PowderJect...making medicines work better
Annual Report 2000 Achieved Key objectives set out in last year’s annual report ✔ Lidocaine FDA end of Phase II review ✔ Results of lidocaine paediatric Phase II trials1 – Out-license lidocaine product2 ✔ Complete first alprostadil Phase II trial ✔ Results of DNA cancer vaccine Phase I clinical trial3 ✔ Initiation of European DNA vaccine Phase I clinical trial – Start Phase I clinical study for a conventional vaccine4 – Further Phase I clinical trial of oral system5 – Start Phase I clinical trials of the reusable system6 ✔ Further Phase I hepatitis B DNA vaccine studies – Start Phase I clinical study of second protein/peptide7
1 Results of first study announced, results of second study in analysis 2 Focus on paediatric indication extends timelines to some extent 3 Analysis of results ongoing 4 Following antigen supplier quality problems, study planned when supply issues resolved 5 Lidocaine development focused on paediatric indication for dermal use 6 Reusable system refined to incorporate advances with single-use device 7 PowderJect FSH progresses into clinical development
Other key achievements ✔ Lead product in Serono collaboration, PowderJect FSH, progresses into clinical development ✔ Promising progress towards development of HIV DNA vaccine ✔ Glaxo Wellcome purchased further DNA vaccine licence ✔ Hepatitis B DNA vaccine clinical trial initiated at Mayo Clinic ✔ Alprostadil Phase II study shows clinical proof of concept in patients ✔ Positive results of European clinical study with malaria DNA vaccine ✔ Further clinical trial successfully completed in glucose monitoring ✔ Positive results in immuno-diagnostic clinical study ✔ Research collaboration with Baxter on delivery of a protein ✔ Strengthened BOC relationship with long-term manufacturing agreement ✔ Selected Bespak for commercial supply of PowderJect Lidocaine devices ✔ Strategic commercialisation collaboration with PA Consulting Group: PA take equity investment in PowderJect ✔ Establised agreement with AdProTech giving rights to innovative adjuvant technology ✔ Prestigious award for innovation announced by Prime Minister ✔ In-licensed ProMetic technology to support Smart particle™ formulation programme
Contents Benefits: Needle-free medicines 02 Pain-free medicines 04 Better medicines 06 Proprietary medicines 08 Branded medicines 10 Chairman’s statement 13 Operating review 18 Reference section 26 Board of Directors 32 Financial review 34 Report of the Remuneration Committee 35 Corporate governance 40 Report of the Directors 43 Report of the auditors 45 Consolidated profit and loss account 46 Statement of total recognised gains and losses 46 Consolidated company balance sheets 47 Consolidated cash flow statement 48 Notes to the financial statements 49 Annual general meeting 63 Notice of meeting 64 Professional advisers 66 Glossary of terms 67 01 PowderJect Pharmaceuticals plc
Powder injection means medicines with no needle, medicines with no pain. But powder injection is much more. Precise delivery of advanced powder formulations can boost the performance of tomorrow’s medicines. To fulfil their potential, many next generation medicines demand specialised delivery. PowderJect offers the solution. PowderJect DNA vaccines are more effective. PowderJect proteins don’t need complicated reconstitution. PowderJect vaccines do away with costly refrigeration. PowderJect alone has a patent ‘lock’ on powder injection, so PowderJect can create an industry standard. PowderJect can build a long-term brand. PowderJect is making medicines work better. 02 PowderJect Pharmaceuticals plc
No needles means safer treatments Removing the needle removes Easy-to-administer products Contaminated needles represent a significant the impact of needle-phobia should improve treatment health hazard, particularly to healthcare The majority of patients dislike needle The PowderJect system is so easy to use workers. The needle-free PowderJect injections, and in the case of children, that healthcare professionals will not require delivery system overcomes this problem. research shows that hypodermic needles are special training. Using the PowderJect US estimates suggest there are 600,000 among the most stress-provoking items they delivery device is very straight forward, so accidental needle-stick injuries in hospitals encounter. By offering needle-free delivery, patients should be able to self-administer each year. In addition, disposal of sharps, powder injection removes the impact of medicines, such as fertility treatment. such as needles, is a major problem, with as needle-phobia and hence removes patients’ This should reduce the need for clinic visits many as one-third of all sharps injuries being desire to avoid treatment. This should and increase patients’ compliance with related to the disposal process. This puts increase patient compliance and therefore their treatment. workers at risk of exposure to pathogens improve treatment. such as HIV, hepatitis B and hepatitis C. To help address this problem, seven US states have passed legislation, with legislation pending in many more, requiring the use of safety needle devices. Delivering medicines via the PowderJect system will help eliminate this serious health hazard.
PowderJect’s powder injection technology is needle-free. That means significant benefits for consumers and health workers, and a big market opportunity for PowderJect. The market for injectable medicines is large, with the number of injections estimated at between 8 and 12 billion each year and the value of protein therapeutics, vaccines and injected small molecules put at over $25 billion. Powder injection provides the opportunity to deliver many of these medicines without a needle, making treatment more pleasant, safer and more convenient. 03 PowderJect Pharmaceuticals plc needle-free medicines needle-free 04 PowderJect Pharmaceuticals plc
Pain-free administration Improved stability provides Stable products should simplify improves treatment easier treatment access to treatment Unlike liquid injection, the PowderJect Some liquid drugs require chilled storage to Treatments for powder injection can be system delivers drug particles that are so maintain their activity, or are unstable in liquid distributed without refrigeration, are easy to small they do not cause tissue distention form and are therefore supplied as dry administer and don’t require reconstitution. sufficient to trigger the pain receptors in the powders. Reconstituting powders for liquid These significant advantages should simplify skin (shown above is a drug cassette injection can be complicated and gives an home delivery of certain medicines, such containing a dose of powder-form medicine). opportunity for error. Medicines requiring as proteins for long-term therapy, improving Research clearly demonstrates that refrigeration or reconstitution include a access to treatment. New marketing administration via the PowderJect system number of small molecule products and the channels such as the internet and is pain-free. This should be particularly majority of vaccines and protein drugs. pharmacies should be ideally suited to important for treatments delivered to These pharmaceuticals represent an many PowderJect medicines because sensitive administration sites and for important commercial opportunity, with of their inherent distribution and consumer paediatric indications. Children’s anxiety protein drugs alone forecast to increase the advantages. before receiving an injection can intensify size of the drug delivery marketplace by 50% their experience of pain, so pain-free powder over the next few years. injection should be particularly advantageous in this important market.
