AT191: An inhaled & precision RNA therapeutic with pan-variant SARS-CoV-2 efficacy
openNIAID - National Institute of Allergy and Infectious Diseases
PROJECT SUMMARY/ABSTRACT
This Phase II SBIR will de-risk a new class of antivirals that can be developed to target any RNA virus from
SARS-CoV-2 to influenza. The effort will specifically translate a lead, platform-derived SARS-CoV-2 candidate
(AT191) designed to be self-administered and to prevent hospitalizations or deaths by any SARS-CoV-2 variant.
Despite vaccines and 2 blockbuster antivirals marketed to prevent hospitalizations, 900,000 Americans were
hospitalized due to SARS-CoV-2 in 2023. Beyond vaccine hesitancy and durability concerns, existing antivirals
only reduce hospitalizations and deaths by 40–50%. SARS-CoV-2 antivirals are further limited by
contraindications (e.g. Paxlovid) and safety concerns (e.g. molnupiravir). Moreover, there is a risk that SARS-
CoV-2 acquires resistance to all existing classes of antivirals—as occurred with all SARS-COV-2 monoclonal
antibodies prior to 2024. There is a clear unmet need for new classes of antivirals, especially antivirals that can:
(i) be used at-home to prevent hospitalizations, and (ii) maintain (variant-proof) efficacy as novel variants emerge.
Encrypted RNA (encRNA) is a new class of RNA developed by Autonomous Therapeutics. The plug-and-play
platform technology can develop antivirals against any RNA virus and can encode any therapeutic protein. Unlike
state-of-the-art mRNA, each platform-derived encRNA only activates its (broad-spectrum) antiviral payload in
targeted virus-infected cells. More specifically, encRNA only translate encoded proteins when bound,
transcribed, and amplified by targeted viral RNA polymerase (RdRp) complexes conserved across a viral
species. Thus, encRNA remain translationally inactive and safe in uninfected cells (e.g. as prophylactics).
AT191 is our lead, first-in-class encRNA therapeutic candidate developed to confer inhaled and variant-proof
efficacy against all variants of SARS-CoV-2 (and SARS-CoV-1). AT191 confers precision and pan-sarbecovirus
efficacy—because AT191’s antiviral payload (IFN-β) is only activated and translated by sarbecovirus RdRp.
In Phase I-equivalent studies, we developed: (i) the encRNA platform technology, (ii) the AT191 lead candidate,
and (iii) an inhalable lipid nanoparticle (LNP) for encRNA self-administration using marketed nebulizers. We
further demonstrated the (iv) variant-proof efficacy of AT191 against every tested SARS-CoV-2 variant in vitro,
and the (v) preliminary in vivo safety and efficacy of AT191 in both mice and hamsters.
Here we propose to develop AT191 into a GLP-ready candidate ready for IND-enabling studies. We propose to
test the pan-sarbecovirus efficacy (SARS-CoV-1 & 2) of AT191 in vivo and to perform critical CMC, inhalation,
dose-timing, and dose-finding studies in hamsters. We will also test safety/efficacy in non-human primates. The
effort will culminate in a pre-IND. If successful in follow-on clinical studies, AT191 could be used at-home as a
prophylactic or therapeutic: e.g. for immediate use after exposure to an infected child or family member.
Beyond SARS-CoV-2, the same encRNA-LNP platform technology could be used to develop precision and
variant-proof candidates for any RNA virus—including viruses for which no safe and effective antivirals exist.
Up to $1.0M
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