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肝胆相照论坛

 

 

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ARC-520 [复制链接]

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671
发表于 2014-12-16 20:51 |只看该作者
淡定,明年年底等消息
还有4774
莫非赛定

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风雨同舟

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发表于 2014-12-16 20:54 |只看该作者
从rep9ac 到arc520 再到brainpant,一步步,大家都来对付hbsag了,说明学术界已经统一了治疗的思路,hbsag是免疫耐受的关键物质,人体在年幼时感染病毒后很难清除,但如果成年后感染病毒,就很容易清除病毒自愈,说明了什么,其实何时感染病毒,都无所谓,病毒也无法改变我们的身体,他就像血液中混入的一些沙子,污染了血液,但不会改变血液的成本和生成的机制,究其原因还是在于,幼年时感染病毒,由于人体的免疫系统还未成熟,无法识别病毒蛋白,(hbsag)所以造成病毒大量复制了hbsag,这个东西就是抑制免疫反应的关键物质,所以hbsag是一种免疫抑制剂,此前人类的抗病毒策略是抑制病毒复制,把病毒复制控制在低端,但问题是即使抑制复制,但病毒的hbsag还是没有受到很大的抑制,所以无法清除病毒。
真正的清除病毒,不是靠核苷,不是靠干扰素,而是靠人体本身的物质,乙肝是自限性病毒,人体在免疫激发的状态下可以自动消灭病毒,如果要恢复免疫功能,可以用这样的思路,把病毒控制到地复制状态,同时抑制表抗的分泌,然后再激发免疫系统,最后一举攻破免疫耐受。
以前听说过幼儿如果感染病毒,及时治疗也是可以完全转阴的,我想就是这个道理,也就是,即使已经感染病毒,但乘病毒立足未稳的时候,一举攻下去,虽然辛苦点,确实可以攻破。
不管是rep9ac 还是arc520 还是brainpant都是这个思路,但我觉得这些药物要起作用,还是会需要核苷类药物的配合,那样胜算会大很多。希望抛砖引玉,期待大家的正面探讨。
日行一善(百善孝为先)

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673
发表于 2014-12-17 09:16 |只看该作者
赞同楼上的意见

不过,大家的讨论没用

只有各大制药公司积极参与,多做实验才能成功

假如论坛上有真正的土豪,或者谁认识有乙肝的土豪,希望大家积极游说土豪们投资,这个才是王道

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发表于 2014-12-17 09:17 |只看该作者
得乙肝的明星不少

土豪还真不知道

不过百富榜上按比例肯定有的

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675
发表于 2014-12-17 12:50 |只看该作者
找政府为我们做后台建立乙肝研究基金会,然后找靠得住的监都,实施!

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才高八斗

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发表于 2014-12-20 04:43 |只看该作者
Arrowhead, Despite ailing Stock, Reloads in RNAi Hepatitis B Fight
Jeff Engel is the editor of Xconomy Wisconsin. Email: [email protected]

Arrowhead Research has had a rough couple of months, but that hasn’t put CEO Christopher Anzalone in panic mode—far from it.

The Pasadena, CA-based biotech company’s (NASDAQ: ARWR) stock price has fallen off a cliff, largely a result of investors getting spooked by some early data in the company’s ongoing Phase 2a study of its RNA interference (RNAi) drug intended to treat hepatitis B, a viral infection that can cause cirrhosis or cancer of the liver.

The data, released in October, prompted multiple law firms to file lawsuits on behalf of investors against Arrowhead, alleging that the company misled them about the experimental drug’s potency. Anzalone says the lawsuits have “no merit,” and he believes the company will prevail in those cases.

He remains upbeat about the company’s technology—which is being developed in Madison, WI—and sees the recent stock decline as just a bump in the road to commercialization.

“We hope that whatever happened over the last two months is really just noise in the long run,” Anzalone says. “Our primary goal here is to create drugs that are going to transform medicine across multiple applications. If we can do that, that’s going to create a ton of value for our shareholders.”

