion or analysis of clinical trials or significant issues regarding
the adequacy of clinical trial designs or the execution of clinical trials and the timing, cost and design of future
clinical
trials
and
research
activities;
the
timing
of
expected
filings
with
the
FDA;
MediciNova’s
failure
to
execute
strategic
plans
or
strategies
successfully;
MediciNova’s
collaborations
with
third
parties;
the
availability
of
funds
to
complete
product
development
plans
and
MediciNova’s
ability
to
raise
sufficient
capital
when
needed;
intellectual
property
or
contract
rights;
and
the
other
risks
and
uncertainties
described
in
MediciNova’s
filings
with
the
Securities
and
Exchange
Commission,
including
MediciNova’s
annual
report
on
Form
10-K
for
the
year
ended
December 31, 2007 and its subsequent periodic reports on Forms 10-Q and 8-K. Undue reliance should not be
placed
on
these
forward-looking
statements,
which
speak
only
as
of
the
date
hereof.
MediciNova
disclaims
any
intent or obligation to revise or update these forward-looking statements.
Forward-Looking Statements
Forward-Looking Statements


©
MediciNova, Inc. 2009
3
Development Company Focused on Differentiated Product
Candidates
Unique access to differentiated, potentially high-value
assets primarily from Japanese alliances
New Approaches to Treat Serious Medical Conditions:
MN-221: IV Acute Exacerbations of Asthma candidate
Potential $500 M US opportunity for MediciNova
MN-166: Oral Multiple Sclerosis candidate
In 2007, over $8.2B in worldwide MS therapeutic
sales*
Corporate Overview:
Corporate Overview:
MediciNova, Inc.
MediciNova, Inc.
*Source: MedAdNews, July 2008
MNOV Headquarters:
San Diego, CA
Key Financials:
Dual listed company on NasdaqGM
and Osaka  Securities Exchange –
Hercules
~$19M Market Cap as of 12/31/08
~$47.5M Cash, Cash Equivalents and Marketable Securities as of 9/30/08


©
MediciNova, Inc. 2009
4
In-License:
Product candidates with significant clinical or preclinical data
Conduct Proof-of-Concept Clinical Trials:
Conduct Phase I and Phase II clinical trials to demonstrate    
efficacy of compound
Two Pathways Towards ROI After Phase II:
1.
Continue internal development of compound towards
commercialization
2.
Seek partnership for further development of compound
MediciNova
has focused its resources on its two prioritized product candidates, MN-221
and
MN-166.
Following
completion
of
the
Phase
II
trial
of
MN-166,
MediciNova
will
not
pursue further significant clinical development of MN-166 until a partnership is secured. In
addition, MediciNova
will pursue
a variety of initiatives to monetize its remaining product
candidates.
Business Model:              
Business Model:              
Return On Investment
Return On Investment


©
MediciNova, Inc. 2009
5
Definition:
Long-lasting and severe asthma episode that is not responsive to initial bronchodilator
or corticosteroid therapy
Market Opportunity:
Approximately 2 million emergency room visits in the US each year*
500,000 hospitalizations in the US
Approximately 4,000 deaths annually in the US*
Potential $500 M market opportunity for MediciNova
Current Standard of Care (SOC):
Beta agonists (all patients) -
Inhaled or nebulized
Corticosteroids (66-77% of patients) -
IV or oral
*Source: National Center for Health Statistics / CDC
Acute Exacerbations of Asthma
Acute Exacerbations of Asthma


©
MediciNova, Inc. 2009
6
MN-221:  A
novel,
highly
selective
2-
adrenergic
receptor
agonist
Three
Potential
Advantages
over
current
therapy
1.
Better delivery system (IV) = Better Bioavailability
2.
Greater
selectivity
for
2
receptors
in
the
lungs
(better
binding)
3.
Partial
agonist
for
1
receptor
in
the
heart
MN-221: A New Approach to Treating
MN-221: A New Approach to Treating
Acute Exacerbations of Asthma
Acute Exacerbations of Asthma