Powder injection of medicines is more than just needle-free. It’s pain-free as well. Using the PowderJect system can take away the discomfort associated with liquid injections, and also the nuisance and potential expense caused by having to reconstitute or refrigerate certain liquid-based pharmaceuticals. By incorporating powder-form medicines that are more stable, PowderJect has the opportunity to increase access to treatment through non-traditional marketing channels such as the internet. 05 PowderJect Pharmaceuticals plc pain-free medicines pain-free 06 PowderJect Pharmaceuticals plc
PowderJect system delivery of DNA vaccines (see page 28 for more details)
PowderJect makes next generation substantially better results, both qualitatively Controlled drug action medicines work better and quantitatively, than injection of liquid can improve treatment PowderJect leads the world in the field of DNA vaccines. Indeed, powder injection has Powder injection offers the ability to improve DNA vaccination, which offers the prospect achieved more complete immune responses certain medicines by controlling the timing of of protection and treatment for some of the with as little as one-thousandth of the drug action. Varying the release of a drug world’s most insidious diseases, such as dose used by liquid injection. In addition, over a period of time, thereby reducing malaria, HIV and cancer. Unlike other delivery PowderJect is capitalising on its dosing frequency, is important for a techniques, powder injection can target world-leading position in the field by range of treatments. By applying proven immune system cells in the epidermal developing other proprietary techniques implant or depot formulation techniques, layer of the skin (such as Langerhans cells – that improve DNA vaccination, such as a PowderJect has the ability to provide this picture opposite shows subcellular detail fusion concept that can enhance immune benefit. Powder injection can also offer the of a human Langerhans cell) generating responses to specific vaccines. As part of advantage of rapid onset, which is important an extremely robust immune response. this strategy PowderJect has pending patent for products requiring quick action such as PowderJect has demonstrated that delivery applications covering this fusion concept. migraine treatments. via the PowderJect system produces
While powder injection is both needle-free and pain-free, it offers much more. PowderJect’s unique technology is actually making medicines work better. PowderJect has harnessed the expertise of highly skilled scientists, engineers, immunologists and drug delivery experts to develop advanced technology that offers unique benefits. By targeting specific layers of the skin, the PowderJect system dramatically improves the efficacy of next generation medicines such as DNA vaccines, achieves higher systemic bioavailability than many competing technologies and allows the possibility of controlled pharmacokinetics such as rapid onset or delayed action. 07 PowderJect Pharmaceuticals plc
Epidermis
Dermis
Sub-Cutaneous Layer
Better bioavailability than many competitors Bioavailability, or the amount of drug that is available biologically, can be important, particularly for expensive treatments. By targeting delivery of drugs at the border of the epidermal/dermal layers in the skin (see diagram of skin cross-section above), PowderJect products can achieve good bioavailability compared with many competitors, by accessing the extensive vascular network of the dermis. Indeed, preclinical research demonstrates that powder injection achieves bioavailability several times greater than many other competing technologies such as pulmonary delivery. better medicines 08 PowderJect Pharmaceuticals plc
PowderJect is in an enviable position: ownership of an entire method of drug and vaccine delivery. Through its extensive patent estate, PowderJect has a lock on the powder injection of medicines. This means PowderJect owns the benefits of powder injection too. By constantly building on its comprehensive patent portfolio PowderJect can maintain its dominance in the field to at least 2019.
Ownership brings commercial strength Broad and deep portfolio PowderJect’s patent portfolio provides ensures exclusivity exclusive, interlocking worldwide coverage PowderJect’s patent strategy is to establish for the transdermal/transmucosal delivery of layers of coverage to support its core any powdered medicine, for any indication, patents covering the method of particle in any mammal, by any and all means other delivery. New patents cover new than by inhalation. This comprehensive applications, such as diagnostics, new ownership gives PowderJect the strength to generations of devices and formulation negotiate commercially attractive agreements techniques. PowderJect has a portfolio of with pharmaceutical companies eager to 60 patent families constructed to maintain exploit the advantages of PowderJect’s the Company’s proprietary position to at technology. PowderJect’s existing large least 2019. collaborations with Glaxo Wellcome and Serono are good examples of this partnering strategy. 09 PowderJect Pharmaceuticals plc proprietary medicines proprietary 10 PowderJect Pharmaceuticals plc
Based on its proprietary position and unique blend of benefits PowderJect has the opportunity to establish powder injection as an industry standard, and build a strong and enduring healthcare brand. Market trends should further drive uptake of PowderJect’s products, strengthening the brand.
Powder injection’s unique blend of Healthcare trends should benefits can set an industry standard strengthen PowderJect’s brand Powder injection benefits key healthcare An expanding drug delivery marketplace, stakeholders – patients, health workers and increasing consumer awareness and pharmaceutical companies – providing an growing focus on healthcare worker opportunity to establish an industry standard. safety could all help drive demand for Powder injection’s combination of benefits is the PowderJect system. Calls for more unique. As well as the obvious advantages consumer-focused medicines, such as of needle-free, pain-free medicines, the call for effective, user-friendly vaccine PowderJect offers commercial benefits. initiatives by the US Centers for Disease The stability of powder-form medicines Control and Prevention, will further assist removes the need for refrigerated cold PowderJect build a powerful brand. chain logistics improving new channels of PowderJect’s proprietary position ensures access to treatment, such as the internet. no direct competition for many years, Pharmaco-economic advantages include giving the window to establish a strong improved healthcare worker safety and healthcare brand. easy disposal of non-hazardous materials. Combined with the ability to alter drugs’ pharmacokinetics and to dramatically increase the effectiveness of next generation medicines such as DNA vaccines, PowderJect has the opportunity to establish powder injection as a pharmaceutical industry standard. 11 PowderJect Pharmaceuticals plc branded medicines 12 PowderJect Pharmaceuticals plc
Financial highlights Turnover £000 1996 305 For the year ended 31 March 2000 1997 461 1998 3,122 1999 5,838 2000 2,749
Loss before tax £000 1996 479 1997 3,610 1998 4,708 1999 9,388 2000 18,354
R&D expenditure £000 1996 292 1997 2,472 1998 7,309 1999 14,170 2000 21,624
Cash and short-term 1996 1,512 investments £000 1997 5,038 1998 20,459 1999 84,088 2000 62,062
Net cash outflow from 1996 698 operating activities £000 1997 2,743 1998 7,124 1999 6,877 2000 20,213 13 PowderJect Pharmaceuticals plc
Chairman’s statement
Dr Paul Drayson, Chairman
Chairman’s statement Extensive database of clinical last year, we rescheduled our pivotal Phase III The last year has been a period of strong experience studies to begin next year in line with our achievement and investment in our core For a young company, PowderJect has built revised development strategy. The decision technology. Firstly, we have continued to a robust pipeline of products and extensive to include paediatric applications will ensure progress our product pipeline, focusing database of clinical experience: we have that the benefits to patients of pain-free on preparing PowderJect Lidocaine for now given over 4,000 administrations to anaesthesia will be available to both adults Phase III trials, as well as advancing our over 1,000 subjects with 10 different and children and will maximise the market major collaborations and further building our products/applications. This year has seen potential of this product. clinical experience as we prepare to bring further progress. We undertook a PowderJect Alprostadil response profile our technology to the market. Secondly, programme of 11 clinical trials and similar to commercial product we have strengthened the infrastructure completed our twenty-fifth clinical study. Our We achieved an important proof of concept and supply chain required to commercialise clinical evidence shows that powder injection with PowderJect Alprostadil, demonstrating our revolutionary new delivery technique. is both well tolerated and effective when that at the appropriate operating conditions Thirdly, we have taken the first steps in appropriately configured for the intended our treatment for male erectile dysfunction extending our strategy of making medicines application. Consequently we are extremely achieves a pharmacological response in work better, by discovering and patenting confident in our technology platform. Recent patients. At the upper end of the dose range innovative DNA based medicines that advances allowing us to model performance tested, the response profile was similar to perform well in the PowderJect system. and predict delivery system behaviour that of the commercial product Caverject™, Financially, losses were £18.4 million combined with clinical experience with our with rapid onset of action and erections (1999: £9.4 million) and we are still on commercial device has allowed us to maintained for 20 minutes (median). target to meet our two-year cash outflow improve device configurations. Development work is required to optimise target. Our position remains sound with During the year we passed a number of the configuration of the product prior to £62.1 million in cash and short-term clinical milestones and have made headway further clinical trials. investments. Investment in research with, and added to, the remainder of our and development grew to £21.6 million Serono moves lead product into clinical product pipeline: (1999: £14.2 million). Revenues decreased development to £2.7 million (1999: £5.8 million), partly PowderJect Lidocaine on track for Our collaboration with Serono, which covers due to the timing of receipt of milestone Phase III in 2001 five therapeutic proteins, is progressing well, payments. Net operating cash outflow With PowderJect Lidocaine we completed and the lead programme has now reached increased as expected to £20.2 million our first clinical study in children, and have an important development milestone and (1999: £6.9 million), and capital expenditure advanced our programme of configuration in will advance into clinical development. was £4.7 million (1999: £2.8 million). preparation for Phase III trials, with an adult Achieving this milestone with our lead study ongoing currently. With the technical product, PowderJect FSH (follicle stimulating risks identified and managed and a data hormone), triggered a £1 million payment to driven configuration process in place, we are confident we can achieve success in this programme. As announced in December 14 PowderJect Pharmaceuticals plc Chairman’s statement
