A number of key biomarkers or endpoints are incorporated into IPFsym v1A, such as:
- Forced vital capacity (FVC)
- Diffusing capacity of the lungs for carbon monoxide (DLCO)
- High resolution computed tomography (HRCT) of the lungs
- Fibroblastic foci volume
- Honeycombing volume
- 6 minute walk distance
- Collagen levels within the lungs
- Activated myofibroblasts
- Immune mediators
- TNF-alpha
- VEGF
- PDGF
- TGF-beta
- MMP-1
- IL-1-beta
- Immune cell infiltration
The heterogeneity within IPF, including the large variability in rate of disease progression, is a major challenge in the quest for new treatments. To this end, IPFsym v1A includes >500 simulated patients with varying stages of IPF. The simulated patients, or SimPops, can be used to optimize clinical trial protocols by determining favorable measurement frequencies and dosing levels, evaluating targets using key internal laboratory or mechanistic clinical data, testing combination treatment approaches across varying patient backgrounds, and comparing efficacy in different patient groups (e.g. stratification). The SimPops has been validated against a large backdrop of key data sets, such as those shown below for FVC, DLCO, and disease progression rates.
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SimPops Validation with FVC Data
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SimPops Validation with DLCO Data
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SimPops Validation with IPF Progression Rate Data
Validation of the various relationships within IPFsym v1A working in harmony has been done with the standards of care pirfenidone and nintedanib. Simulation results from SimPops with both drugs compared to placebo effects are shown below. The IPFsym simulations successfully recapitulate the drug effects relative to placebo.
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SimPops Validation with Pirfenidone and Nintedanib