©
MediciNova, Inc. 2009
7
Human
Human
-Adrenergic Receptor
-Adrenergic Receptor
Selectivity
Selectivity
Test Drug
1
IC
50
(M)
2
IC
50
(M)
2
-Adrenoceptor Selectivity
(IC
50
for
1
/ IC
50
for
2
)
Levalbuterol
7.40E-06
1.40E-06
5.3
Albuterol
9.40E-06
1.60E-06
5.9
Terbutaline
6.00E-05
6.50E-06
9.2
MN-221
5.90E-06
1.40E-07
42.4


©
MediciNova, Inc. 2009
Effect on Heart rate:                      
Effect on Heart rate:                      
Combination of MN-221 & Albuterol
Combination of MN-221 & Albuterol
in Dogs
in Dogs
8


©
MediciNova, Inc. 2009
9
MN-221-CL-004 Study Design
Randomized, placebo-controlled, double-
blind, dose escalation
23 subjects with mild-to-moderate stable
asthma (FEV
1
60% predicted) 
Doses tested (all for 15 minutes):
0.35
µg /min
1.0
µg /min
3.5
µg /min
10
µg /min
MN-221: Positive Phase IIa
MN-221: Positive Phase IIa
Data
Data
MN-221-CL-005 Study Design
Randomized, single-blind, placebo-controlled,
dose rate escalation
17 subjects with moderate-to-severe stable
asthma (40%
FEV
1
75% predicted)
Two doses tested:
16 µg/min for 15 minutes followed by
8 µg/min for 105 minutes (2-hour infusion
with toal
dose of 1,080 µg) or placebo
30
µg/min for 15 minutes followed by
15 µg/min for 45 minutes (1-hour infusion
with a total dose of 1,125 µg) or placebo
MN-221-CL-004 and MN-221-CL-005 Safety Data:
No clinically significant cardiovascular, ECG or vital sign changes, or other safety concerns
observed at any dose tested
16 µg/min
30 µg/min
60 µg/min


©
MediciNova, Inc. 2009
Mean Change in FEV
Mean Change in FEV
1
1
Study: MN-221-CL-004
Study: MN-221-CL-004
10
Mean
Baseline:
77.83%
77.67%
76.78%
81.60%
74.66%
75.78%
78.07%
79.78%
At 15 Minutes:
77.54%
79.45%
80.06%
85.74%
82.02%
83.90%
89.65%
88.04%
%
Predicted:
-0.29%
1.78%
3.28%
4.14%
7.36%
8.12%
11.58%
8.26%
P = 0.0106
P = 0.0006
P < 0.0001
P < 0.0001
P < 0.0001
P = 0.11
P = 0.07
Placebo       0.35µg/min    1.0 µg/min    3.5µg/min     10µg/min   16µg/min     30µg/min     60µg/min


©
MediciNova, Inc. 2009
Mean Change in FEV
Mean Change in FEV
1
1
Study: MN-221-CL-005
Study: MN-221-CL-005
11
Mean
Baseline:
69.4%
Mean
Baseline:
64.6%
Mean:
81.5%
Mean:
82.0%
Placebo Mean
Baseline:
68.6%


©
MediciNova, Inc. 2009
Phase II Interim Data                 
Phase II Interim Data                 
Study: MN-221-CL-006
Study: MN-221-CL-006
12
These reviews included data from a
total of 18 of 36 planned patients with
severe, acute exacerbations of asthma
treated in emergency departments.
Decrease in the hospitalization rate
from 50% to 10% with the addition of
MN-221 (in10 subjects) to
standardized care (in 8 subjects)
Improvement in FEV
1
values generally
appeared to be greater for patients
receiving MN-221 in addition to
standardized treatment
No safety concerns with adding     
MN-221 to standardized care were
identified in these reviews


