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COWEN
COLLABORATIVE INSIGHTS
February 25, 2019

GW's platform allows it to produce chemotypes with precise concentrations of various cannabinoids, and the company is testing numerous other cannabinoids. GW's CBDV drug is in a 10 patient investigator sponsored trial in autism spectrum disorders, and a Phase II 100 patient placebo controlled trial in this indication began in December 2018. GW is also investigating CBDV for use in epilepsy, though the first clinical trial was not successful.

Zynerba studied its transdermal CBD gel ZYN002 in Fragile X syndrome in a 12 week Phase II open-label study in children and adolescents. In the trial, patients were initiated on a dose of 50mg daily with the option to titrate up to 250mg daily. The primary endpoint was the Anxiety, Depression, and Mood Scale (ADAMS) Total Score. Twenty patients were enrolled, 18 of whom completed the 12 week treatment. At 12 weeks, two patients were on 100mg and 16 were on 250mg. On the primary endpoint, subjects saw an average improvement of 14.1 points (or 45.8%) from baseline (p<0.0001) with the greatest improvements seen in social avoidance (52.9%), general anxiety (54.0%), and manic/hyperactive behavior (p=0.0003). Twelve patients continued in a long-term extension study out to 12 months of follow up. These patients showed statistically significant improvements in mean % change from baseline in ADAMS Total Score, as well. The extension trial also contributed to a more robust safety dataset. The most common treatment-emergent adverse events were gastroenteritis (14%) and upper respiratory tract infection (12%); no serious AEs were reported. A randomized, double-blind, placebo-controlled trial to extend these findings to a larger population is ongoing in Australia, New Zealand, and the U.S.

Figure 130 ZYN002 Produced Reductions In ADAMS At 12 Weeks...

[Table Data]
Scale: ADAMS | Baseline (n=20) | Week 12 (n=18) | Week 12 Δ (% Improvement Group Mean) | P-value^a
Total Score | 33.4 | 18.1 | -14.1 (45.8) | <0.0001
Social Avoidance | 10.2 | 4.8 | -5.1 (52.9) | 0.0002
Manic/Hyperactive Behavior | 9.4 | 6.1 | -2.7 (35.1) | 0.0003
Depressed Mood | 2.8 | 2.0 | -0.9 (28.6) | 0.1417
General Anxiety | 10.0 | 4.6 | -4.8 (54.0) | <0.0001
Compulsive Behavior | 2.8 | 1.4 | -1.2 (50.0) | 0.0262
Source: Zynerba

Figure 131 ...And Efficacy Persisted Out To 12 Months In An Extension Study
[Chart Graphic showing Mean % Improvement from Baseline for ADAMS scores at Month 3, Month 9, and Month 12]
Source: Zynerba

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