PowderJect. The decision to move into the study in the field of malaria reconfirmed the Diagnostics’ second successful year clinic was based on the completion of initial ability of DNA vaccines delivered by the Last year we reported on a new area of testing, and further demonstrates the PowderJect system to activate the cellular business for PowderJect, clinical diagnostics. strength of powder injection in delivering arm of the immune system, which is believed This year we have made good progress in large complex biomolecules. Delivery of to be key in achieving a balanced immune this field, with successful clinical studies in protein drugs represents a significant market response to fight diseases such as HIV, glucose monitoring and immuno-diagnosis. opportunity. Last year, sales of Serono’s malaria and cancer. In addition, early stage Building on our encouraging immunological leading FSH product, Gonal-F®, accounted research demonstrated that PowderJect diagnostic results, we plan to clinically for $350 million, an increase of over 40% on DNA vaccination offers qualities demanded evaluate our HIV skin test in the coming year. the previous year. of an effective vaccine for HIV. Building the foundations for Glaxo Wellcome purchased fifth DNA New agreement signed with Baxter commercialisation vaccine licence On the commercial front, we continue Building up to full scale manufacturing, We have made clinical and commercial to make progress. We were pleased to meeting regulatory requirements and progress in our DNA vaccine collaboration announce that we have recently signed establishing quality standards demand with Glaxo Wellcome. Earlier this year we an agreement with Baxter International Inc focus, skill and experience. Our progress in announced that Glaxo Wellcome purchased to investigate the delivery of a scaling up capacity ahead of launch is on a fifth DNA vaccine licence as part of our therapeutic protein. schedule. During the year we manufactured ongoing collaboration, and continues with all approximately 100,000 PowderJect doses, AdProTech vaccine adjuvant of the options covered by our original and we now have the capacity to agreement signed agreement. This decision, reflecting the manufacture supplies for approximately Recently, we have established an results achieved with our unique technology, 1 million PowderJect administrations per agreement with AdProTech giving us rights resulted in a payment of $1.75 million to year, in preparation for scale-up to to their innovative adjuvant technology. PowderJect. In addition, our lead commercial quantities. PowderJect has been This agreement covers relevant fields of collaborative programme, PowderJect building its infrastructure over many years DNA vaccination, offering PowderJect Hepatitis B DNA vaccine, continues to push and during the last year we have formalised the potential to further enhance the forward. We successfully completed a study our network of manufacturing suppliers. efficacy of DNA vaccines delivered via demonstrating the safety of our vaccination As part of this process we have selected the PowderJect system. approach, and initiated a further clinical the world-class medical device company study at the Mayo Clinic in patients who PowderJect conventional flu vaccine Bespak for the commercial supply of did not respond to commercially available prepared for clinical study PowderJect Lidocaine devices, as well hepatitis B vaccine. We planned to begin our first conventional as signing a long-term commercial-scale vaccine clinical study with PowderJect flu manufacturing agreement with BOC World-leading position in DNA vaccines vaccine. Unfortunately, our antigen supplier, covering the helium micro-cylinders that This year has seen confirmation of our Parkedale, experienced problems with the power the PowderJect device. We now offer leading position in DNA vaccination, an FDA. Our preparations remain in place and our clients an advanced delivery technology important new technology offering the we are also investigating alternative sources with an impressive supporting infrastructure. possibility of therapeutic as well as of influenza antigen. We have also strengthened our team by prophylactic vaccines. Results of a clinical recruiting many of the highly skilled Chairman’s statement 15 PowderJect Pharmaceuticals plc
individuals we need to commercialise PowderJect DNA vaccine that protects Patent protection strengthening our technology, in particular process against different variants of the disease. our ‘lock’ on powder injection to development, clinical manufacturing and We have also developed and filed a patent at least 2019 commercial specialists. While headcount on a unique DNA vaccine design concept, During the year we received further notice of increased fairly rapidly to 31 March 2000, which when studied in a widely accepted our status as an innovator company: the up approximately 50% to 225 (1999: 154), model of HIV resulted in an unprecedentedly issue of 28 patents. We now have 60 patent we now see this growth slowing. high cellular immune response of the type families in total. As our scientists have that may protect against infection. Therefore, continued to solve the technical challenges As part of our strategy of leveraging in addition to our ownership of the delivery arising as we progress to market, we have external expertise to progress our technology method, the formulation and the device been able to file on new patentable material, to market, we have strengthened our system, we are now extending our franchise strengthening our ‘lock’ on the field of long-standing relationship with PA Consulting to include ownership of the medicine itself. powder injection, with our coverage Group. This strategic collaboration allows us We will continue to exploit our lead in DNA extending to at least 2019. to benefit from PA’s significant experience vaccines, where the use of PowderJect’s in industrialising drug delivery devices. Market review technology allows us to progress candidates In addition, PA will take a strategic equity During the second half of the year our share rapidly for study. While this work is higher investment in PowderJect through the price has been badly hit by adverse market risk than our drug delivery technology purchase of PowderJect Ordinary Shares conditions and concern about competition development, it offers great potential to by cash subscription, which represents from other technologies. I would like to tackle major diseases. independent validation of the strength of our reassure shareholders that PowderJect is in consumer-focused drug delivery technology. Worldwide 15 academic groups and an excellent position to build a sustainable This partnership with PA will provide vaccine research companies are now using long-term business based on a significant additional resources required to develop PowderJect technology in the search for market opportunity, to confirm that there our growing product portfolio. new vaccines and you will now find powder continues to be no competition offering the injection mentioned in the latest immunology same unique benefits as our powder Extending our franchise to include textbooks. We anticipate that involving injection technology and to state that I am ownership of the medicine PowderJect in the cutting edge of vaccine confident of leading this company to bring I am very pleased to report that this year for research will provide exciting new the revolutionary PowderJect technology to the first time, our scientific research has commercial opportunities for us in the future. market. My confidence in PowderJect is well demonstrated how PowderJect’s unique founded. The Company has exclusive rights delivery technology can be used as a tool for Recognition of PowderJect’s for many years to an entire field of discovering completely new DNA based innovative technology pharmaceutical delivery that will completely medicines. By combining this research tool In the past year PowderJect’s innovative change the injection of medicines and create with our inhouse immunology expertise we science has been recognised through the a substantial market. This view of the future have developed and filed patents on a receipt of several awards, including is backed by real experience. Our clinical limited number of new PowderJect DNA recognition as a Technology Pioneer at trials give us solid proof of principle for our vaccines. This is exemplified by our patent Davos 2000 and the award of Millennium delivery system, and major pharmaceutical filing on an influenza conserved gene (DNA) Product status by the Design Council. companies have already contracted with that remains constant between strains of the The quality of our science has also been us to develop medicines based on virus, thereby offering the potential of a recognised by publications in leading PowderJect’s technology targeting markets scientific journals such as the Journal worth billions of dollars in total. of Immunology. 16 PowderJect Pharmaceuticals plc Chairman’s statement