©
MediciNova, Inc. 2009
MN-221-CL-007:
A randomized, double-blind, placebo-controlled Phase II clinical trial designed
to evaluate the safety and efficacy of MN-221 in patients with severe, acute
exacerbations of asthma
Approximately 35 clinical sites in North America, Australia and New Zealand
Enroll approximately 200 patients
Enrollment anticipated to begin in March 2009 for North American
clinical sites      
(enrollment expected to complete after nine to twelve months)
Doses:
1.2mg of MN-221 over one hour + Standardized Care
Placebo + Standardized Care
Primary efficacy endpoint will be improvement in FEV
1
(% predicted) at 5 hours
MN-221:  Next Steps
MN-221:  Next Steps
13


©
MediciNova, Inc. 2009
14
MN-221 Development Plan
MN-221 Development Plan
Note: Development plans / timelines for MN-221 are subject to change
*Anticipated commencement and completion dates based on current projections
If
we
are
successful
in
completing
the
double-blind
Phase
IIb
clinical
trial,
we
plan
to
conduct
a
Phase
III
program.
If
we
are
successful
in
completing
the
Phase
III
program,
we
would
then
plan
to
file
an
NDA
with
the
FDA
to
seek
regulatory
approval
for
MN-221.


©
MediciNova, Inc. 2009
15
Definition: 
Multiple sclerosis (MS) is an inflammatory demyelinating
disease of the central nervous
system (CNS), affecting approximately 500,000 people in the United States and 2 million
people worldwide.
There is no cure for the disease.
Multiple Sclerosis Market:
Over $8.2 B worldwide sales in 2007*
Current Standard of Care:
Beta interferons
(Rebif, Avonex, Betaserone), Copaxone
®
, Tysabri
®
Administered either by intramuscular or subcutaneous injection or infusion
Multiple Sclerosis
Multiple Sclerosis
*Source: MedAdNews, July 2008


©
MediciNova, Inc. 2009
16
MN-166:
Anti-inflammatory and neuroprotective
properties in vitro
and in vivo
Demonstrated effects on brain volume and lesion evolution to axonal damage
Targets primarily chronic aspects of multiple sclerosis
Oral administration
Mechanisms of Action:
Stimulates Neurotrophic
Growth Factor Release
Inhibits nitric oxide and reactive oxygen species production
Inhibits
Th1
cytokine
production
(IFN-
,
TNF-
,
IL-1
,
IL-6)
Pilot studies found reduced relapse rate and Th1
Th2 cytokine shift
Phosphodiesterase
IV and Leukotriene
inhibitor
MN-166: A New Approach to
MN-166: A New Approach to
Treating Multiple Sclerosis
Treating Multiple Sclerosis


©
MediciNova, Inc. 2009
Placebo-controlled, randomized, double-blind Phase II study:
Year 1 -
0, 10 mg tid, 20 mg tid
Year 2 -
10 mg tid, 20 mg tid
n ~ 100 MS patients/group @ 25 sites in Serbia, Ukraine, Belarus, Bulgaria and
Romania
Key inclusion criteria:
Males or females aged 18 to 55 years, with relapsing remitting (RR) and/or
secondary progressive (SP) Multiple Sclerosis with continued relapses;
A definite diagnosis of relapsing MS using the new International
Committee
recommendations (MacDonald Criteria);
One MRI scan taken two weeks prior to treatment start using a standardized MRI
protocol with at least one Gd-enhancing lesion;
An EDSS score of 5.5 or less at the screening and baseline visits.
Current Clinical Studies:     
Current Clinical Studies:     
MN-166-CL-001
MN-166-CL-001
17


©
MediciNova, Inc. 2009
MN-166 Effects Outcomes Related to Disease Progression in RRMS Patients
Clinical and MRI Outcomes:
Indicative of Potential Neuroprotective
Effect:
1.
Reduced Brain Volume Loss
2.
Reduced Conversion of Acute Lesions to Persistent Black Holes
3.
Sustained disability progression was significantly less likely (~50%)
Acute Clinical Benefit:
Prolong time to relapse (by 127 days.)
MN-166 was very well tolerated in Phase II study:
89%
(264 of 297) of subjects completed the first 12 months of the study
82.5% (245 of 297) of subjects completed the full 24 months of
the study
GI adverse effects as a group and depression were the only adverse events to occur
more frequently in MN-166-treated than in placebo-treated subjects
18
P-Value:  0.044
P-Value:  0.030
MN-166 Targets Primarily
MN-166 Targets Primarily
Chronic Aspects of MS
Chronic Aspects of MS
P-Value:  0.026
P-Value:  0.011