To get there, Arrowhead will have to make good on the promise of RNAi drugs, a field that enjoyed a lot of hype and billions of investment dollars over the last decade, but which has its fair share of skeptics because the technology has struggled to produce clinically successful drugs.

RNAi therapies aim to prevent disease-related genes from producing proteins that would otherwise wreak havoc in the body. A big stumbling block for developers of these drugs has been finding reliable ways to deliver the short RNA strands that they’re based upon to diseased cells before the delicate molecules break down. Arrowhead’s approach to this problem is to use polymer nanoparticles called dynamic polyconjugates to shepherd the RNAs through the body, shielding them from destructive enzymes until they reach the target cells. Its lead candidate, ARC-520, uses this nanoparticle system to deliver an RNA that attacks hepatitis B by blocking its production of a protein that is believed to help protect the virus from the immune system. Take that protein out of the equation, the idea goes, and the immune system can more effectively battle the disease.

Arrowhead is trying to find the right dosage level that will result in a 90 percent “knockdown” of the target hepatitis protein after just one dose of ARC-520, a target Anzalone has admitted is “somewhat arbitrary.” Indeed, he says, no one knows how much of a reduction in the protein is enough to enable the immune system to win against hepatitis B—or if such a conquest is even possible.

The data that Arrowhead has released so far from a 24-patient Phase 2a study showed that a 1 mg/kg dose of ARC-520 resulted in an average peak 39 percent reduction of the target protein, while twice that dose produced a 51 percent drop. The company hasn’t yet released data for a third group of patients who received 3 mg/kg of the drug, and it is still recruiting a fourth group that would receive 4 mg/kg.

Those numbers have clearly disappointed Wall Street. Arrowhead shares tumbled 41 percent on Oct. 8, the day the preliminary data was made public, going from $11.92 per share at the opening bell to $7.03 per share at close. Lately, the stock has been trading around $5 or $6 per share. That’s a far cry from the 52-week apex of $27.63 per share. The company is valued at $334 million, down from about $400 million on Oct. 9.

Neither did the Phase 2a data impress W. Thomas London, a physician and hepatitis researcher at Fox Chase Cancer Center in Philadelphia, who has collaborated with Baruch Blumberg, the discoverer of the hepatitis B virus. “I’m not overwhelmed … because the drug did not reduce the level of [the protein] to zero with one injection,” London says of Arrowhead’s early data. There was still a lot of viral material present and “presumably a lot of virus still being made. I would call it a marginal result.”

To be fair, those were “just the first doses of a dose escalation study,” Anzalone says. “We had said all along we were confident we were going to get good, deep knockdown, we just didn’t know what dose would be required to get there in humans.” He sees promise in the early data because the drug so far appears to be safe, and it’s demonstrating an impact on the target protein, albeit not as much of an impact as the company is ultimately hoping to achieve.

He’s also encouraged by the duration of the drug’s effect. The company thought the biggest reduction in the viral protein might be seen around 10 to 14 days after the dose, but then it expected it to return to baseline levels by around the 30th day, Anzalone says. Instead, the second-highest dose showed a statistically significant effect for 43 days, with the peak typically seen on day 33.

“We thought that was a good starting point,” Anzalone says. “Just imagine as we increase the dose and as we provide a multiple dose regimen, what kind of knockdown we’re going to see. We’re really excited about that.”

But that theory still needs to be proven in additional clinical trials, and the company must demonstrate the drug’s safety with a larger group of patients, Anzalone says. “There’s clearly still a lot of risks ahead of us.”

While Arrowhead completes the Phase 2a study, it’s moving forward with two Phase 2b studies that will test the effects of multiple doses of ARC-520 in combination with commercially available hepatitis B treatments entecavir (Baraclude) and tenofovir (Viread). Arrowhead filed an investigational new drug application with the FDA this week, and it’s planning to seek approval for similar studies in Europe and Asia.