Recently other drug delivery technologies, Clearly, delivering an asthma drug directly Furthermore, we have leveraged our such as liquid jet injection technology, into the lungs in a formulation that is quickly scientific advantage into a strong commercial have been the focus of some attention. absorbed is a great example of the value position. PowderJect has a global patent These technologies have a role to play in the of advanced drug delivery. PowderJect’s ‘lock’ for many years on the whole field of marketplace. However, liquid injection does vision is to do the same for a wide range of powder injection. No company has a lock on not provide the benefits achieved by precise medicines that would otherwise be limited in inhalation or liquid jet injection; the market is PowderJect delivery of advanced powder their usefulness from having to be injected as fragmented among many companies formulations. Some commentators have liquids. Removing the water that makes up competing for business. This allows us to questioned whether the long lead-times over 90% of liquid injection formulations offer our clients a particularly attractive associated with reformulating medicines allows us to target the drug or vaccine at commercial proposition: exclusive rights to as powders for PowderJect are worth it. the right part of the body, rather than the field of powder injection for their They are. Let me explain why, using inhalers injecting it where there is enough room. molecule or field of interest. Our clients know as an example. We apply state-of-the-art science in device that their molecule is not going to face engineering and pharmaceutical formulation imminent competition from any other powder Having been an asthmatic since I was a to the challenge of injecting the molecule in injection type system. This is reflected in the child, I have personally experienced the the right quantity, to the right part of the scope and magnitude of the development dramatic improvement to my life that inhalers body, whether it be DNA vaccines into agreements we have reached with our have made. Back in the early 1960s the only the immune cells of the outer skin layer, pharmaceutical company partners. available treatments for sudden asthma or alprostadil into the tip of the penis. PowderJect is therefore in an excellent attacks were either a tablet, which took far Our mission is to make medicines work commercial position. Our strategy is to too long to work, or a liquid injection that, better. Maximising the effectiveness of the create a new market segment based on although fast acting, I absolutely hated. medicine, whilst minimising its side effects. powder injection of medicines, to be first into The new inhalers introduced around 1970 This approach allows us to improve the this market with strong PowderJect brand meant that at last a pharmaceutical performance of certain medicines and offer products and to lead this market as we grow product existed that provided an effective, others in patient-friendly formats that are it. In this way we will build a solid sustainable emergency treatment for my condition that pain-free, easy to self administer and long-term business. I could administer myself. It was, quite require no refrigeration or reconstitution. literally, a life saver. Furthermore it was I make the above points to stress three The lesson is clear. In the pharmaceutical the combination of the inhaler device and things. Firstly, the great potential of this business, product innovation that drives the reformulation of the drug that made technology to improve the lives of patients. improved medical outcomes, strong the pharmaceutical product so effective. Secondly, to explain to you my personal pharmacoeconomics and increased patient It delivered the right amount of drug commitment to bring this technology to benefit are what count. Patients and doctors directly to the lungs for maximum effect. market and thirdly to highlight the substantial rightly demand the best product that That product, thirty years later is still value we are building within your Company pharmaceutical science can provide, without improving people’s lives, including my own. as we progress towards the market. compromise. That’s what we aim to deliver. Today, there are many inhaler medicines on It’s that simple. the market with the worldwide market for these therapies estimated to be worth over $10 billion this year. Chairman’s statement 17 PowderJect Pharmaceuticals plc
While the development of some of our Longer term as the human genome is responded to the challenges of the last products has taken longer than expected sequenced, and the function of genes six months by being even more focused we have now overcome many of the (DNA) identified, we envisage that there will and determined. I should also like to express challenges causing these delays. We have be an increasing flow of candidate medicines my gratitude to shareholders for their the technology to develop our broad range based upon DNA or on the proteins that continued support. of innovative medicines. We are confident of the genes encode. All of these candidate Overall, PowderJect has had a challenging progress going forward. medicines will require effective delivery but successful year with a number of key and this will be a significant development Outlook accomplishments. I believe that, in time, challenge for the industry. We believe that There will be several key drivers for the this will prove to have been a pivotal year by establishing PowderJect’s delivery Company over the next year. In particular where the strengths of the business technology as the most attractive for DNA we aim to make clinical progress in our were tested and proved to be sound. and protein delivery, with the path to market, collaborations with Glaxo Wellcome and Significant challenges remain in transitioning supply chain and growing consumer brand Serono and add further partners to our client PowderJect from a development-stage in place, we will be perfectly placed to list. Other important milestones will include organisation to a profitable global become the standard method of delivery. preparing PowderJect Lidocaine for pivotal pharmaceutical company, however we are Phase III studies and undertaking clinical Regarding Board matters, we have confident in our ability to reach our goal. trials in our protein programmes. continued to develop our Board composition I look forward to updating shareholders on to reflect the changing nature of the In the medium term as the biopharmaceutical progress at our AGM. Company as it grows. We welcomed a new industry continues to restructure and Non-Executive Director, Richard Spizzirri, consolidate and the drug delivery and to PowderJect earlier this year. Richard has vaccine markets expand, we see extensive experience as a board director of opportunities for us to establish powder late-stage bio-pharmaceutical companies injection as an industry standard through in the US. Richard brings to PowderJect further strategic collaborations, acquisitions outstanding strategic vision and a wealth or joint ventures. This process will take time of experience in corporate development. and careful management to ensure that our During the year, James Noble stepped pipeline remains manageable and contains Dr Paul Drayson down from the Board. I would like to the correct balance of products to maximise Chairman record our appreciation for the commitment, shareholder value. To help drive this process judgment and expertise James brought we have strengthened our commercial to PowderJect. department during the last year. In addition, we continue to review and evolve our PowderJect has a world-class team of portfolio of development programmes to people who have worked extremely hard prioritise our most attractive opportunities over the past year to deliver these results. and balance risk. I would like to thank them for their commitment and professionalism. I am proud of the way the PowderJect team has 18 PowderJect Pharmaceuticals plc
Operating review PowderJect has had another fruitful year. We have successfully completed a number of important clinical trials and our lead programmes, particularly our collaborations with Glaxo Wellcome and Serono, are progressing well.
PowderJect has a history of firsts in the field of DNA vaccination: first in the world to elicit a protective immune response in humans, and first in Europe to study DNA vaccination in healthy volunteers.
PowderJect/Glaxo Wellcome DNA PowderJect DNA vaccines During the year PowderJect also vaccine collaboration At the end of 1998 PowderJect achieved a collaborated on an academic DNA vaccine We were extremely pleased to announce world first: our hepatitis B DNA vaccine clinical trial. The study explored a new in March this year that Glaxo Wellcome became the first DNA vaccine ever to elicit immuno-therapeutic strategy for treating purchased a further DNA vaccine licence protective immunity in humans. We also cancer involving the use of a DNA vaccine as part of our ongoing collaboration. confirmed that the vaccine induced a to focus the immune system on eliminating Glaxo Wellcome also continues with all of the balanced immune response, stimulating both the disease. Initial data from this Phase I options covered by our original agreement. the cellular and antibody arms of the study in patients with advanced skin cancer This decision, reflecting the success immune system, which is thought to be (melanoma) demonstrate that the DNA achieved with our technology, resulted in important for developing effective vaccine delivered via the PowderJect a payment of $1.75 million to PowderJect. prophylactic vaccines against infectious system was safe and well tolerated. This brings the number of Glaxo Wellcome’s diseases and therapeutic vaccines that treat During the dosing period of the study, we licences to five, with options over six further disease. Therefore we were very pleased became aware that a fragment of the DNA vaccines. this year to achieve another first: the first vaccine construct was inappropriate in European DNA vaccine clinical study in this application, and although PowderJect The lead product in our collaboration, healthy volunteers. The Phase I trial in the and all of the parties involved agreed that PowderJect Hepatitis B DNA Vaccine, field of malaria, conducted in collaboration there should not be any risk to patients, we continued to make good progress during the with Professor Adrian Hill at Oxford agreed to err on the side of caution and year. As part of this programme we have University, reconfirmed the efficacy of closed the study. recently begun a clinical study at the Mayo DNA vaccines delivered via the PowderJect Clinic, in patients who did not respond to In addition to our advances in the clinic, system at activating the cellular arm of previous vaccination with commercially we have also made progress in earlier stage the immune system. We now have data available hepatitis B vaccine or whose studies. Research in a widely accepted demonstrating good cellular responses to antibody titres are waning. laboratory model of HIV demonstrated that PowderJect DNA vaccines for both viral and DNA vaccination via the PowderJect system We have also successfully completed a parasitic pathogens, highlighting the strength results in an unprecedentedly high cellular clinical study examining particle distribution of our technology in this new approach immune response of the type that may in the skin. The results demonstrate that to vaccination. protect against infection. This killer T cell following DNA vaccination via the response is thought to be important for PowderJect system the ongoing natural effective vaccines against some of the world’s process of skin shedding and renewal most insidious diseases, such as malaria, removes the particle-form vaccine from cancer and HIV. The research explored two the epidermis within days. Removal of key aspects of HIV infection: regular mutation the DNA vaccine, combined with the of the virus which can result in new variants tolerability shown by our preclinical that avoid the immune system, and results, clearly highlights the safety of transmission which can occur through both our immunisation approach. sexual contact and needle-use. The results demonstrate that PowderJect DNA vaccination offers the qualities demanded of an effective vaccine for HIV: protection against different virus variants and two major routes of transmission used by the virus. Operating review 19 PowderJect Pharmaceuticals plc
PowderJect is leveraging its leading position in DNA vaccination to develop proprietary technologies that enhance this next generation of vaccines.
