Development

OMEICOS' OMT-28 Shows Promise in Phase 2a Trial for Primary Mitochondrial Diseases

OMEICOS Advances Mitochondrial Disease Therapy with Promising Phase 2a Results

OMEICOS Therapeutics GmbH announced positive topline results from its Phase 2a PMD-OPTION study evaluating OMT-28, an orally available biased S1PR1 receptor modulator, in patients with primary mitochondrial diseases (PMD). The study suggests potential therapeutic benefits for patients with mitochondrial myopathy and cardiomyopathy, a rare group of genetic disorders characterized by impaired cellular energy production.

Trial Specifics

The open-label Phase 2a study enrolled 29 patients with primary mitochondrial diseases across nine expert sites in Germany, Italy, and The Netherlands. Participants received 24 mg of OMT-28 once daily for up to 24 weeks, following a 12-week untreated run-in period used as an integrated control.

The trial demonstrated a response rate exceeding 60%, with statistically significant improvements in functional tests including the 12-Minute Walk Test and 5x Sit-to-Stand Test. Notably, the study observed approximately 30% increases in NAD+ levels among responders and significant improvements in glutathione metabolism markers.

OMEICOS executives indicated the company will prepare for a potentially pivotal Phase 2b/3 study, with readiness anticipated in the second half of 2026.

Research Context

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OMT-28 operates through a novel mechanism targeting the Sphingosine-1-Phosphate Receptor 1 (S1PR1) and activating mitochondrial sirtuins SIRT1 and SIRT3. These molecular targets are critical in regulating mitochondrial metabolism, reducing oxidative stress, and improving cellular energy production.

Primary mitochondrial diseases represent a challenging therapeutic landscape, characterized by genetic heterogeneity and limited treatment options. Current management remains largely supportive, with no approved disease-modifying therapies for most PMD subtypes.

Competitive Landscape

While several S1PR1 modulators exist in multiple sclerosis and inflammatory conditions—such as ozanimod (Bristol Myers Squibb) and siponimod (Novartis)—OMT-28 represents a potentially differentiated approach specifically targeting mitochondrial dysfunction.

Other investigational therapies in the mitochondrial disease space include EPI-743 (Edison Pharmaceuticals) and idebenone (Santhera Pharmaceuticals), highlighting the growing interest in addressing these complex genetic disorders.

The research suggests OMT-28 could offer a promising therapeutic strategy, though further clinical validation remains necessary to establish its long-term efficacy and safety profile.


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