• Robust post-dosing changes continue to be seen in key markers associated with severity of disease
  
• Pharmacodynamic data from the first three participants show sustained reductions in N-acetylaspartate (NAA) in the brain and urine, suggesting that the investigational therapy is producing functional ASPA enzyme 
• If successful, BridgeBio’s gene therapy could be the first therapeutic option for children born with Canavan disease, a devastating and fatal neurodevelopmental disorder 

BridgeBio Pharma, Inc. (Nasdaq: BBIO) (“BridgeBio” or the “Company”), a commercial-stage biopharmaceutical company focused on genetic diseases and cancers, today presented promising pharmacodynamic, tolerability and preliminary functional efficacy data from the first three participants dosed in CANaspire, its Phase 1/2 clinical trial of BBP-812, an investigational intravenous (IV) adeno-associated virus serotype 9 (AAV9) gene therapy for the treatment of Canavan disease. An update on the CANinform natural history study, which continues to enroll new participants globally, was also presented. Canavan disease is an ultra-rare and fatal disease with no approved therapies. 
  
New data from the third CANaspire participant are consistent with the first two treated children:

• At Month 3 post-treatment, Participant 3 showed:
  • 89% reduction of NAA in cerebrospinal fluid (CSF)
  • 45% reduction in urine NAA
  • Magnetic resonance spectroscopy (MRS) NAA data are not yet available

In addition, Participant 2 showed a continued decline in urine NAA at Month 6 with an 85% decrease compared to pre-treatment.

In June, BridgeBio Pharma reported

• At Month 6 post-treatment, Participant 1 showed:  
  • 77% reduction of NAA in CSF 
  • 15% reduction in NAA in brain white matter by MRS imaging 
  • 45% reduction in urine NAA 
• At Month 3 post-treatment, Participant 2 showed:  
  • 89% reduction of NAA in CSF 
  • 53% reduction in NAA in brain white matter by MRS imaging 
  • 81% reduction in urine NAA 

No additional brain or CSF NAA data are available for Participants 1 and 2 since the last announcement given the study schedule for MRS imaging and lumbar punctures. IV infusions of BBP-812 have been well-tolerated by all 3 participants with no reported treatment-related serious adverse events.

The consistent reductions in CSF and brain NAA observed to date continue to support the ability of BBP-812 to reach the central nervous system and express active aspartoacylase (ASPA) enzyme. "The most critical biomarker, in my mind, is NAA. Reduction in NAA levels, whether in the brain, CSF fluids, or in the urine, may indicate a sign of improvement because the gene missing in Canavan disease directly leads to accumulation of NAA. So, showing that NAA is decreasing is very important,” said Guangping Gao, Ph.D., scientific founder of Aspa Therapeutics, the BridgeBio Gene Therapy affiliate company developing the gene therapy for Canavan disease.

The data, presented today in two posters (linked here and here) at the 2022 Child Neurology Society conference, combined with early signs of clinical change previously noted by Dr. Florian Eichler, Principal Investigator in the Aspa gene therapy trial, are encouraging signs that the therapy may be working as intended.

Both studies continue to enroll and a broader Phase 1/2 data readout, including safety and efficacy findings and updates on the pharmacodynamic data is expected in 1H 2023. 

“We are encouraged by the sustained reduction in key biomarkers for this condition, a novel observation in the treatment of Canavan disease, and by the early reports of improvement in function we are hearing from our investigator. We are excited to continue advancing our development efforts for BBP-812 and look forward to our interactions with regulatory authorities to determine the optimal path for our program,” said Genevieve Laforet, MD, PhD, Vice President of Clinical Development at Aspa Therapeutics. “Our deepest thanks go out to all the families in our natural history and gene therapy studies for their partnership as we work to deepen our understanding of Canavan disease and explore the potential of BBP-812 as a therapeutic option for Canavan patients.”

BridgeBio is also grateful to the following patient organizations who are an integral part of this mission:

• Canavan Foundation https://www.canavanfoundation.org/   
• Canavan Research Illinois https://www.canavanresearch.org/
• National Tay Sachs and Allied Diseases Association (NTSAD) https://www.ntsad.org/

About CANaspire  
CANaspire is a Phase 1/2 open-label study designed to evaluate the safety, tolerability, and pharmacodynamic activity of BridgeBio’s AAV9 gene therapy candidate, BBP-812, in pediatric patients with Canavan disease. Each eligible patient will receive a single intravenous (IV) infusion of BBP-812. The primary outcomes of the study are safety, as well as change from baseline of urine and central nervous system N-acetylaspartate (NAA) levels. Motor function and development will also be assessed.  

For more information about the CANaspire trial, visit TreatCanavan.com or ClinicalTrials.gov (NCT04998396). 

