Abstract 14720: Pre-clinical Safety Assessment of SLN360, a Novel Short Interfering Ribonucleic Acid Targeting <i>LPA</i>

Introduction: SLN360 is a liver-targeted N-acetyl galactosamine (GalNAc)-conjugated siRNA with a promising profile for addressing Lp(a)-related cardiovascular risk. We previously reported the pharmacodynamic effects of SLN360 in female (F) cynomolgus monkeys (cynos) 1 . Here we describe the findings from key pre-clinical safety studies. Methods: SLN360 was tested in vitro in primary human hepatocytes for LPA knockdown and effects on hypothetical off targets identified through in silico screening. An in vivo biodistribution study was performed in rats over 21 days (4 males [M]/4 F per timepoint; single 10 mg/kg s.c. injection). In a GLP safety study, healthy cynos received 5 once weekly s.c. injections of saline control or SLN360 (3 M / 3 F per group, up to 200 mg/kg) followed by an 8-week recovery period (2 M / 2 F in saline and top dose). A standard battery of safety assessments was performed. Results: In vitro, SLN360 reduced LPA expression in primary human hepatocytes with no effects on any hypothetical liver-expressed human off-target genes at concentrations &gt;300-fold the human LPA IC 50 . SLN360 showed a typical rodent GalNAc distribution pattern, with significant levels in liver and kidney (peak 126 or 246 mg/g tissue at 6h respectively; estimated liver half-life of 56 hours). Levels in other organs (including reproductive organs) were &lt;1% of peak liver levels. In cynos, no clinical observations were observed following 5 s.c. doses of SLN360. Liver LPA mRNA levels were significantly reduced by 98% at day 30 and 95% after the 8-week recovery period, while serum Lp(a) was undetectable at both timepoints. Findings were restricted to the liver (increased weight and diffuse hepatocyte hypertrophy) and lymph nodes (vacuolated macrophages) at day 30. These were considered non-adverse due to reversibility after recovery. No dose-related changes in clinical chemistry, hematology, circulatory and ECG parameters, respiratory rate, neurobehavior, plasma cytokines, complement activation or CRP were noted. The NOAEL was defined as 200 mg/kg, &gt;60-fold the active dose in cynos. Conclusions: Overall, the off-target profile, biodistribution and NOAEL of SLN360 indicate suitability for entry into clinical studies. 1 Aleku et al., 2019. Circulation. 2019, 140:A9538.