©
MediciNova, Inc. 2009
N=71                           1.59
Chronic Efficacy Demonstrated:  
Chronic Efficacy Demonstrated:  
Effects on Brain Volume
Effects on Brain Volume
N=70                                         1.79
N=34                                                         2.08
N=45                                                             2.12
Percent Brain Volume Reduction
Percent Brain Volume Reduction (0 -
24 months)
Brain volume loss was significantly less (p=0.030) in patients receiving 60 mg
per day of MN-166 for 24 months compared to the other treatment groups
19


©
MediciNova, Inc. 2009
Parameter
Treatment Groups
Placebo
30 mg/day
60 mg/day
Number Patients w. New Lesions at Month 2
72
64
56
Total Number New Lesions in all Patients
426
338
315
Total Number of Persistent Black Holes
98
58
47
Proportion of Lesions Evolving to PBH
0.23
0.17
0.14
p Value
-
0.036
0.004
New T1 gadolinium-enhancing or new T2 lesions were defined as NL in the first
on-study MRI at month 2
Lesions that were hypointense
and inactive at month 10 were PBH
Relative Risk (RR) of NL evolution to PBH was analyzed using a general linear
model with the error term from the Poisson distribution
Reduction of Persistent Black Hole
Reduction of Persistent Black Hole
(PBH) Formation
(PBH) Formation
20


©
MediciNova, Inc. 2009
TREATMENT
Time Period
Placebo to Active
(N=100)
Active Drug
[30 mg (N=94), 60 mg (N=98)]
2 Years
21/100 (21%)
20/194 (10.4%)
21
Disability Progression is defined as a sustained increase in EDSS
(increase in EDSS
1 maintained for four consecutive months)
Sustained Disability Progression
Sustained Disability Progression
P-Value:  0.026
21


©
MediciNova, Inc. 2009
22
Acute Efficacy Demonstrated:
Acute Efficacy Demonstrated:
Time to First Relapse
Time to First Relapse
Median 401 days
Median 244 days
P-Value:  0.044


©
MediciNova, Inc. 2009
23
MN-166:  NEXT STEPS
MN-166:  NEXT STEPS
Seek Partnership for Further Development:
MediciNova’s
strategic objective for MN-166 is to secure a partner to
advance the clinical development of MN-166, and MediciNova
is actively
pursuing that objective


©
MediciNova, Inc. 2009
24
Commercially-Attractive
Commercially-Attractive
Diversified Portfolio
Diversified Portfolio


©
MediciNova, Inc. 2009
25
Dual Listing:
MNOV (NasdaqGM), December 2006
4875 (Osaka –
Hercules), February 2005
Cash, Cash Equivalents and Marketable Securities as of 6/30/08 :
~$47.5 M as of 9/30/08
Market cap as of 12/31/08:
~$19M
Shares outstanding:
11.9 M
Key Financials
Key Financials


©
MediciNova, Inc. 2009
26
Leadership
Years
Experience
Background
Yuichi Iwaki, MD, PhD
CEO & President
33
Prof. USC, Formerly Prof. Pitt;
Advisor to JAFCO, Tanabe
Richard Gammans, PhD, MBA
Chief Development Officer
31
Incara, Indevus, BMS
Shintaro
Asako, CPA
Chief Financial Officer
10
KPMG USA (Audit), Arthur Andersen USA
Michael Kalafer, MD
Chief Medical Officer
25
Board Certified in Pulmonary Medicine, Critical
Care Medicine and Internal Medicine.
Associate Clinical Professorship of Medicine at
UCSD School of Medicine since 1985
Masatsune
Okajima, CMA
VP, Head of Japanese Office
17
Daiwa Securities SMBC,
Sumitomo Capital Securities, Sumitomo Bank
Management Team with Global
Management Team with Global
Experience
Experience