About BBP-812 
BBP-812 is an investigational AAV9 gene therapy for Canavan disease. Using AAV gene therapy, BridgeBio seeks to deliver functional copies of the ASPA gene throughout the body and into the brain, potentially correcting the disease at its source. Preclinical proof-of-concept results have shown the approach restores survival and normal motor function in Canavan disease models. BBP-812 was granted Fast Track Designation, Rare Pediatric Drug Designation, and Orphan Drug Designation by the U.S. Food and Drug Administration. BBP-812 was also granted Orphan Drug Designation by the European Medicines Agency. 

About Canavan Disease 
Affecting approximately 1,000 children in the United States and European Union, Canavan disease is an ultra-rare, disabling and fatal disease with no approved therapy. Most children are not able to meet developmental milestones, are unable to crawl, walk, sit or talk, and die at a young age. The disease is caused by an inherited mutation of the ASPA gene that codes for aspartoacylase, a protein that breaks down a compound called N-acetylaspartate (NAA). Deficiency of aspartoacylase activity results in accumulation of NAA, and ultimately results in toxicity to myelin in ways that are not currently well understood. Myelin insulates neuronal axons, and without it, neurons are unable to send and receive messages as they should. The current standard of care for Canavan disease is limited to supportive therapy. 

About BridgeBio Pharma, Inc. 
BridgeBio Pharma, Inc. (BridgeBio) is a commercial-stage biopharmaceutical company founded to discover, create, test and deliver transformative medicines to treat patients who suffer from genetic diseases and cancers with clear genetic drivers. BridgeBio’s pipeline ranges from early science to advanced clinical trials. BridgeBio was founded in 2015 and its team of experienced drug discoverers, developers and innovators are committed to applying advances in genetic medicine to help patients as quickly as possible. For more information visit bridgebio.com and follow us on LinkedIn and Twitter. 

BridgeBio Pharma, Inc. Forward-Looking Statements 
This press release contains forward-looking statements. Statements we make in this press release may include statements that are not historical facts and are considered forward-looking within the meaning of Section 27A of the Securities Act of 1933, as amended (the Securities Act), and Section 21E of the Securities Exchange Act of 1934, as amended (the Exchange Act), which are usually identified by the use of words such as “anticipates,” “believes,” “estimates,” “expects,” “intends,” “may,” “plans,” “projects,” “seeks,” “should,” “will,” and variations of such words or similar expressions.  We intend these forward-looking statements to be covered by the safe harbor provisions for forward-looking statements contained in Section 27A of the Securities Act and Section 21E of the Exchange Act and are making this statement for purposes of complying with those safe harbor provisions.  These forward-looking statements, including statements relating to the timing and success of BridgeBio’s Phase 1/2 clinical trial of BBP-812 for the treatment of Canavan disease, expectations, plans and prospects regarding BridgeBio’s regulatory approval process for BBP-812, the ability of BBP-812 to be the first therapeutic treatment option for children born with Canavan disease, data from subsequent CANaspire participants also showing rapid and robust post-treatment decreases in NAA in urine and in CSF and brain tissue as shown by MRS, reduction in brain NAA being an early signal suggesting that BBP-812 administered IV has reached its intended target behind the blood-brain barrier and is expressing functional ASPA enzyme, the biochemical change seen to date suggesting that the trial is reaching cells critical to the disease process, and the timing and success of final top-line Phase 1/2 date of BBP-812, including the final safety and efficacy profile of the investigational gene therapy, reflect our current views about our plans, intentions, expectations, strategies and prospects, which are based on the information currently available to us and on assumptions we have made. Although we believe that our plans, intentions, expectations, strategies and prospects as reflected in or suggested by those forward-looking statements are reasonable, we can give no assurance that the plans, intentions, expectations or strategies will be attained or achieved.  Furthermore, actual results may differ materially from those described in the forward-looking statements and will be affected by a number of risks, uncertainties and assumptions, including, but not limited to, BridgeBio’s ability to continue and complete its Phase 1/2 clinical trial of BBP-812 for the treatment of Canavan disease, past data from preclinical studies or early data from two participants in the open-label trial not being indicative of future or final data from clinical trials, BridgeBio’s ability to advance BBP-812 in clinical development according to its plans, the ability of BBP-812 to treat Canavan disease, the ability of BBP-812 to retain Fast Track Designation, Rare Pediatric Drug Designation, and Orphan Drug Designation from the U.S. Food and Drug Administration and Orphan Drug Designation from the European Medicines Agency, and potential adverse impacts due to the global COVID-19 pandemic such as delays in regulatory review, manufacturing and clinical trials, supply chain interruptions, adverse effects on healthcare systems and disruption of the global economy; as well as those set forth in the Risk Factors section of BridgeBio’s most recent Annual Report on Form 10-K filed with the U.S. Securities and Exchange Commission (SEC) and in subsequent SEC filings, which are available on the SEC’s website at www.sec.gov. Moreover, BridgeBio operates in a very competitive and rapidly changing environment in which new risks emerge from time to time. Except as required by applicable law, we assume no obligation to update publicly any forward-looking statements, whether as a result of new information, future events or otherwise. 

BridgeBio Contact:
Vikram Bali
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