Albuferon in Phase 2b Trial for the Treatment of Chronic Hepatitis C
Jun 2, 2005, 13:16, Reviewed by: Dr.
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"The current standard of care for the treatment of chronic hepatitis C is a combination of pegylated interferon alpha and ribavirin. This combination produces cures in approximately 42-46 percent of all genotype 1 HCV patients completing therapy, leaving more than 50 percent who relapse or do not respond."
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By Human Genome Sciences, Inc.,
Human Genome Sciences, Inc. announced today that it has begun dosing patients in a Phase 2b clinical trial of Albuferon(TM) (albumin-interferon alpha) in combination with ribavirin to evaluate the efficacy and safety of Albuferon in patients with chronic hepatitis C virus (HCV) genotype 1 who are naive to interferon alpha-based treatment regimens. Genotype 1 accounts for nearly 70% of all HCV infections in North America and is generally regarded as the most difficult HCV genotype to treat.(1)
The trial is a randomized, open-label, multi-center, active-controlled, dose-ranging study conducted in Australia, Canada, Czech Republic, France, Germany, Israel, Poland and Romania. A minimum of 440 patients will be enrolled in the Phase 2b study and randomized into four treatment groups, three of which will receive subcutaneously administered Albuferon (900 mcg at 14-day intervals, 1200 mcg at 14-day intervals, and 1200 mcg at 28-day intervals(1)). The fourth treatment group will serve as the active control group and will receive weekly 180-mcg doses of subcutaneously administered Pegasys (peginterferon alfa-2a). All patients will receive weight-based oral daily ribavirin at 1000 or 1200 mg in two divided doses. The primary objectives of the Phase 2b study are to evaluate the efficacy and safety of Albuferon in combination with ribavirin in interferon alpha-naive patients with chronic hepatitis C genotype 1. The primary efficacy endpoint will be sustained virologic response, defined as undetectable virus at 24 weeks after completion of 48 weeks of treatment.
John McHutchison, M.D., Coordinating Center Principal Investigator for the Phase 2b study, and Professor of Medicine and Director, GI/Hepatology Research, Duke Clinical Research Institute and Duke University Medical Center, Durham, NC, said, "The current standard of care for the treatment of chronic hepatitis C is a combination of pegylated interferon alpha and ribavirin. This combination produces cures in approximately 42-46 percent of all genotype 1 HCV patients completing therapy, leaving more than 50 percent who relapse or do not respond. Clearly, chronic hepatitis C represents a significant unmet medical need. The preclinical and clinical evidence to date supports the continued evaluation of the potential of Albuferon to help meet this need. The next logical step is the current study of Albuferon in combination with ribavirin in a larger population of treatment-naïve genotype 1 patients with chronic hepatitis C."(2-11)
David C. Stump, M.D., Executive Vice President, Drug Development, said, "Based on the preclinical and clinical results that have emerged thus far, we believe that Albuferon has the potential to become an important therapeutic option for the treatment of chronic hepatitis C. The Phase 2b study announced today is the largest Albuferon trial to date. We recently reported the positive results of a Phase 2 study of Albuferon monotherapy in interferon alpha-naïve patients with genotype 1 hepatitis C.(12-13) The data that emerged demonstrate that Albuferon is well tolerated, has a prolonged half- life and shows robust antiviral activity, with durable dose-dependent reductions in HCV viral load. The data also enabled our identification of the range of active doses that will be evaluated in the larger Phase 2b trial announced today. In February 2005, we disclosed preliminary data from a separate ongoing Phase 2 clinical trial of Albuferon in combination with ribavirin, which show that Albuferon can be administered safely and repetitively at 2-week or 4-week intervals in combination with ribavirin in patients who have failed to respond to previous interferon alpha-based treatment regimens.(14) The results of clinical and preclinical studies to date afford confidence in the ability to administer Albuferon safely in combination with ribavirin to treatment-naïve patients.(15-21) We are hopeful that Albuferon will one day provide an important therapeutic option for the treatment of chronic hepatitis C."
The results of a Phase 2 clinical trial of Albuferon monotherapy in interferon alpha-naive patients with genotype 1 chronic hepatitis C were presented at the 40th Annual Meeting of the European Association for the Study of the Liver (EASL).(12-13)
Data presented on 56 patients demonstrate that Albuferon exhibited robust antiviral activity in genotype 1 HCV. A mean reduction in HCV viral load of 3.2 log at Day 28 was observed in the combined 900 mcg and 1200 mcg dose cohorts, with 69% of patients (18/26) in these cohorts showing a more than 2-log reduction in HCV viral load at Day 28. Undetectable viral load was observed at Day 42 (28 days after the second injection) in 23% of patients (6/26) in the combined 900 mcg and 1200 mcg dose cohorts.