The company might also run pilot studies of ARC-520 in combination with drugs that stimulate the immune system, and it will try dosing schedules that are more or less frequent than the once-a-month regimen used in the current anchor studies, Anzalone says. The company might also explore subcutaneous delivery of ARC-520, which to date has been administered intravenously, he adds.

“We’re going to be learning an awful lot about this virus, how we’re going to attack this virus, throughout 2015,” Anzalone says.

It helps to have a $132.5 million cash stockpile, according to the company’s most recent disclosure. That allows Arrowhead to conduct multiple trials at once, without the help of a business partner, and it also provides some insulation against a fluctuating stock price, Anzalone says. “We have the luxury of being able to keep our heads down and focus on” the company’s work, he adds.

Still, Arrowhead probably can’t afford any major setbacks because the competition to develop better hepatitis B treatments is heating up. Gilead Sciences (NASDAQ: GILD) has three drugs in its pipeline, including one in Phase 3 trials, but none of those are RNAi drugs. Alnylam Pharmaceuticals (NASDAQ: ALNY), however, is developing an RNAi drug targeting hepatitis B. It acquired the technology when it bought Sirna Therapeutics from Merck in January for $175 million.

That’s an interesting twist because Alnylam and Arrowhead signed a cross-licensing deal in 2012 in which Alnylam licensed its RNAi chemistry technology for hepatitis B to Arrowhead—that’s what ARC-520 is based around—and Arrowhead licensed its dynamic polyconjugates delivery technology to Alnylam, which it can use for a disease target that has yet to be disclosed, Anzalone says.

Biotech is “full of stories of competitors collaborating on some drugs and competing on other drugs. That just is going to happen,” Anzalone says. Arrowhead is focused on getting its hepatitis B drug to market as quickly as possible, and he notes that it entered clinical trials in mid-2013, while Alnylam won’t enter the clinic until 2016. “We’ll have a substantial lead on them,” Anzalone says. “We also just need to make sure that we have a better drug.”

More companies are trying to develop hepatitis B treatments in part because a flurry of hepatitis C treatments have been approved in the past three years that, in tandem with earlier approved drugs, effectively cure that disease. Those new treatments include Gilead’s sofosbuvir (Sovaldi), Gilead’s combined sofosbuvir and ledipasvir (Harvoni), Janssen Therapeutics’ simeprevir (Olysio), and Merck’s boceprevir (Victrelis). Now, some companies have set their sights on hepatitis B.

About 350 million people worldwide suffer from chronic hepatitis B—more than double those who suffer from chronic hepatitis C. So, why did hepatitis C get “solved” first?

Turns out, the two diseases manifest themselves in completely different ways, and hepatitis B has proven to be a more difficult nut to crack than hepatitis C, London says. The hepatitis B virus lodges itself in the DNA of liver cells, which complicates things. Hepatitis C, meanwhile, replicates itself in the cytoplasm of cells, rather than in the nucleus. “It is more accessible to drugs, and that’s what’s turned things around,” London explains.

Currently, typical hepatitis B treatment involves drugs, like entecavir and tenofovir, that prevent the existing copies of virus from replicating, but don’t eradicate them, so patients have to take the medications for the rest of their lives, London says. And even with antiviral treatment, the patients still have a heightened risk of developing cirrhosis of the liver and cancer, Anzalone says.

For his part, London thinks RNAi is an “interesting” technology that could be useful in fighting hepatitis B, but he’s doubtful it holds the answer to defeating the virus for a variety of reasons related to the biology of the virus and the way it hides out in the liver cells it infects. “If it happened, it’d be wonderful,” he says, “but I just am skeptical.”