©
MediciNova, Inc. 2009
27
MN-221 (Acute Exacerbations of Asthma):
Proven mechanism of action
Highly selective with improved safety profile vs. standard of care
Positive Phase IIa
efficacy data
Phase IIb
study initiated by holding an Investigator’s meeting in January 2009
MN-166 (Multiple Sclerosis):
Both chronic and acute efficacy have been demonstrated in clinical studies completed
to date
MediciNova
seeking a partner to advance the clinical development of MN-166
Minimized Burn Rate:
Annual burn rate reduced compared to previous years as a result of focus on MN-166
and MN-221 development programs
~$47.5M Cash, Cash Equivalents and Marketable Securities as of 9/30/08
Investment Highlights
Investment Highlights


Addendum:
Addendum:
Additional Data


©
MediciNova, Inc. 2009
MN-221-Study 6 Design
MN-221-Study 6 Design
Randomized, modified single-blind, dose escalation, placebo-controlled
Phase II Study in acute asthma patients in EDs
Approx. 36 patients in 3 dose cohorts at 8 ED clinical sites
Doses:
16µg/min x15 (240µg)
30µg/min x15 (450µg)
16µg/min x15;8µg/min x105 (1,080µg)
Patients will receive Standard of Care (SOC) treatment in addition to
adjunctive treatment with MN-221 or placebo
Safety and efficacy (FEV1 and other) data will be summarized
No inferential statistical analysis
Help inform design of future, larger Phase III clinical trials
A.1


©
MediciNova, Inc. 2009
MN-221: Safety
MN-221: Safety
Phase IIa
Study Safety Findings:
No clinically significant cardiovascular, ECG, or vital sign changes, or other safety
concerns, observed at doses up to 30 micrograms/minute for 15 minutes or any time
point thereafter
60 micrograms/minute infusion improved FEV1 significantly (p< 0.0001) without clinically
significant cardiovascular, ECG or vital sign changes
Safety Database:
MN-221 has been tested in over 300 subjects in the US and Europe to
date
Subjects have had infusions with no clinically significant adverse events at:
16 micrograms/minute for up to 4 hours and at lower doses for up
to 24 hours
A.2


©
MediciNova, Inc. 2009
31
Description
Efficacy
(relapse rate)
Current agents offer only 30-50% relapse reduction
Neutralizing antibodies can diminish efficacy over time
Progression (RRMS) –neurodegeneration
leads to
permanent
functional disability
No approved treatment for PPMS, SPMS
AEs—including flu-like symptoms
SAEs
–Rare, fatal PML and heptotoxicity
with Tysabri
Reports of significant  FTY side effects (e.g. hepatotoxicity),
serious or fatal opportunistic infections, skin cancer
Safety/
tolerability
Injections –
daily up to weekly
Infusions --
monthly
Administration
Increasing interest in combination therapies given
incomplete efficacy with current “core”
agents
Black box on combination with Tysabri, REMS program
Combination
Historically, anti-inflammatory agents have shown little
impact on disease progression
Demonstrated neuroprotection, that is, reduction in disease
progression,  would be groundbreaking
Neuroprotection
There are substantial unmet
There are substantial unmet
needs in MS
needs in MS
A.3