Robust dose-dependent viral kinetics were observed, with the majority of patients in the 900 mcg and 1200 mcg cohorts exhibiting a second-phase decline in viral load of more than 0.3 log per week, which has previously been shown to be predictive of sustained virologic response (SVR) in treatment with the pegylated interferons.(22)
Reductions in viral load of equal to or greater than 2 log are reported in approximately 42% of genotype 1 HCV patients treated with pegylated interferon alpha products in combination with ribavirin.(23) The results presented at EASL demonstrate that Albuferon remained in the blood substantially longer than is reported for recombinant interferon alpha and pegylated interferon alpha. Albuferon exhibited a median half-life of 148 hours, supporting dosing at intervals of 2-4 weeks. This compares with a reported mean (range) elimination half-life of 80 hours (50-140 hours) for Pegasys and 40 hours (22-60 hours) for PEG-Intron.(23-25) Albuferon was well tolerated with adverse events that were transient and mostly mild to moderate in severity. There were no discontinuations due to reductions in hematologic cell counts. No subjects developed newly emergent antibodies to alpha interferon.
Albuferon is a novel, long-acting form of interferon alpha. Recombinant interferon alpha is approved for the treatment of hepatitis C, hepatitis B and a broad range of cancers. Human Genome Sciences modified interferon alpha to improve its pharmacological properties by using the company's proprietary albumin fusion technology.
Hepatitis C infection is an inflammation of the liver caused by the hepatitis C virus. It is the most common chronic blood-borne infection in the developed world. It is estimated that as many as 170 million people worldwide are infected with hepatitis C virus. This includes nearly four million people in the United States. The hepatitis C virus is transmitted primarily through significant or repeated exposures to infected blood. Intravenous drug use and sexual contact with infected persons account for the majority of new hepatitis C infections. When detectable levels of the hepatitis C virus in the blood persist for at least six months, a person is diagnosed as having chronic hepatitis C. 
- The results of a Phase 2 clinical trial of Albuferon monotherapy in interferon alpha-naive patients with genotype 1 chronic hepatitis C were presented at the 40th Annual Meeting of the European Association for the Study of the Liver (EASL)
www.hgsi.com
For more information about Albuferon, see http://www.hgsi.com/products/albuferon.html. Health professionals interested in more information about trials involving Human Genome Sciences products are encouraged to inquire via the Contact Us section of the company's web site, http://www.hgsi.com/products/request.html, or by calling (301) 610-5790, extension 3550.
Human Genome Sciences is a company with the mission to treat and cure disease by bringing new gene-based protein and antibody drugs to patients.
HGS, Human Genome Sciences and Albuferon are trademarks of Human Genome Sciences, Inc.
This announcement contains forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended. The forward-looking statements are based on Human Genome Sciences' current intent, belief and expectations. These statements are not guarantees of future performance and are subject to certain risks and uncertainties that are difficult to predict. Actual results may differ materially from these forward-looking statements because of the Company's unproven business model, its dependence on new technologies, the uncertainty and timing of clinical trials, the Company's ability to develop and commercialize products, its dependence on collaborators for services and revenue, its substantial indebtedness and lease obligations, its changing requirements and costs associated with planned facilities, intense competition, the uncertainty of patent and intellectual property protection, the Company's dependence on key management and key suppliers, the uncertainty of regulation of products, the impact of future alliances or transactions and other risks described in the Company's filings with the Securities and Exchange Commission. Existing and prospective investors are cautioned not to place undue reliance on these forward-looking statements, which speak only as of today's date. Human Genome Sciences undertakes no obligation to update or revise the information contained in this announcement whether as a result of new information, future events or circumstances or otherwise.
Footnotes:
1. It is important to note that the method of measurement for dose
determination in the Phase 2b study of Albuferon in combination with
ribavirin in treatment-naïve patients (as well as in other Phase 2
studies of the compound) is different from the method of measurement
in the Phase 1/2 study of Albuferon. Accordingly, the 900-mcg dose in
the current study is equivalent to a 680-mcg dose in the Phase 1/2
study, and the 1200-mcg dose is equivalent to 900 mcg in the Phase 1/2
study.
2. Manns MP, McHutchison JG, Gordon S, et al. Peginterferon alfa-2b plus
ribavirin compared with interferon alfa 2b plus ribavirin for initial
treatment of chronic hepatitis C: a randomized trial. The Lancet
2001; 358:958-65.
3. Fried MW, Shiffman ML, Reddy KR, et al. Peginterferon alfa-2a plus
ribavirin for chronic hepatitis C virus infection. New England Journal
of Medicine 2002; 347:975-982.
4. Carithers RL, Zeuzem S, Manns MP, et al. Multicenter, randomized
controlled trial comparing high dose daily induction interferon plus
ribavirin versus standard interferon alfa-2b plus ribavirin.
Hepatology 2000; 32:3317A (abstr).
5. Zeuzem S. Heterogeneous virologic response rates to interferon-based
therapy in patients with chronic hepatitis C: who responds less well?
Ann Intern Med 2004; 140:370-381.
6. Alter MJ. Epidemiology of hepatitis C in the West. Semin. Liver
Disease. 1995;15:5-14.
