Wave Life Sciences' WVE-006 Demonstrates Durable AAT Protein Production in Alpha-1 Antitrypsin Deficiency Trial
Key Insights
Wave Life Sciences reported positive data from the RestorAATion-2 trial showing WVE-006 achieved durable serum AAT (search) protein production at therapeutically relevant levels of 11.9 µM following repeat 200 mg doses in patients with alpha-1 antitrypsin deficiency (search).
The RNA editing therapy demonstrated the first-ever restoration of physiological serum AAT (search) production in a Pi*ZZ individual during an acute phase response, reaching 20.6 µM total AAT and 10.3 µM M-AAT (search) during a kidney stone episode.
WVE-006 showed a favorable safety profile with only mild to moderate adverse events and no serious adverse events or discontinuations, supporting monthly or less frequent subcutaneous dosing regimens.
Wave Life Sciences has announced breakthrough results from its ongoing RestorAATion-2 trial, demonstrating that WVE-006, an RNA editing therapy, achieved durable production of serum alpha-1 antitrypsin (AAT (search)) protein at levels associated with reduced risk of liver and lung diseases in patients with alpha-1 antitrypsin deficiency (search) (AATD (search)). The data represent a significant milestone for both AATD treatment and the field of RNA editing therapeutics.
Clinical Trial Results Show Therapeutic Promise
The Phase 1b/2a RestorAATion-2 study evaluated WVE-006 in patients with the homozygous Pi*ZZ mutation, affecting approximately 200,000 people in the US and Europe. In the 200 mg multidose cohort (n=8), total AAT (search) reached therapeutically relevant levels of 11.9 micromolar (µM), with wild-type M-AAT (search) increasing from below quantitation at baseline to 7.2 µM. This represented a significant increase from levels achieved during the single dose portion of the cohort (4.8 µM; p=0.012).
M-AAT (search) levels reached 64.4% of total AAT (search), while mutant Z-AAT (search) protein declined from baseline by 60.3%. Importantly, M-AAT levels were durable and sustained at greater than 50% of total AAT for at least two months following the last dose. The production of functional M-AAT was confirmed through increases in neutrophil elastase inhibition from baseline.
First Demonstration of Physiological Response During Acute Phase
A particularly notable finding occurred when one patient experienced a kidney stone-related acute phase response following a single 200 mg dose. During this episode, total AAT (search) levels reached 20.6 µM, including M-AAT (search) levels of 10.3 µM, demonstrating that WVE-006 enables endogenous regulation and dynamic increased secretion of AAT protein during acute phase responses, as indicated by concurrent C-reactive protein elevation.
"Wave's clinical trial provides two important findings. First, RNA editing resulted in the endogenous production of M protein in ZZ individuals. Second, serendipitously the study observed that the stress of a kidney stone was associated with marked upregulation of M protein production. This suggests that RNA editing has the potential to restore, at least in part, both endogenous M protein production and its normal regulation in AATD (search). These results are extremely exciting," said Stephen Rennard, MD, Professor of Medicine in the Division of Pulmonary, Critical Care and Sleep Medicine at the University of Nebraska Medical Center.
Higher Dose Shows Additional Promise
A single 400 mg dose of WVE-006 resulted in total AAT (search) levels of 12.8 µM and M-AAT (search) levels of 5.3 µM. Circulating serum M-AAT levels reached 47.2% of total AAT, and Z-AAT (search) decreased by 49% versus baseline. Data from both the 200 mg and 400 mg cohorts support monthly or less frequent subcutaneous dosing regimens. The 400 mg multidose cohort is ongoing with monthly dosing, with data expected in the first quarter of 2026.
Favorable Safety Profile Maintained
WVE-006 continued to demonstrate a favorable safety profile throughout the study. All adverse events were mild to moderate in intensity, with no serious adverse events or discontinuations reported. This safety profile supports the potential for chronic administration in AATD (search) patients.
Addressing Unmet Medical Need
AATD (search) is caused by a G-to-A point mutation in the SERPINA1 (search) gene, resulting in mutant Z-AAT (search) protein that becomes trapped in the liver while leaving lungs vulnerable to damage due to lack of protective AAT (search) protein. Current treatment options are limited to weekly IV augmentation therapy for lung disease (search), representing over $1.4 billion in worldwide sales in 2023. No approved therapies exist for AATD liver disease (search), often requiring liver transplantation.
WVE-006 is designed to address both manifestations by correcting the Z mutation in SERPINA1 (search) mRNA, converting Z-AAT (search) to wild-type M-AAT (search) without altering endogenous transcriptional regulation. This approach enables the dynamic generation of protective M-AAT protein when needed while reducing liver-damaging mutant protein aggregation.
Commercial Partnership and Future Development
GSK holds the exclusive global license for WVE-006, with development and commercialization responsibilities transferring to GSK after Wave completes the RestorAATion-2 study. Wave is eligible for up to $525 million in milestones plus tiered royalties on net sales.
"Today's data represent a significant clinical milestone for individuals living with AATD (search), as well as the field of RNA editing, with WVE-006 enabling the dynamic generation of wild-type M-AAT (search) protein when needed," said Paul Bolno, MD, MBA, President and Chief Executive Officer at Wave Life Sciences. "Collectively, our data highlight WVE-006's potential to provide a transformative treatment option for people living with AATD."
Wave plans to advance additional wholly-owned RNA editing programs toward clinical development in 2026, with new preclinical data expected at the company's Research Day in fall 2025.