©
MediciNova, Inc. 2009
Approx. Sales
2007**
Compound
Sponsor
Side Effects
$3.3 Billion
Copaxone®
Teva
&
Sanofi-Aventis
Pain, redness, swelling, itching, chest pain,
weakness, infection, nausea, anxiety are
most common, also heart palpitations and
trouble breathing after injection
$1.9 Billion
Avonex®
Biogen-Idec
Depression and Flu-like symptoms most
common, also  liver injury, severe allergic
reactions, drop in red/white blood cell count
$1.7 Billion
Rebif®
Serono
& Pfizer
Depression and Flu-like symptoms most
common, also liver problems, injection site
problems, severe allergic reactions, trouble
breathing/loss of consciousness
$1.4 Billion
Betaseron®
Bayer
Lymphopenia, injection site reaction,
asthenia, flu-like symptoms are most
common, also necrosis at injection site
$343 Million
Tysabri®
Biogen-Idec
Infections, depression, pneumonia, acute
hypersensitivity reactions, appendicitis most
common, also liver damage, PML
Multiple Sclerosis Market*
Multiple Sclerosis Market*
*All these top selling drugs for MS are immunomodulators
**Source: MedAdNews, July 2008 and BIIB annual report 2007
A.4


©
MediciNova, Inc. 2009
Brain volume changes are linked to axonal loss
Chronic Efficacy Demonstrated:
Chronic Efficacy Demonstrated:
Effects on Brain Volume
Effects on Brain Volume
1.20
A.5


©
MediciNova, Inc. 2009
Reduction of
Persistent Black Hole (PBH) Formation
Parameter
Treatment Groups
Placebo
30 mg/day
60 mg/day
# Patients w. New Lesions at Month 2
72
64
56
# Patients w.
1 PBH (% of Pts. w. New Lesions)
41 (56.9%)
33 (51.6%)
28 (50%)
Mean Proportion of Lesions Evolving to PBH
0.24
0.20
0.16
Median Proportion of Lesions Evolving to PBH
0.17
0.08
0.04
Relative Risk (for Evolution to PBH) vs. placebo
-
0.74
0.63
p Value
-
0.074
0.011
New T1 gadolinium-enhancing or new T2 lesions were defined as NL in the first
on-study MRI at month 2
Lesions that were hypointense
and inactive at month 10 were PBH
Relative Risk (RR) of NL evolution to PBH was analyzed using a general linear
model with the error term from the Poisson distribution
Reduction of Persistent Black Hole (PBH)
Reduction of Persistent Black Hole (PBH)
Formation, a Sign of Axonal Loss
Formation, a Sign of Axonal Loss
A.6


©
MediciNova, Inc. 2009
MN-166 was very well tolerated in Phase II study:
89%
(264 of 297) of subjects completed the first 12 months of the study
82.5% (245 of 297) of subjects completed the full 24 months of the study
Discontinuation
due
to
adverse
effects
was
infrequent
(5.1%
in
60
mg/day
for
24
months,
2.1%
in 30 mg/day for 24 months, 2.0% in placebo to 60 mg/day, 1.9% in placebo to 30 mg/day)
Adverse effects were generally mild and self-limiting
GI adverse effects as a group and depression were the only adverse events to occur more
frequently in MN-166-treated than in placebo-treated subjects
Tolerance to the GI side effects occurred rapidly (2-4 days) and tended to occur early in
treatment whether MN-166 treatment was initiated in Year 1 or Year 2
Mild-to-moderate depression was reported in 8 subjects; depression is common in MS
patients and was reported only towards the end of the study
No significant increase in adverse laboratory or ECG findings was observed
20 serious adverse events were reported; all were not
or unlikely
to be attributable to
treatment
No deaths occurred in the study
MN-166 Overview-Safety
MN-166 Overview-Safety
A.7


©
MediciNova, Inc. 2009
Compound
Sponsor
Current
Phase
Safety Profile
from Phase II trials
MN-166
MediciNova
Phase II
Mild, transient GI upset
FTY 720
Novartis
Phase III
Blood pressure
Heart rate
Dyspnea
Liver
enzymes
Lymphopenia
Cladribine
Merck
Serono
Phase III
Fever
Nausea,
Vomiting
Leucopenia
BG-12
Biogen-Idec
Phase III
H/A,
Nasopharyngitis
GI
disorders
Liver
enzymes
Laquinimod
Teva
Phase III
Liver enzymes
Arthralgia
Fibrinogen
Hemoglobin
Safety Comparison with Other
Safety Comparison with Other
Oral Agents
Oral Agents
A.8