Our successes this year highlight epitope (part of an antigen that is recognised PowderJect conventional vaccines PowderJect’s world-leading position in by the immune system). We also aim to Our conventional vaccine programmes the field of DNA vaccines. We aim to further leverage our immunology skills by have also made good headway this year, capitalise further on the potential value of developing a limited number of DNA with preparations in place for our first clinical this new area of medicine by exploiting our vaccines. These fit well with our consumer- trial. We planned to enter the clinic with our immunological expertise. This year we focused product strategy, as exemplified by PowderJect influenza vaccine this year, but revealed that our research interest in the field our proprietary flu DNA vaccine that offers our antigen supplier, Parkedale, experienced extends beyond powder injection and the potential to protect against different problems with the FDA. However, our plans encompasses a novel technique of DNA strains of the disease. This early stage remain in place and we will conduct the vaccine construction that has been shown to development work utilises our existing clinical study as soon as supply issues enhance the immune response. PowderJect expertise and therefore consumes limited are addressed. has pending patents covering this broadly resources, but has the potential to reap applicable technique, which involves fusing significant rewards. core hepatitis B antigen to a disease specific
Vaccine pipeline Feasibility Preclinical Phase I Phase II Phase III Conventional vaccines Influenza vaccine Hepatitis B vaccine Diphtheria/tetanus vaccine Aventis Pasteur vaccine1 Celltech/Medeva Hepagene vaccine1
DNA vaccines Hepatitis B prophylaxis (GW)1 Hepatitis B therapeutic (GW)1 Prophylaxis No. 2 (GW)1 HIV therapy (GW)1 Therapeutic No. 3 (GW)1 Therapeutic No. 4 (GW)1 Tumour antigen No. 1 (GW)1 Tumour antigen No. 2 (GW)1 Influenza Herpes Simplex Virus Malaria2 Tumour2 1 Partnered programmes 2 Academic collaborations 20 PowderJect Pharmaceuticals plc Operating review
The strength of PowderJect’s technology in delivering large biomolecules is demonstrated by the recent progress with PowderJect FSH which is part of the Company’s multi-protein collaboration with Serono.
We have also made good scientific progress The second area of progress involved This decision follows excellent study results in two important areas that could result in PowderJect scientists achieving another first achieved with the collaboration’s lead better vaccines delivered by the PowderJect for the Company. They demonstrated that product PowderJect FSH (follicle stimulating system. Scientists have long explored powder immunisation of the skin’s outer hormone). Serono’s leading FSH product, the use of adjuvants to increase vaccine layer, the epidermis, can protect against Gonal-F® (recombinant gonadotrophin), is the efficacy, but the approach was not routinely pathogens, such as flu and HIV, that are world’s leading drug for fertility treatment. accepted because of adjuvant toxicity. transmitted through the mucosal tissue Our collaboration with Serono, which we However, promising new results demonstrate (the moist membrane lining body cavities signed in February last year, covers five that powder injection of adjuvant-containing such as the mouth, respiratory tract and therapeutic proteins, including products vaccines can be well tolerated at doses that vagina). This research opens up the in the fields of reproductive health and would be toxic when delivered traditionally. possibility of generating mucosal immune immunology. The positive results achieved This raises the prospect of improving safety responses to vaccines delivered into the in our development programme to date are and/or efficacy by using potent adjuvants skin in PowderJect’s convenient consumer- reflected in the decision by Serono to move in PowderJect vaccines that would be focused format, reinforcing the great the lead therapeutic protein into clinical unacceptably toxic as liquid injections potential of epidermal immunisation via development. Over the coming year, we look administered subcutaneously the PowderJect system. forward to the continued development of the or intramuscularly. PowderJect/Serono collaboration other proteins covered by our agreement. We were extremely pleased to announce recently that our collaboration with Serono reached an important development milestone, with the lead programme progressing into clinical development. Achievement of this milestone triggers a payment of £1 million to PowderJect.
Drugs pipeline Feasibility Preclinical Phase I Phase II Phase III Generic drugs Alprostadil Insulin Lidocaine dermal1 Lidocaine oral1 Calcitonin
Proprietary drugs Levobupivacaine1 Acute migraine1 Prostate cancer1 Growth deficiency Gonal-F®(Serono)1 Immunology (Serono)1 1 Partnered programmes Operating review 21 PowderJect Pharmaceuticals plc
The broad applicability of powder injection opens up a large potential market, delivering drugs, biopharmaceuticals, vaccines, DNA vaccines and diagnostics.
PowderJect’s drug development programmes are moving ahead, with PowderJect Alprostadil achieving proof-of- concept in patients and PowderJect Lidocaine beginning configuration studies in preparation for pivotal Phase III trials.
PowderJect proteins Our in-house development programmes, Finally, clinical trial results of our first The delivery of proteins and peptides concentrating on a generic technology paediatric Phase II study identified a set of represents an important market platform for the delivery of proteins and operating conditions that provide effective opportunity for PowderJect, with advances peptides, have also borne fruit. By focusing anaesthesia in children, which match the in biotechnology resulting in a significant on calcitonin and various generic formulation conditions shown previously to be effective increase in the number of these drugs approaches, we have identified new efficient, in adults at the same sensitive site, the coming to market. These biomolecules commercially scalable processes for the antecubital fossa (inside of the elbow). typically have more specific biological production of peptide and large protein As paediatric trials in this field are more activity than traditional small molecule formulations, with the required physical complex than adult studies, this decision synthetic drugs, offering the potential of more properties and chemical stability for will extend our development timelines effective treatment with reduced side-effects. powder injection. We aim to utilise the somewhat. However, we believe that The greater structural complexity of protein refined technology resulting from this this is more than balanced by the market and peptide molecules means that they programme during the coming year potential. Phase III clinical trials for present the industry greater challenges in in a further clinical study with our most PowderJect Lidocaine, including paediatrics, processing, formulation and delivery. advanced biomolecule: PowderJect are planned to begin in 2001. Leading up Consequently, the majority of these large Calcitonin, our osteoporosis treatment. to the commencement of these pivotal trials molecules are currently administered PowderJect Lidocaine we will conduct a series of configuration by needle and syringe, often with the We announced in December last year an studies to define the device operating complications of refrigerated storage important change of strategy for our lead conditions to take forward into the studies. and complex handling. These often product PowderJect Lidocaine, which we We have already made good progress in expensive to produce, potent treatments are developing in partnership with Celltech this programme during the last few months. are ideally suited to powder injection. Group Plc. For compelling commercial Configuration studies in adults have already The advantages offered by our technology reasons, the decision was taken to include begun, with a trial ongoing currently, and in this field are reflected in our commercial paediatric indications in our first regulatory paediatric studies are scheduled to begin progress this year. We are exploring a filing, whereas our original strategy focused later this financial year. number of partnering opportunities and on adults as our lead indication. A number have recently signed an agreement with PowderJect Alprostadil of factors contributed to this decision. Baxter International Inc to investigate the At the end of 1999, following earlier positive Firstly, feedback from the market indicated delivery of a therapeutic protein. studies in healthy volunteers, we reported that paediatrics is a significant market preliminary results of a Phase II trial in opportunity for PowderJect Lidocaine. patients with our treatment for male erectile Both market research and prospective dysfunction (MED), PowderJect Alprostadil. marketing partners confirmed this Further analysis of the results confirms opportunity. Secondly, discussions with our initial conclusion: at the appropriate regulators both in the US and Europe operating conditions PowderJect Alprostadil suggested that because of the significant potential for use in children, paediatric safety data would be required in an initial filing. 22 PowderJect Pharmaceuticals plc Operating review
PowderJect has an extremely large commercial opportunity in the rapidly growing drug delivery market, which is expected to grow from about $11 billion in 1998 to $35-38 billion in 2008.