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发表于 2014-12-20 04:44 |只看该作者
箭头,尽管疲弱的股票,在重新加载RNA干扰乙肝战斗
杰夫·恩格尔是Xconomy威斯康星编辑器。电子邮件:[email protected]

箭头研究已经有了一个大概的几个月,但是这并没有把CEO克里斯托弗·Anzalone恐慌模远非如此。

帕萨迪纳,CA为基础的生物科技公司(NASDAQ:ARWR)股价已经跌落悬崖,主要是投资者的结果得到惊吓由公司正在进行2a期的RNA干扰(RNAi)药物研究一些早期数据用于治疗乙型肝炎,病毒感染,可能导致肝硬化或癌症。

的数据显示,10月发布,促使多个律师事务所提交代表投资者对箭头的诉讼,指控该公司误导了他们对实验性药物的效力。 Anzalone说,官司有“没有好处”,他相信该公司将在这些情况下为准。

他仍然看好公司的技术,这是正在开发的麦迪逊,WI-并认为近期股市下跌在商业化之路只是一个肿块。

“我们希望,不管发生在过去两个月中真的只是噪音,从长远来看,”Anzalone说。 “我们这里的首要目标是创造药物要跨多个应用程序变换药。如果我们能做到这一点,那将创造大量的价值,我们的股东。“

为了达到这个目标,箭头会好好对RNAi药物,即享受了很多炒作和数十亿美元的投资在过去十年的领域的承诺,但有其合理怀疑的份额,因为这项技术一直在努力生产临床成功的药物。

的RNAi疗法旨在防止疾病相关的基因从生产的蛋白质,否则将造成严重破坏在体内。这些药物开发的一大绊脚石已经找到可靠的方式来提供,他们正在根据患病细胞前的微妙分子分解的短RNA链。箭头的办法处理这一问题的方法是使用所谓的动态polyconjugates通过身体来牧养的RNA纳米聚合物,破坏性酶保护他们,直到他们到达靶细胞。它的主角候选人,ARC-520,采用这种纳米粒子的系统提供了通过阻断其生产被认为有助于保护病毒的免疫系统蛋白质的攻击乙肝的RNA。取该蛋白质的方程,这个想法的推移,和免疫系统可以更有效地战斗的疾病。

箭头正试图找到合适的剂量水平,这将导致在短短的一剂ARC-520后,90%的“击倒”的目标肝炎蛋白质,Anzalone承认的目标是“有点武断。”事实上,他说,没有人知道多少,在蛋白质的减少,就足以使免疫系统战胜乙肝,或者如果这样的征服甚至有可能。

该箭头从24病人2a期研究发布至今的数据表明,1毫克/公斤剂量的ARC-520后,目标蛋白的平均峰值降低了39%,而两倍剂量产生了51%的下降。该公司尚未公布数据的谁收到的药物3毫克/公斤患者第三组,它仍然是招募,将收到4毫克/公斤的第四组。

这些数字清楚地失望了华尔街。箭头股价重挫10月8日,根据初步数据公布当天41%,从11.92美元每股打算在开盘至7.03美元每股报收。最近,该股目前的交易约为5或每股6美元。这是一个相去甚远27.63美元每股52周的顶点。该公司价值为3.34亿美元,从约4亿美元下降10月9日。

也没有2a期的数据打动W.托马斯伦敦,一名医生和肝炎研究员Fox Chase癌症中心在费城,谁曾与巴鲁克布隆伯格,乙肝病毒的发现者。 “我不是不知所措......因为药物[蛋白质]的水平没有降低到零注射一次,”伦敦说的箭头的早期数据。仍然存在着大量的病毒材料现在和“想必很多病毒仍在进行。我把它叫做边际的结果。“

公平地说,这些人“只是第一剂剂量递增的研究,”Anzalone说。 “我们说,一直以来,我们有信心,我们将要获得良好的,深刻的击倒,我们只是不知道什么剂量将需要到那里的人类。”他认为,承诺在早期的数据,因为该药物至今出现是安全的,并且它显示出靶蛋白上的冲击,尽管没有那么多的影响,因为该公司最终希望达到。