7. Strader DB, Wright T, Thomas DL, and Seeff, LB. AASLD Practice
Guideline: Diagnosis, Management, and Treatment of Hepatitis C.
Hepatology 2004 April; 39 (4): 1147-1171.
8. Hadziyannis SJ, Sette H, Morgan TR, et al. Peginterferon alfa 2a and
ribavirin combination therapy in chronic hepatitis C. Ann Intern Med
2004; 140:346-355.
9. Shiffman ML, Di Bisceglie AM, Lindsay KL, et al. Peginterferon alfa
2a and ribavirin in patients with chronic hepatitis C who have failed
prior treatment. Gastroenterology 2004; 126:1015-1023.
10. Zeng N, Cohen CK, Schwartz P, Rai R. Treatment of HCV infected
patients, including non-responders to PEG-IFN alfa-2b/RBV, with PEG
IFN alfa-2a/RBV: the Johns Hopkins experience. Digestive Disease
Week 2004 Internet Conference Report. Abstract #1233.
11. Management of Hepatitis C: 2002. National Institutes of Health
Consensus Development Conference.
12. Bain V, et al. A Phase 2 study to assess antiviral response, safety,
and pharmacokinetics of Albuferon in IFN alpha-naive subjects with
genotype 1 chronic hepatitis C. 40th Annual Meeting of the European
Association for the Study of the Liver (EASL), Paris. April 14,
2005. Oral presentation. (Abstract #18.)
13. (HGSI Press Release) Human Genome Sciences Reports Positive Results
of Phase 2 Clinical Trial of Albuferon in Treatment-Naive Patients
with Chronic Hepatitis C. April 14, 2005.
14. (HGSI Press Release) Human Genome Sciences Completes Enrollment in a
Phase 2 Clinical Trial of Albuferon in Treatment-Naive Patients with
Chronic Hepatitis C. February 16, 2005.
15. Balan V, et al. Albuferon(TM) -- A Novel Therapeutic Agent for
Hepatitis C: Results of a Phase 1/2 Study in Treatment Experienced
Subjects with Chronic Hepatitis C. 55th Annual Meeting of the
American Association for the Study of Liver Diseases, Boston.
November 2, 2004. Oral presentation (Abstract #265).
16. (HGSI Press Release) Human Genome Sciences Reports Positive Results
of Phase 1/2 Clinical Trial of Albuferon(TM) in Chronic Hepatitis C.
November 2, 2004.
17. Liu C, Zhu H, Xu Y, Nelson DR, et al. Albuferon(TM) exhibits
efficient anti-HCV activity in cell culture. Digestive Disease Week
(DDW) 2005, Chicago. Abstract #S920.
18. (HGSI Press Release) Human Genome Sciences Reports Results of
Preclinical Study Comparing Anti-Viral Activity of Albuferon and
Three Other Forms of Interferon Alpha Used to Treat Hepatitis C.
May 17, 2005.
19. Balan V, et al. Molecular profiles of drug response in HCV infected
patients during the first four weeks of therapy for chronic hepatitis
C virus with pegylated interferon containing regimens or Albuferon.
54th Annual Meeting of the American Association for the Study of
Liver Diseases, Boston. October 25, 2003.
20. Moore P, Balan V, et al. Modulation of interferon specific gene
expression by Albuferon in subjects with chronic hepatitis C and
correlation with anti-viral response. 40th Annual Meeting of the
European Association for the Study of the Liver (EASL), Paris. April
14, 2005. (Abstract #447).
21. Osborn B, Olsen H, Nardelli B, et al. Pharmacokinetic and
Pharmacodynamic Studies of a Human Serum Albumin-Interferon-a Fusion
Protein in Cynomolgus Monkeys. J Pharmacol Exp Ther 2002 Nov; 303:
540-548.
22. Neumann AU et al. The second phase HCV decline slope is the best
predictor of sustained viral response during treatment of chronic HCV
genotype 1 patients with peg-interferon-a-2b and ribavirin. 53rd
Annual Meeting of the American Association for the Study of Liver
Diseases, Boston. November 1-5, 2002. Abstract #778. Hepatology
2002: Vol 36 No 4, Pt 2 of 2.
23. Di Bisceglie AM, Rustgi VK, Thuluvath P, et al. Pharmacokinetics and
pharmacodynamics of pegylated interferon alfa-2a or alfa-2b with
ribavirin in treatment naive patients with genotype 1 chronic
hepatitis C. Hepatology 2004;40,4;734a, abstract LB18.
24. PEGASYS(R) Physicians Desk Reference. (Last updated December 2003).
25. PEG-INTRON(R) Physicians Desk Reference. (Last updated September
2003).
CONTACT: Jerry Parrott, Vice President, Corporate Communications,+1-301-315-2777, or Kate de Santis, Director, Investor Relations,+1-301-251-6003, both of Human Genome Sciences, Inc.
Web site: http://www.hgsi.com/
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