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标题: Assembly的HBV核心抑製劑的臨床數據在Digital Internati [打印本页]

作者: StephenW    时间: 2020-8-30 12:39     标题: Assembly的HBV核心抑製劑的臨床數據在Digital Internati

Clinical Data from Assembly Biosciences' HBV Core Inhibitors Presented at The Digital International Liver CongressTM EASL 2020
August 28, 2020 | About: ASMB +2.31%

SOUTH SAN FRANCISCO, Calif., Aug. 28, 2020 (GLOBE NEWSWIRE) -- Assembly Biosciences, Inc. ( ASMB), a clinical-stage biotechnology company developing innovative therapeutics targeting hepatitis B virus (HBV) and diseases associated with the microbiome, announced that clinical data for its lead HBV core inhibitor vebicorvir (VBR, or ABI-H0731), its second-generation core inhibitor ABI-H2158, as well as its highly sensitive HBV assays were highlighted during The Digital International Liver Congress™(ILC), the Annual Meeting of the European Association for the Study of the Liver (EASL).

“The long-term clinical data in a broad patient population continue to demonstrate vebicorvir’s favorable safety profile and ability to achieve deeper reductions in HBV DNA and pgRNA than the current standard of care alone,” said Scott Fung, MD, FRCPC, Associate Professor, Department of Medicine, University of Toronto. “A combination therapy resulting in improved viral suppression also has the potential to result in higher off-treatment response rates, which would be an important advancement for the field of HBV and the millions of patients living with this chronic disease.”

“This has been an important year of progress and execution across our portfolio of HBV core inhibitors,” said John McHutchison, AO, MD, Chief Executive Officer and President of Assembly. “At EASL this year, we are pleased to share four presentations with the medical and scientific communities. We believe that core inhibitors are central to future finite and also curative strategies for chronic HBV infection, and we look forward to moving ahead with current and additional trials as we drive toward these goals for patients living with this disease. To that end, we are excited that patients meeting the stopping criteria continue coming off treatment with vebicorvir and standard-of-care therapy in our Phase 2 open-label extension study. We are now following these patients to assess for sustained virologic response (SVR) following treatment.”

EASL Digital International Liver Congress Presentations
The oral presentation and posters are available in the Investors section of Assembly’s website.

Vebicorvir (VBR, or ABI-H0731), Assembly’s Lead HBV Core Inhibitor
Oral Presentation AS070: Antiviral activity and safety of the hepatitis B core inhibitor ABI-H0731 administered with a nucleos(t)ide reverse transcriptase inhibitor (NrtI) in patients with HBeAg-negative chronic hepatitis B infection
Lead Author: Scott Fung, MD, FRCPC, Associate Professor, Department of Medicine, University of Toronto

Key Results:

    Assembly’s novel core inhibitor vebicorvir in combination with standard-of-care NrtI continues to demonstrate a favorable safety and tolerability profile, with no observed treatment-emergent resistance in patients with HBeAg negative chronic HBV infection in this ongoing Phase 2 clinical trial (Study 211).
    Approximately 30% of patients were virologically-suppressed at baseline as measured by commercial assays but had evidence of residual viral replication using Assembly’s highly sensitive HBV DNA assay. This viral replication was detected even though these patients had received chronic, long-term NrtI therapy (mean duration 4 years).
    After adding VBR to chronic NrtI therapy, nearly all patients reached undetectable levels of HBV DNA.
    All patients have achieved HBV DNA + pgRNA levels less than the limit of quantification by Assembly’s highly sensitive composite assay, which is a component of the study’s stopping criteria.
    Assembly continues to project that approximately 88% of patients initially enrolled in Study 211 will achieve its stopping criteria and will be taken off therapy to be assessed for SVR.

Late-Breaking Poster LBP30: Antiviral activity and safety of the hepatitis B core inhibitor ABI-H0731 administered with a nucleos(t)ide reverse transcriptase inhibitor in patients with HBeAg-positive chronic hepatitis B infection in a long-term extension study
Lead Author: Man-Fung Yuen MD, PhD, Chief of Division of Gastroenterology and Hepatology, Queen Mary Hospital, Hong Kong

Key Results:

    Vebicorvir in combination with NrtI continues to demonstrate a favorable safety and tolerability profile, with no observed treatment-emergent resistance in patients with HBeAg positive chronic HBV infection in Study 211.
    In treatment-naïve patients with HBeAg positive chronic HBV infection:
        The addition of VBR to NrtI therapy led to greater declines in HBV DNA and pgRNA and ALT normalization.
    Currently, it is projected that approximately 65% of these patients will achieve an initial virologic response and extend treatment with VBR and NrtI for an additional 48 weeks to enable these patients to reach the stopping criteria.
    In virologically-suppressed patients with HBeAg positive chronic HBV infection:
        The addition of VBR to NrtI therapy led to greater proportions of patients achieving undetectable HBV DNA and pgRNA levels, as measured by Assembly’s highly sensitive HBV nucleic acid assays.
        Assembly continues to project that approximately 49% of these patients initially enrolled in Study 211 will achieve its stopping criteria to be taken off therapy to be assessed for SVR.