PowderJect’s HIV skin test and glucose monitoring system both have the potential to offer significant product advantages in major markets.
achieves a pharmacological effect in MED PowderJect Diagnostics for HIV, suggests that our approach could sufferers. Experts consider this type of Last year we reported on a new area of work in HIV-infected humans. Based on response appropriate for further testing in application for our innovative technology: these results we aim to undertake a key the home setting, away from the clinical clinical diagnostics. Since then we have Phase I clinical study in HIV-infected conditions of the study. At the upper end made good progress in assessing the clinical individuals later in the year. of the dose range tested, the profile of the feasibility of the PowderJect system in this PowderJect has also moved forward with response was similar to that obtained with field. Our research programmes have its blood-free, pain-free glucose monitoring the commercially available Caverject™, focused primarily on two areas of system for diabetics. A clinical study in over which is injected via a needle into the base application: 250 subjects built on the clinical proof of of the penis. Onset of action was rapid – human immunodeficiency virus (HIV) principle work reported last year. The study (10 minutes) with patients maintaining an skin test used a multi-use PowderJect delivery erection on average (median) for 20 minutes. device and monitoring system, which – glucose monitoring. Following this important proof of concept, has the potential to enable easy glucose we have undertaken a significant market Most of the currently available HIV tests self-measurement by diabetics. The results research programme to identify the product detect HIV antibodies, which generally demonstrated a good correlation between characteristics necessary to ensure a appear within three months of infection, interstitial fluid glucose levels, measured by successful product launch. The MED market but may take up to six months in some the PowderJect test, and blood glucose. has changed dramatically over the past few individuals. This means attaining a positive Additionally, the clinical study highlighted the years, with oral drug therapies becoming result can take a significant amount of time consumer-oriented approach of the pain-free available and increasing the treatment and negative results can only be confirmed PowderJect method: nearly all subjects options available to both physicians and after many months, which can result in preferred the PowderJect test, with no-one patients. With the change in therapies, the great anxiety. PowderJect’s skin test offers expressing a preference for the finger prick overall market size has grown to almost the potential of more rapid diagnosis, which method. This is particularly important, $1 billion, with analysts predicting four-fold would allow patients to start treatment much because many diabetics do not test their growth over the next three years. Due to sooner, thereby dramatically improving their glucose levels as frequently as recommended problems with drug-drug interactions, prognosis. Our test for in vivo diagnosis (several times per day), partly because of the slow onset, and lack of efficacy in certain of HIV infection involves monitoring the discomfort associated with the current finger populations, approximately 30% of the functional cytotoxic T-lymphocyte (CTL) prick method. market is treated with non-oral immune response. As this cellular immune The outlook for PowderJect diagnostics is pharmaceutical therapies. response occurs much earlier in the very positive. The commercial opportunity infection, the PowderJect test could enable in both of the areas investigated this year is earlier detection of disease compared with substantial. The total HIV diagnostics and current antibody tests. monitoring market in the US alone is During the year we completed estimated to be in excess of $500 million encouraging research demonstrating while the 1999 worldwide market for whole the feasibility of our immuno-diagnostic blood glucose monitoring was predicted approach. A clinical trial involving stage-IV to reach $3.3 billion, up 13% from the melanoma patients demonstrated that the previous year. PowderJect approach can detect a disease- specific CTL response. In addition, research in SIV, a widely accepted laboratory model Operating review 23 PowderJect Pharmaceuticals plc
PowderJect is constantly evolving the technique of powder injection, with preliminary work now complete on the next generation of devices, which offer even greater potential benefits.
PowderJect delivery technology These advances allow us to model with a proprietary technology to produce This year we have made significant performance and give us the ability to predict particles that are ideal for powder injection. advances in the optimisation of the delivery system behaviour. The development These particles can be produced cost- PowderJect delivery system, with efforts and testing of the first commercial system effectively with the correct characteristics concentrated on the system functionality of in clinical trials has enabled us to increase for loading a variety of pharmaceuticals, this innovative technology. We have achieved our understanding of the interactions and including small molecules, peptides, proteins this through the use and development of dependencies of formulation, gas dynamics and vaccines. sophisticated modelling and analytical and particle penetration. By characterising Patent progress techniques, such as Computational Fluid commercially produced devices using PowderJect’s business strategy is to establish Dynamics (CFD), Particle Image Velocimetry the advanced modelling and analytical powder injection as an industry standard on (PIV) and Particle Penetration Modelling techniques described above we have which to build a global healthcare brand. (PPM). By harnessing the power of these improved device configurations. Achieving A key element in this strategy is the advanced tools our scientists and engineers this increased control is part of the process Company’s strong intellectual property can model the complex gas dynamics in the of optimising PowderJect Lidocaine in position, comprising of extensive patents PowderJect delivery device using CFD, preparation for pivotal Phase III trials, and protecting the technique of powder injection, measure actual fluid dynamics and particle will help us move forward with our entire as well as design and trademark registrations entrainment velocities utilising PIV and product portfolio. on which to base the PowderJect brand. predict particle penetration into human skin As part of our ongoing programme to with PPM. This year we have added significant new refine the technique of powder injection, layers of protection to all areas of our patent Using these techniques we have: we have developed initial prototypes of a portfolio helping to further extend our lock next generation system. This early work – identified configuration improvements to on the field of powder injection. We have is extremely encouraging, with our next the commercial dermal delivery system for also added important new patents covering generation system offering the potential our lead product, lidocaine second-generation devices, various aspects additional benefits of exceptionally low of conventional and nucleic acid-based – more specifically defined the noise, smaller devices and enhanced immunisation (DNA vaccination) and new particle/formulation requirements for product performance. formulation techniques. With these new optimum particle delivery and penetration Smart particle™ formulations filings, the Company’s patent estate now of a range of therapies In addition to advances in refining the numbers 60 discrete patent families, and – identified conditions for further targeting PowderJect delivery device, our Smart we intend to continue to expand this the penetration of drug particles particle™ formulation programme has also portfolio in the coming year. moved forward. This strategic programme – improved distribution of particles across focuses on developing advanced formulation our target delivery area. technologies to enhance the performance of medicines delivered by powder injection. During the last year we have seen the benefits of this approach, with improvements in bioavailability and the potential to optimise formulations for a range of therapies. As part of our strategy to build this type of expertise, we entered an agreement with ProMetic Biosciences Inc last year which provides us 24 PowderJect Pharmaceuticals plc Operating review
PowderJect now has 60 discrete patent PowderJect is well advanced in families putting a lock on the entire field establishing the infrastructure, people of powder injection, with design and and strategic partnerships required to trademark registrations providing a basis commercialise the revolutionary technique for branding PowderJect’s unique of powder injection. technology.