他还鼓励药物的效果持续时间。公司认为在病毒蛋白质的最大减少可能会在给药后10至14天左右可见,但随后,预计它通过恢复到基线水平周围的第30天,Anzalone说。取而代之的是,第二高剂量表现出统计学显著效果43天,用通常看到的第33天的峰值。

“我们认为这是一个很好的起点,”Anzalone说。 “试想一下,当我们增加剂量,并为大家提供了多剂量方案,我们要去什么样的击倒的看到。我们真的很兴奋。“

但这一理论仍然需要在更多的临床试验被证实,该公司必须证明药品的安全性具有较大的组病人,Anzalone说。 “有显然还是有很多风险摆在我们面前。”

而箭头完成2a期研究中,它的前进用两个阶段2b研究,将测试结合市售B型肝炎的治疗恩替卡韦(博路定)和替诺福韦(Viread的)多剂量ARC-520的效果。箭头提交给FDA的研究性新药申请,本周,它的计划,以寻求批准在欧洲和亚洲的同类研究。

该公司还可能运行的ARC-520的试验性研究,结合药物刺激免疫系统,而且它会尝试给药方案是或多或少频繁比当前锚研究中使用的一次的月疗程,Anzalone说。该公司还可能探讨皮下输送ARC-520,它至今已静脉给药的,他补充道。

“我们将要学习的一个可怕的很多关于这种病毒,我们如何去攻击这个病毒,在整个2015年,”Anzalone说。

它有助于有一个132500000美元的现金储备,根据该公司的最新披露。这使得箭头可以一次进行多次试验,没有一个商业合作伙伴的帮助下,它也提供了对一个波动的股票价格一定的保温,Anzalone说。 “我们有能够保持我们头上来,专注于奢侈品”公司的工作,他补充道。

尽管如此,箭头可能无法承受任何重大挫折,因为在竞争中更好地发展乙型肝炎的治疗正在升温。吉利德科学公司(纳斯达克股票代码:GILD)有三种药物在其管道,其中包括在第三阶段临床试验,但这些都不是RNAi药物。 Alnylam制药(NASDAQ:ALNY),然而,正在开发的RNAi药物靶向乙型肝炎它收购的技术,当它买了siRNA治疗默克公司在一月份1.75亿美元。

这是一个有趣的转折,因为Alnylam公司和箭头在2012年签署了交叉许可协议,其中Alnylam公司授权其RNA干扰的化学技术,乙肝箭头,这就是ARC-520是基于-和箭头授权其动态polyconjugates交付技术,Alnylam公司,它可以用在尚未被公开的疾病靶,Anzalone说。

生物技术是“完全的竞争对手合作,对某些药物和其他药物的竞争故事。这只是事情发生,“Anzalone说。箭头专注于获取其乙肝药物市场尽快,他指出,它进入临床试验,2013年中期,而Alnylam公司不会进入诊所,直到2016年。“我们将有一个大幅领先于他们的“Anzalone说。 “我们也只需要确保我们有一个更好的药物。”

越来越多的公司试图开发乙肝治疗中的一部分,因为丙型肝炎治疗乱舞已批准在过去三年,在串联与早期批准的药物,有效地治疗这种疾病。这些新的治疗方法包括Gilead公司sofosbuvir(Sovaldi),Gilead公司结合sofosbuvir和ledipasvir(Harvoni),扬森治疗“simeprevir(Olysio)和默克公司用boceprevir(VICTRELIS)。目前,一些企业已经设置了对乙肝的景点

全世界约有3.5亿人患有慢性乙肝患有B-一倍以上那些谁慢性丙型肝炎那么,为什么丙肝得到“解决”先苦?