ABI-H2158, Assembly’s Second-Generation HBV Core Inhibitor
Late-Breaking Poster LBP05: Antiviral activity, pharmacokinetics and safety of the second-generation hepatitis B core inhibitor ABI-H2158 in a Phase 1b study of patients with HBeAg-positive chronic hepatitis B infection
Lead Author: Kosh Agarwal, MD, Kings College Hospital, London

Key Results:

    Assembly’s second-generation core inhibitor ABI-H2158 is approximately ten-fold more potent against cccDNA formation than its first-generation core inhibitor VBR in preclinical in vitro assays.
    In this Phase 1b dose-ranging clinical trial, ABI-H2158 demonstrated a favorable safety profile when orally administered for 14 days at doses of 100, 300, and 500 mg daily.
    Dose-dependent reductions in HBV DNA and pgRNA were observed.
    At the 300-mg dose, the mean decline from baseline to day 15 in HBV DNA and pgRNA levels were 2.5 log10 IU/mL and 2.3 log10 U/mL, respectively.
    ABI-H2158 is being evaluated in an ongoing randomized, placebo-controlled Phase 2 clinical trial (n=80) where treatment-naïve patients with HBeAg positive chronic HBV infection are being treated with ABI-H2158 at the 300 mg dose in combination with entecavir.

Assembly’s Highly Sensitive HBV Assays
Poster FRI403: Development of a highly sensitive multiplex platform assay to monitor low levels of HBV DNA and pgRNA in samples from patients with chronic hepatitis B
Lead Author: Qi Huang, PhD, Vice President, Virology Discovery, Assembly Biosciences

Key Highlights:

    There is a need for new assays as the HBV field moves toward finite treatment.
        Assembly’s assays provide greater sensitivity than the currently available commercial HBV DNA assays.
        There are no approved assays for HBV pgRNA, and recent research suggests that pgRNA is associated with persistent HBV replication and pgRNA negativity is a predictive marker for off-treatment response.
    In samples from virologically-suppressed patients on chronic NrtI therapy in Study 201, the majority of patients who were negative for HBV DNA <20 IU/mL as measured by the COBAS assay were found to be positive using Assembly’s highly sensitive HBV Total Nucleic Acids assay. This demonstrates the limitations of current commercial assays.
    Assembly’s composite quantitative PCR assay allows for simultaneous detection and measurement of HBV Total Nucleic Acids (HBV DNA and HBV pgRNA), which has been incorporated in guiding treatment discontinuation decisions.

About Assembly Biosciences’ HBV Core Inhibitor Portfolio
Assembly’s HBV portfolio includes three clinical-stage small molecule candidates, all of which are HBV core inhibitors that target multiple steps of the HBV lifecycle. In Phase 2 clinical trials, first-generation core inhibitor vebicorvir (VBR, or ABI-H0731) administered with nucleos(t)ide analogue reverse transcriptase inhibitor (NrtI) therapy has been well-tolerated, has shown statistically superior antiviral activity in HBV DNA suppression compared to NrtI therapy alone, and has demonstrated significant declines in HBV pgRNA that may indicate decreased cccDNA levels. In the ongoing Phase 2 open-label extension trial, Assembly has begun transitioning patients off combination therapy, to then monitor for sustained virologic response (SVR).

Assembly’s HBV portfolio also includes two more potent, second-generation candidates, ABI-H2158 in a Phase 2 clinical trial and ABI-H3733 in Phase 1 development.

Vebicorvir and ABI-H2158 both have been granted Fast Track designation by the U.S. Food and Drug Administration for the treatment of chronic HBV infection.