In addition to new filings, PowderJect is very DNA vaccines, conventional vaccines and Operational progress pleased to have been awarded several diagnostics. Several of these segments, As we move closer to the market, we are important patents in the US and Europe. particularly the delivery of biopharmaceuticals putting in place the necessary infrastructure For example, a new European patent was and vaccines, are predicted to enjoy to support the commercialisation of our granted on our seminal oral and mucosal significant growth in the near future. technology. In January 2000, we announced powder injection devices, and US patents Biopharmaceuticals are typically delivered the expansion of our partnership with were awarded on several different powder by needle and syringe, and the conversion The BOC Group Plc. This long-term injection devices as well as the use of certain of these products to less invasive, more agreement provides the framework for nucleic acid constructs for use in cancer patient-friendly delivery methods is expected establishing commercial-scale micro-cylinder immunotherapeutics. to drive market growth of 50% by 2005. manufacturing to support the launch of Another segment, conventional vaccines, PowderJect’s lead products. PowderJect As part of our strategy to brand our is also traditionally administered by needle and BOC have successfully collaborated proprietary technology, we have pursued and syringe. The market for conventional since 1996, to design, develop, and design registration protection on our major vaccines is estimated to grow from about establish the pilot-scale manufacturing device configurations. This year we have $4 billion to $20 billion over the next capacity for the proprietary helium micro- been awarded registrations covering our 10 years. Throughout all of PowderJect’s cylinder that acts as the PowderJect device’s dermal powder delivery devices and a US market segments, healthcare trends moving internal power source. The micro-cylinder design patent covering our reusable device toward prevention of accidental needle-stick pilot plant, located at BOC’s Morden site has configuration. We have also made good injuries and more consumer-oriented been qualified at a scale sufficient to support progress in trademark registration, with products should enable our needle-free, all of our clinical trial requirements. several secured in the US, UK and Europe patient-friendly delivery method to capture during the last year. In December 1999, we selected Bespak Plc significant market share. as our supplier for Dermal PowderJect Market outlook An excellent example of the market Lidocaine. Bespak will produce the delivery PowderJect has an extremely large potential for our products is PowderJect device’s plastic mouldings and assemble commercial opportunity in the rapidly FSH‚ which is the lead product in them with BOC micro-cylinders and pre-filled growing drug delivery market. This market is PowderJect’s collaboration with Serono. drug cassettes supplied by PowderJect. expected to grow from about $11 billion in Recombinant gonadotrophin preparations We are particularly pleased to complete the 1998 to $35-$38 billion in 2008. PowderJect administered by needle and syringe injection supply chain for our lead product with this is uniquely positioned in the drug delivery are widely used as a treatment for infertility, strategic relationship with Bespak, who have universe because it participates in all the with Serono’s Gonal-F®, the world’s leading world-class experience in the scale-up and major market segments: traditional small drug in this field, accounting for sales of manufacture of medical devices. molecule drugs, biopharmaceuticals, approximately $350 million in 1999, an increase of over 40% on the previous year. Operating review 25 PowderJect Pharmaceuticals plc
The future for PowderJect holds significant promise, with the prospect of progressing existing collaborations with pharmaceutical partners and market conditions providing the opportunity to get closer to the marketplace.
One of the key elements of the PowderJect continued to expand our facilities to meet the Interest in PowderJect’s technology from manufacturing infrastructure is the capability requirements of our development pipeline. both the vaccine and pharmaceutical sectors we have established to reproducibly produce In November 1999, we completed the continues unabated and we look forward to unit doses of small quantities of powder-form initial qualification of the $2.1 million facility further collaborations that will drive revenue pharmaceuticals. This is a core competence expansion at Middleton (Madison) to support and provide further validation of the for PowderJect and consequently we have DNA vaccine Phase I/II programmes. PowderJect technology platform. As the invested significant resources in this area Continuing expansion at that site will be biopharmaceutical industry continues to over the last year and reached several completed in June 2000. restructure and consolidate and the drug important milestones. In particular, the delivery market expands, we also see PowderJect continues to recruit the high pilot-scale filling system for lidocaine, opportunities for us to get closer to the calibre people needed to commercialise our which is in place to support clinical trials, marketplace and further build the PowerJect products and drive our business forward. has demonstrated the process capability brand, through collaboration, acquisition, We have significantly strengthened the required for commercial production. joint venture or in-licensing. This process will commercial side of our business and In addition, the commercial system to take careful management to ensure that our have also boosted our scale up capability automate and scale up the pilot process has pipeline remains manageable and contains through the recruitment of experienced been designed and is under construction. the correct balance of products to maximise process development and clinical We have also demonstrated the feasibility value. To help drive this process we have manufacturing specialists. of developing a proprietary filling process, begun a comprehensive review of our which will enable the cost-effective Future outlook development programmes to prioritise those commercial-scale production of reproducible The next year holds significant promise for that can rapidly progress toward significant low doses of potent compounds. PowderJect. On our existing pipeline, we are market opportunities. looking forward to continued development of As part of the process of developing our our lead product, PowderJect Lidocaine. commercialisation strategy, we have Additional trials in children will give us the expanded our long-standing relationship foundation we require as we assemble the with the leading technology consultants, manufacturing infrastructure and move PA Consulting Group. This strategic towards the pivotal clinical trials needed to collaboration is progressing well, with PA register this product. We believe our providing us with significant expertise in late- collaboration with Serono will continue to stage development and commercialisation move forward as our lead protein product, of drug delivery technologies. Additionally, PowderJect FSH‚ moves into the clinic and under the terms of the collaboration, additional Serono products move PA took a strategic equity investment into development. On the DNA vaccine in PowderJect through the purchase side, we look forward to continued clinical of PowderJect Ordinary Shares by progress in our collaboration with Glaxo cash subscription. Wellcome. We also expect to continue our In the vaccines field, PowderJect signed an conventional vaccine advance into the clinic agreement with AdProTech giving us rights and that this area of our product pipeline will to their innovative adjuvant technology, move forward quickly. offering the potential to further enhance the efficacy of our DNA vaccines. In addition we 26 PowderJect Pharmaceuticals plc
Reference section How the PowderJect system works
Dermal PowderJect device with key components
Actuation pin
Safety catch
Powdered drug cassette
Silencer Actuation cover BOC helium micro cylinder
Nozzle
Drugs, vaccines or diagnostics in The dermal PowderJect system uses a particle form can be painlessly and helium gas jet to accelerate drug or effectively delivered into the body when vaccine particles to a velocity sufficient they are appropriately formulated and to deliver them to the target tissue. travelling at a sufficiently high velocity. Generating a high velocity injection The core technology Actuation of the PowderJect system opens PowderJect’s core technology involves the a microcylinder to release helium gas at high high velocity injection of particle formulated pressure. The helium flows down the device drugs or vaccines into any physically to a drug cassette that holds the powdered accessible tissue. PowderJect systems may drug or vaccine between two plastic provide therapy or prevention of disease by membranes. At the designed pressure, optimal delivery of small molecules, peptides, both membranes burst open virtually proteins or DNA. The basic principle is that instantaneously allowing the rapidly solid form particles can be painlessly and expanding gas to sweep the powder down effectively delivered into the body if they are the device nozzle accelerating it to speeds appropriately formulated and travelling at of up to 600–900 metres per second. sufficiently high velocity. This principle can be When the helium gas containing the particles applied to deliver any drug or vaccine that leaves the nozzle and hits the skin surface, can be formulated into solid particles having the particles have sufficient momentum the appropriate characteristics of size to penetrate the skin. The helium gas is distribution, density and strength. By using reflected into a silencer. Individual particles the appropriate PowderJect system, this of powder pass through the outer barrier technique may be employed to deliver a layer of the skin (stratum corneum), range of drugs into the skin (intradermal), penetrating to the required level in the tissue. into the tissues of the mouth or vagina The drug dissolves to either act locally or (transmucosal) or directly into other tissues diffuses into the blood stream to deliver via catheter or minimally invasive surgical its beneficial effect. entry. PowderJect’s initial focus is on the intradermal and buccal transmucosal routes but systems for delivery by means of a catheter to internal organs and for direct delivery to the eye are also intended. Reference section 27 PowderJect Pharmaceuticals plc
