Bavarian Nordic Announces Interim Results for the First Nine Months of 2021 Page 5 of 20
Company Announcement no. 35 / 2021
Update on strategic priorities
Bavarian Nordic’s mission is to save and improve lives by
unlocking the power of the immune system and in the medium
term, we have established a bold vision and aspiration to become
one of the largest pure play vaccine companies by developing
innovative life-saving vaccines, excelling in commercialization
and being a best-in-class vaccine manufacturer.
Commercial
The establishment of the commercial infrastructure and transfer
of marketing and distribution for Rabipur/RabAvert and Encepur
from GSK has been completed for all markets, except Japan, in
accordance with plans and in record time. In addition, market
shares have either been maintained or increased during the
transition and the awareness of Bavarian Nordic among health
care practitioners has increased in key markets.
Preparations are ongoing to expand the commercial portfolio in
2022 with the addition of HEPLISAV-B
®
hepatitis B vaccine from
Dynavax, which Bavarian Nordic will market and distribute in
Germany, as well as the DUKORAL
®
cholera vaccine and IXIARO
®
Japanese encephalitis vaccine from Valneva which Bavarian
Nordic will market and distribute in Germany and Switzerland
according to the agreements entered with both companies during
2020 and 2021.
R&D innovation
Several key pipeline projects have advanced during 2021,
supporting the Company’s strategy to develop innovative life-
saving vaccines.
COVID-19 vaccine
Initial data from the first-in-human study of ABNCoV2, the capsid
virus like particle (cVLP) COVID-19 vaccine candidate licensed
from AdaptVac, were reported in August, and the remaining data
for the high dose groups have now become available. The phase
1/2 dose-escalation trial enrolled 45 healthy SARS-CoV-2-naïve
adult volunteers, who received two doses (dose ranges from 6-70
μg) of ABNCoV2, formulated with and without adjuvant. The high
doses (50 μg and 70 μg) were however all administered without
adjuvant. The results demonstrate that the vaccine was well
tolerated across all dose groups with no observed difference in
the adverse event profile following the first and second
vaccinations. No serious adverse events were reported, and the
safety profile was comparable to other vaccines based on
recombinant protein-technology.
In all dose groups, antibody titers were boosted after the second
vaccination to levels significantly higher than those reported for
current approved COVID-19 vaccines. Titers were up to 12-fold
higher than those measured in convalescent human samples with
similar strong responses seen across the groups receiving 25, 50
and 70 μg, indicating a plateau within this range. This could
potentially provide rationale for reducing the dose of the
vaccine, while maintaining optimal effect, and thus could lead to
an optimization of manufacturing costs, however more data is
needed to facilitate a meaningful conclusion.
Importantly, ABNCoV2 demonstrated high neutralization titers
against all SARS-CoV-2 variants of concern, including the
dominant Delta variant.
A phase 2 clinical trial was initiated in August to investigate the
potential of ABNCoV2 as a booster vaccine for individuals with
previous COVID-19 disease or vaccination. Upon assessment of
the phase 1 results, the phase 2 trial has been amended and will
expand the group of healthy volunteers with existing immunity to
a total of 180 (previously 150 subjects), of which 90 subjects will
receive a single dose of 100 μg ABNCoV2 and 90 subjects will
receive 50 μg of ABNCoV2, thus seeking to confirm the optimal
dose for boosting the existing levels of SARS-CoV-2 neutralizing
antibodies. Enrollment has been completed in the first group
with initial results expected in December 2021 according to plan.
The second group is expected to initiate enrollment later in
November.
In August a funding agreement, valued at up to DKK 800 million,
was entered with the Danish Ministry of Health to support the
completion of the development of ABNCoV2 towards licensure.
The agreement includes an upfront payment of DKK 80 million, in
addition to payments of up to DKK 720 million, which are
contingent upon reaching a number of predefined milestones
including among others completion of the ongoing phase 2 trial,
phase 3 development milestones and milestones related to
upscaling of manufacturing for clinical and commercial
production of the vaccine.
All payments are potentially subject to repayment, however only
upon successful marketing authorization of the vaccine by the
European Commission. Repayment may occur via supply of
vaccines and royalty payments from the sale of the vaccine to
other customers. Royalty payments are only triggered upon
reaching a certain volume in sales. The Danish Ministry of Health
could be entitled to an additional, capped royalty payment if the
sales reach a certain threshold.
The phase 3 trial of ABNCoV2 is anticipated in 2022, pending
results from the ongoing phase 2 trial and further discussions and
feedback from the regulatory authorities.
The manufacturing of vaccines for the phase 3 trial has been
agreed with a contract manufacturer and is planned for
December 2021, with filling at Bavarian Nordic’s own facility
anticipated during first quarter of 2022.
RSV
In September, positive results from the human challenge trial of
MVA-BN
®
RSV were reported. The phase 2 double-blinded,
placebo-controlled trial enrolled healthy adult volunteers,
between 18-50 years of age who were randomized to receive
either a single vaccination of MVA-BN RSV or placebo. Volunteers
were challenged intranasally with an RSV type A strain 28 days
after vaccination. A total of 61 subjects were evaluable.
The study demonstrated a significant reduction in viral load in
vaccinated subjects (n=30) versus placebo (n=31), thus meeting
the primary endpoint of this critical study. At the same time, the
vaccinated subjects showed a significant reduction in clinical
symptoms typically associated with RSV infections. The MVA-BN
RSV vaccine demonstrated a vaccine efficacy of up to 79% in
preventing symptomatic RSV infections.
No vaccine-related serious adverse events were observed, and
the vaccine was well tolerated, consistent with the safety profile
previously reported in phase 1 and phase 2 clinical studies.
Pending further analysis of the current RSV infection rates,
discussions with regulatory authorities about the phase 3 design,
and funding/partnering considerations, the Company will
determine the immediate next steps and expects to communicate
these during fourth quarter of 2021. In the meantime,
preparations are ongoing to enable a trial start in 2022 should
this be decided upon.
MVA-BN smallpox, freeze-dried
The tech transfer of the freeze-dried version of the MVA-BN
smallpox vaccine to Bavarian Nordic’s fill and finish line has been
initiated, which, together with the completed phase 3 trial (lot
consistency trial) will form basis for submission of a supplement