作者: StephenW    时间: 2020-8-30 12:39

大會生物科學公司的HBV核心抑製劑的臨床數據在Digital International Liver CongressTM EASL 2020上發表
2020年8月28日|關於:ASMB + 2.31%

加利福尼亞州南舊金山,2020年8月28日-全球生物技術公司Assembly Biosciences,Inc.(ASMB),該公司致力於開發針對乙型肝炎病毒(HBV)和與微生物組相關疾病的創新療法,宣佈在Digital International Liver Congress™(ILC)期間重點介紹了其領先的HBV核心抑製劑vebicorvir(VBR或ABI-H0731),第二代核心抑製劑ABI-H2158的臨床數據以及高度敏感的HBV分析,歐洲肝臟研究協會(EASL)的年會。

“在廣泛的患者群體中,長期的臨床數據繼續表明,vebicorvir的安全性良好,並且能夠比目前的單獨治療標準更進一步降低HBV DNA和pgRNA,” FRCPC醫學博士Scott Fung表示,多倫多大學醫學系。 “能夠改善病毒抑製作用的聯合療法也有可能導致更高的非治療反應率,這對於HBV領域和數百萬患有這種慢性疾病的患者而言將是一個重要的進步。”

“這是我們HBV核心抑製劑產品系列取得進展和執行的重要一年,” AO總經理兼大會主席AO醫師John McHutchison說。 “在今年的EASL,我們很高興與醫學和科學界分享四個演講。我們相信核心抑製劑是未來慢性HBV感染有限和治療策略的核心,並且我們期待著為患有該病的患者實現這些目標,從而繼續進行當前和其他試驗。為此,我們感到興奮的是,在我們的第二階段開放標籤擴展研究中,符合停止標準的患者繼續接受依維比韋韋和護理標準療法的治療。我們現在正在追踪這些患者,以評估治療後的持續病毒學應答(SVR)。”

EASL數字國際肝臟大會演講
大會網站的“投資者”部分提供了口頭介紹和海報。

Vebicorvir(VBR或ABI-H0731),裝配體的主要HBV核心抑製劑
口服藥物AS070:乙型肝炎核心抑製劑ABI-H0731與核苷(t)逆轉錄酶抑製劑(NrtI)聯合使用對HBeAg陰性的慢性乙型肝炎患者的抗病毒活性和安全性
主要作者:馮國道醫學博士,FRCPC,多倫多大學醫學系副教授

主要結果:

    Assembly的新型核心抑製劑vebicorvir與護理標準NrtI的結合繼續顯示出良好的安全性和耐受性,在這項正在進行的2期臨床試驗中,未觀察到HBeAg陰性慢性HBV感染患者的治療緊急耐藥性(研究211) 。
    通過商業化檢測,大約有30%的患者在基線時被病毒抑制,但是使用Assembly的高度敏感的HBV DNA檢測,有殘留病毒複製的跡象。即使這些患者接受了長期的長期NrtI治療(平均持續時間為4年),也可以檢測到這種病毒複製。
    在慢性NrtI治療中加入VBR後,幾乎所有患者的HBV DNA含量均達到不可檢測的水平。
    所有患者的HBV DNA + pgRNA水平均低於Assembly的高度敏感的複合測定法(該研究的停止標準的組成部分)的定量極限。
    大會繼續預測,最初參與研究211的患者中約88%將達到其停止標準,並將退出治療以評估SVR。

晚期突破海報LBP30:長期延伸研究中,HBeAg陽性慢性乙型肝炎感染患者中給予核苷酸逆轉錄酶抑製劑的乙型肝炎核心抑製劑ABI-H0731的抗病毒活性和安全性
主要作者:袁文峰博士,香港瑪麗醫院消化內科和肝病科主任

主要結果:

    Vebicorvir聯合NrtI繼續顯示出良好的安全性和耐受性,在研究211中,未觀察到HBeAg陽性慢性HBV感染患者的治療緊急耐藥性。
    在未經治療的HBeAg陽性慢性HBV感染患者中:
        在NrtI治療中添加VBR會導致HBV DNA和pgRNA以及ALT正常化程度的更大下降。
目前,預計這些患者中約有65%將獲得初始病毒學應答,並將VBR和NrtI治療延長48週,以使這些患者達到終止標準。
    在病毒學抑制的HBeAg陽性慢性HBV感染患者中:
        通過Assembly的高度敏感的HBV核酸檢測,VBR被添加到NrtI治療中,導致更多的患者達到無法檢測到的HBV DNA和pgRNA水平。
        大會繼續預測,最初參加研究211的這些患者中,大約49%將達到停止治療的標準,以接受SVR評估。

大會的第二代HBV核心抑製劑ABI-H2158
最新突破海報LBP05:第二代乙型肝炎核心抑製劑ABI-H2158在HBeAg陽性慢性乙型肝炎患者的1b期研究中的抗病毒活性,藥代動力學和安全性
主要作者:倫敦國王學院醫院醫學博士Kosh Agarwal

主要結果:

    在臨床前體外試驗中,Assembly的第二代核心抑製劑ABI-H2158對cccDNA形成的效力是其第一代核心抑製劑VBR的十倍。
    在此1b階段的劑量範圍臨床試驗中,ABI-H2158以每天100、300和500 mg的劑量口服14天顯示出良好的安全性。
    觀察到HBV DNA和pgRNA的劑量依賴性降低。
    在300 mg劑量下,HBV DNA和pgRNA水平從基線到第15天的平均下降分別為2.5 log10 IU / mL和2.3 log10 U / mL。
    ABI-H2158正在一項正在進行的,隨機,安慰劑對照的第二階段臨床試驗(n = 80)中進行評估,其中初治的HBeAg陽性慢性HBV感染患者需接受300 mg劑量的恩替卡韋聯合ABI-H2158的治療。

組裝的高度敏感的HBV檢測
海報FRI403:開發一種高靈敏度的多重平台檢測方法以監測慢性乙型肝炎患者樣品中的低水平HBV DNA和pgRNA
主要作者:黃琦,博士,Assembly Biosciences病毒發現副總裁

主要亮點:

    隨著HBV領域向有限治療邁進,需要新的檢測方法。
        組裝檢測法比目前市售的HBV DNA檢測法靈敏度更高。
        尚無批准的HBV pgRNA檢測方法,最近的研究表明pgRNA與持久性HBV複製有關,而pgRNA陰性是治療後反應的預測指標。
    在研究201中接受慢性NrtI治療的受病毒抑制的患者的樣本中,使用Assembly的高度敏感的HBV總核酸檢測法,通過COBAS分析測得的大多數HBV DNA <20 IU / mL陰性的患者為陽性。這證明了當前商業測定法的局限性。
    Assembly的複合定量PCR分析法可同時檢測和測量HBV總核酸(HBV DNA和HBV pgRNA),該核酸已被納入指導治療終止的決策中。

關於Assembly Biosciences的HBV核心抑製劑產品組合
Assembly的HBV產品組合包括三個臨床階段的小分子候選物,所有這些都是針對HBV生命週期多個步驟的HBV核心抑製劑。在2期臨床試驗中,對核苷酸類似物逆轉錄酶抑製劑(NrtI)給藥的第一代核心抑製劑韋比考韋(VBR或ABI-H0731)具有良好的耐受性,在HBV DNA中具有統計學上優越的抗病毒活性與單獨使用NrtI治療相比,其抑製作用顯著降低,並且已證明HBV pgRNA顯著下降,這可能表明cccDNA水平下降。在正在進行的2期開放標籤擴展試驗中,Assembly已開始將患者從聯合治療中轉移出來,然後監測持續的病毒學應答(SVR)。

Assembly的HBV產品組合還包括另外兩個有效的第二代候選產品,即處於2期臨床試驗的ABI-H2158和處於1期開發的ABI-H3733。

Vebicorvir和ABI-H2158均已獲得美國食品和藥物管理局的快速通道認證,可用於治療慢性HBV感染。
作者: newchinabok    时间: 2020-8-30 13:18

真心没看懂
作者: windu    时间: 2020-8-30 15:17

目前病毒检测下限其实还存在病毒,然后0731可以把这个下限降低,甚至降到0?不知道是不是这个情况,算是积极信号吗?
作者: windu    时间: 2020-8-30 15:25

当pgRNA达到检测下限时,停止用药进行观察评估,就是说验证cccdna完全耗尽以后是否能达成功能性治愈?
作者: 乙肝人1949    时间: 2020-8-30 22:37

其实,核苷类药也可以让hbsag,慢慢减少。不过这种减少是间接性的,不是直接作用hbSag,君不见8年恩替卡韦,也有一小部分人hbsag转阴吗。说明核苷可以减少hbsag。但为什么表面抗原哀减慢,可能确实核苷类,歼杀hbsDNa存在漏网之鱼,使的CcCDna,一直有补充。如果从这个方面来说,O731+核苷可以使这个漏洞堵的更严实,基本半年hbvDNa和rna基本降低非常低水平,而且持续降。(但是不是绝对零数值不清楚)。如果随着时间推移,CCcDna少了这个循环补充通道,可让CCCDna下降速度快点。但CcCDNa有其他循环补充通道如肝内感染新生肝细胞
作者: 乙肝人1949    时间: 2020-8-30 22:43

其实,我个人非常期待,这2到3年能有一款新药能出来估计都是非常好的,这样可以加入到,核苷+干扰素:的组合中,通过中国医生的一顿操作,肯定做出大餐,大大提高治愈率
作者: StephenW    时间: 2020-8-31 12:19

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"但CcCDNa有其他循环补充通道如肝内感染新生肝细胞" - 请问 "肝内感染新生肝细胞" 是什么
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