Oral PowderJect device Reusable dermal PowderJect device with its key components
Safety tab Actuation mechanism Disposable cartridge Actuation pin Actuation button
Nozzle Dust cover
Shock tube Micro cylinder Filter Silencer Expansion chamber
Membrane
Actuation ring Gas exhaust ports Dome Powdered drug
The PowderJect system can be For applications that require a longer course For delivery into enclosed spaces such as modified to suit different needs. of therapy a reusable system is more the mouth, other natural body orifices or Current prototypes include a dermal appropriate and economical because only minimally invasive surgical openings, a and oral device for delivery into the the helium energy source and drug cassette prototype device called the oral PowderJect skin and mucosal membranes need to be replaced for each injection. system is being developed. This device, respectively. Reusable and A design is shown above in which the helium pictured above, has many of the same disposable devices are suited cylinder and the accelerating nozzle are elements but instead of using the helium flow to different dosing regimes. positioned side by side and a protective to accelerate the particles, it uses the energy cover is provided to enclose the system of the shock wave to invert a dome shaped PowderJect system configurations between uses. This configuration captures membrane. The powdered drug is held on For preclinical and initial clinical research, all the operational features of the linear single the external concave surface of this flexible PowderJect has from its inception employed use disposable system but is designed to membrane. Inversion of the dome refillable and reusable hand fabricated be more transportable and to be used over accelerates the particles to sufficient prototypes. In late 1998, a commercial many months to deliver drugs such as fertility momentum that they may penetrate tissue configuration comprised of moulded plastic treatment. Reusable PowderJect system while the strong membrane retains the gas parts and a single use welded aluminium concepts are being refined and designs for inside the system from which it is vented helium microcylinder was completed and economical manufacturing are being finalised slowly after delivery. has been refined based upon results of that incorporate the improvements indicated clinical testing. by extensive clinical experience with the single use disposable systems. 28 PowderJect Pharmaceuticals plc
Reference section How PowderJect vaccines work
DNA vaccination with the PowderJect system efficiently delivers DNA directly into the cell Sectional diagram of the skin showing (intracellularly) to elicit a protective or therapeutic immune response using over 1,000 fold delivery of PowderJect particles to the less DNA than liquid injection epidermis (Not to scale)
DNA vaccine delivery Extracellular Gold Antigen Presenting Cell Particle Delivery particle coated Nucleus with DNA MHC Stratum Corneum
DNA µ Transcribed Epidermis: 50 m to RNA Translated to Protein Processed Antigens presented into antigen to the immune system peptides MHC-Antigen Stratu invoke humoral and m presentation Basale cellular response Dermis: 1-2mm
The PowderJect system can be The PowderJect system can be The PowderJect system delivers modified to ensure delivery to the modified for use with DNA vaccines an intradermal injection. optimal target tissue, for example the to ensure they are delivered into Targeted delivery to skin layers extracellular delivery of conventional the cell (intracellularly). Skin consists of several layers. Beneath the vaccines to the epidermis. DNA vaccine delivery outer keratinous stratum corneum, which Drug and conventional vaccine delivery DNA must enter the cell (intracellular delivery) consists of dead cells and is the body’s main In the case of conventional drugs, the object if it is to have its effect. PowderJect’s DNA barrier to drug delivery, is an outer epidermis of the PowderJect system is to deliver the delivery process involves coating a desired and an inner dermis. The epidermis is a thin drug in therapeutically effective quantities into DNA expression construct onto microscopic epithelial membrane. The dermis is a thicker the target tissue where it either acts locally or gold particles and then using a powder layer and is comprised of connective tissue. is absorbed via the blood capillaries or lymph injection device to accelerate the coated A deep extension of the dermis, the in the treated tissues into the systemic gold particles so that they penetrate the subcutaneous layer, anchors the skin to circulation of the body to have its desired skin, and a proportion enter directly into the underlying tissues. effect. It is not intended that the drug should the cells, avoiding the need for cell uptake. Most drugs with a systemic action, such as be delivered directly into cells. The process of transferring DNA into cells proteins and peptides, are ideally delivered is known as transfection. In this case, the to the border of the epidermis and dermis in particles are formulated to be much smaller order to access the area with the highest than cell size so that they can penetrate the density of blood capillaries. Conventional cell membranes without disrupting the cells. and DNA vaccines are ideally delivered into Once inside, the DNA directs the cell to the epidermis. manufacture a specific protein, for example, a protein from an infectious agent that can The PowderJect system delivers an intra- trigger an immune response. Phase I dermal injection. The depth of penetration of clinical trials have now demonstrated the the drug particles is optimised by adjusting immunological effect of administration the momentum density of the particles of DNA vaccines in human volunteers. within the gas flow. Particle mass and area PowderJect’s technology advantage is are controlled through formulation and the optimisation of delivery to the depth processing of the drug. Velocity is controlled in the skin at which the natural antigen within the device by three parameters: nozzle presenting cells are most numerous. geometry, membrane burst strength and gas The expression and natural display of pressure. the antigenic proteins by transfected cells is highly effective because it appears to closely mimic a natural infection. Reference section 29 PowderJect Pharmaceuticals plc
PowderJect DNA vaccines invoke both cellular and humoral immunity like attenuated live organism vaccines without the risk of causing disease. These may well be used for therapy Process of cellular immune response as well as prophylaxis. 1) Antigen presenting cells bind the antigens from Cellular immune response the invading pathogen. Antigen MHC class I presentation MHC Presenting Cell 2) Antigens are presented to T cells by the major Class I histocompatibility complex (MHC 1). mT Cell 3) Antigens are recognised as either self or non-self. Cellular immune response is stimulated. 4) T Cells mediate the destruction of the pathogen CD8 T Cell infected cells. MHC Class I 5) Memory T cells and antibodies can recognise Peptides presentation foreign antigens previously presented for elimination, thus protecting the body from infection or diseases Memory T Cells from the same agent (e.g. chicken pox). However, fight infections immunity is not always permanent (e.g. tetanus).
How conventional vaccines work How DNA vaccines work Conventional vaccines work by harnessing DNA vaccines represent one of the next the body’s immune system to fight disease. generations of vaccine technologies. On vaccination, the immune response is They work by providing the instructions to triggered in the same way as if infected by a enable the body to manufacture the desired live pathogen (or disease causing organism). antigen. The evidence from current research in a wide variety of laboratory models and Once vaccinated or infected, the immune PowderJect Phase I clinical trials clearly system becomes primed so that the next demonstrates that DNA-based immunisation time it is challenged by the same live invokes both humoral and cellular responses. pathogen, for example tetanus, cholera, etc, it can mount an immune response with Hepatitis B sufficient rapidity to destroy the organism Hepatitis B virus infection of humans causes before it can cause harm. This is because in an acute liver disease that most often a previously infected or vaccinated individual resolves without any permanent damage to antibodies and/or T cells have already been the liver. On occasion, however, the acute activated which recognise the pathogen phase is replaced by a slowly developing immediately. chronic stage that ultimately can lead to liver cirrhosis and primary liver cancer. These two The immune response can be subdivided very different end-points reflect the difference into the cellular immune response and the in how the infected individual’s immune humoral immune response. In the cellular response handles the infection. Although response, pathogens are destroyed by both kinds of patients generate antibody and T cells and in the humoral response, they are cell mediated immune responses, there is a destroyed by antibodies. The sequence of qualitative difference in the response such events following vaccination (or infection by that the immune response in some disease) is illustrated above and overleaf for individuals is insufficient to resolve the each response. disease and they progress to the chronic disease states. It is thought that the critical deficiency in those who progress to chronic infection, in some, is part of the cell mediated immune response. 30 PowderJect Pharmaceuticals plc Reference section
Earlier sub-unit vaccines based on first generation Process of antibody immune response recombinant technology elicit a humoral response. 1) Antigens bind antibodies on the surface of B cells. Together with help from antigen specific T cells, the Humoral immune response antibody response is stimulated. (antibodies) Antigen Presenting Cell 2) Antibodies mediate destruction of the pathogen. MHC class II presentation CD4 T Cell
Processed into peptides
Cytokines Protein