消息来源:2012 AASLD
Myrcludex to be presented at AASLD in Nov 2012
新型HBV和HDV进入抑制剂Myrcludex首次人体药物安全试验成功
Successful first administration of Myrcludex B, a first-in-class Hepatitis B and D Virus entry inhibitor, in humans
ABSTRACT BODY: Background and aims: Current antiviral therapies for
chronic hepatitis B virus (HBV) and hepatitis D virus (HDV) infections
are limited and mostly non-curative. This requires the development of
novel strategies interfering with hitherto unaddressed steps of virus
replication. Myrcludex B an HBV envelope-protein derived lipopeptide
specifically inactivates an essential HBV/HDV-receptor on
differentiated hepatocytes. Myrcludex B is highly effective against
HBV and HDV in animal models, has successfully passed preclinical
studies and represents the first-in-class entry inhibitor for HBV/HDV
infection. We have conducted a prospective, open-label,
non-randomized, non-controlled Phase 0/1 clinical study to evaluate
safety, tolerability, pharmacokinetics (PK), and immunogenicity of
single ascending doses of Myrcludex B in healthy volunteers.
Methods: Single doses of Myrcludex B (0.3, 3, 10, 100, 800, 3000, and
5000 µg) were administered IV or SC (800 µg) to cohorts of 3
participants, followed up for 28 days. Dose escalation to the
subsequent higher dose was performed after positive safety evaluation
of comprehensive clinical and laboratory data by an independent Data
Safety Monitoring Board. Plasma concentrations were determined by
HPLC-MS from repeated samples collected up to 72h after dosing and PK
parameters were calculated using a two-compartment model.
Immunogenicity was studied by RIA.
Results: 24 participants were exposed and 53 adverse events were
recorded (none was serious). All events were transient, recovered
without sequelae, did not show a pathophysiological relation to the
study drug’s mode of action, and appeared dose-independent. No signs
of liver involvement were detected. PK in humans was linear up to the
dose of 3 mg. At dose exposures of 5 mg, markedly increased plasma
concentrations and decreased clearance were observed possibly
indicating saturation of the central compartment (liver). This result
was consistent with in vivo studies in different species, including
chimpanzee. No anti-drug antibodies (ADA) were detected.
Conclusion: Myrcludex B was very well tolerated in healthy volunteers
for all investigated doses for up to 5 mg IV and 0.8 mg SC. The PK
profile is in line with the expectations based on animal studies.
Continuation to multiple dose human studies is encouraged by these
results.
从MedHelp的Studyforhope的评论]
Here is the most important aspect of this research:
以下是本研究的最重要的方面:
These results show the dosing at which a saturation of liver binding sites can be expected. That is approx 3mg. Since a complete saturation is not necessary to cause a complete block of HBV entry, the truly required dose can be estimated to be in the range of 1mg or less. This was thus far just a wild educated guess, now it is established by exact measurement of PK parameters.I consider this a sensational breakthrough of this liver conference, since it places the Myrcludex treatment in a dose range that is doable and affordable and will work with clockwork certainty in humans to achieve the effect of complete blockage of viral spreading, and allow any processes of infected cell reduction to lead to a continuous decrease of cccDNA.
While the speed of such reduction will vary widely from patient to patient and depend on his HBV specific Tcell and other immune activities, it will lend itself to acceleration by interferon or even better by Replicor, which will open an attack on surface antigen specific epitopes that have not been used due to the blocking action of high levels of HbSAg.
[Posts from MedHelp]
According to the Ministry of Health to the site by typing in the study of 36 people, many of them on baraklyude can only guess, probably half. The other half - the mirklyudekse divided into three groups with different doses.
Will there be someone to take a survey? I think not, and so normal.
Yes, according to the protocol the end of second phase of research - 31.12.2013.
Наименование организации, осуществляющей проведение КИ: ООО "Гепатера"
Цель клинического исследования: Изучение терапевтической эффективности трех различных доз препарата Мирклудекс Б (подбор оптимальных дозировок лекарственного препарата), и его клинической безопасности, а именно: оценка изменения уровня HBsAg под воздействием лечения 3-мя различными дозами препарата, оценка вирологического ответа на лечение (уровень HBV DNA), биохимический ответ на лечение, а также изучение фармакокинетического профиля и иммуногенности препарата у пациентов с HBeAg–негативным хроническим вирусным гепатитом В
Начало 13.08.2012
Окончание 31.12.2013
"Mirkludeks B» (Myrcludex B)
Resolution № 231
Name of organization conducting clinical trials: OOO "Gepatera"
The purpose of the clinical study was to assess the therapeutic efficacy of three different doses of the drug Mirkludeks B (selection of optimal dose of the drug), and its clinical safety, namely: assessment of changes in the level of HBsAg under the influence of treatment with 3 different doses of the drug evaluation virologic response to treatment (level HBV DNA), biochemical response to treatment, and to study the pharmacokinetic profile and immunogenicity of the drug in patients with HBeAg-negative chronic hepatitis B