事实证明,这两种疾病表现在完全不同的方式,和乙肝已被证明是一个更加难啃的骨头比丙型肝炎,伦敦说。乙肝病毒递交本身在肝细胞的DNA,其中复杂的东西。丙型肝炎,同时,复制本身在细胞的细胞质中,而不是在细胞核中。 “这是更容易获得药物,这是发生了什么转身的事情,”伦敦说。

目前,典型的乙肝治疗药物包括,如恩替卡韦和替诺福韦,防止病毒的现有副本的复制,但不消灭他们,所以患者必须采取药物治疗为他们的余生,伦敦说。甚至与抗病毒治疗,患者仍然有发展的肝肿瘤的肝硬化的高风险,Anzalone说。

对他而言,伦敦认为RNAi是一个“有趣”的技术,可以在战斗乙肝有用的,但他怀疑它拥有的答案击败病毒相关的各种病毒的生物学和它隐藏的方式的原因在肝细胞内它感染。 “如果它发生了,这将会是美妙的,”他说,“但我很怀疑。”

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发表于 2014-12-20 09:29 |只看该作者
还是需要耐心等待。。

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W. Thomas London,的观点总而言之就是疗效不确定

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才高八斗

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发表于 2014-12-24 02:04 |只看该作者
AASLD 2014: Experimental siRNA Therapy Lowers HBsAg Levels in Hepatitis B Patients

   
Details
    Category: HBV Treatment   
    Published on Tuesday, 23 December 2014 00:00
    Written by Liz Highleyman


ARC-520, a novel therapy using short interfering RNA, appeared safe and was associated with a reduction in hepatitis B surface antigen levels in chronic hepatitis B patients taking entecavir, according to Phase 2a study results reported at the American Association for the Study of Liver Diseases (AASLD) Liver Meeting last month in Boston.

Antiviral therapy using nucleoside/nucleotide analogs like tenofovir (Viread) or entecavir (Baraclude) is the mainstay of chronic hepatitis B treatment. Although these drugs can effectively suppress hepatitis B virus (HBV) replication during therapy, they typically do not eradicate the virus and do not lead to serological response, or HBV antigen loss or antibody seroconversion.

Man-Fung Yuen from the University of Hong Kongand colleagues tested a new type of hepatitis B treatment using short interfering RNA (siRNA). siRNA are small pieces of double-stranded ribonucleic acid (RNA) that can "silence" or block expression of messenger RNA.

ARC-520 is a novel liver-targeted siRNA therapy designed to interfere with HBV replication and protein production. Previous studies have shown that it decreased expression of viral proteins and reduced the number of viral particles in HBV mouse models and in an HBV-infected chimpanzee.

Viral proteins -- in particular hepatitis B "e" antigen (HBeAg) and hepatitis B surface antigen (HBsAg) -- have been implicated in immune tolerance, sustained infection, and disease progression, the researchers noted as background. Therapies targeting viral proteins might enable immune reconstitution, thereby promoting HBsAg clearance.

Yuen's group conducted a Phase 2a trial to test the efficacy of single doses of ARC-520 in reducing HBsAg levels in HBeAg negative chronic hepatitis B patients taking long-term entecavir.

This randomized, double-blind, dose-ranging study enrolled 24 adult hepatitis B patients at 2 centers. They were randomly assigned to receive single intravenous injections of ARC-520 at escalating doses of 1, 2, or 3 mg/kg, or else placebo, preceded by an oral antihistamine (Benadryl) as a precaution against hypersensitivity reactions. They continued to take entecavir throughout the study.

The researchers reported data from 8 patients in Cohort 1 (1 mg/kg) and 8 in Cohort 2 (2 mg/kg), evaluated through post-dose day 85. A majority (63%) were men, all were of Chinese ethnicity, and ages raged from 37 to 59 years. Cohort 3 is ongoing and remains blinded.

ARC-520 activity was assessed by measuring percent change in HBsAg from the baseline level.

Results

    ARC-520 recipients experienced greater decreases in serum HBsAg compared to placebo recipients, and HBsAg levels declined more with the 2 mg/kg dose than with the lower dose.
    In Cohort 1, patients receiving ARC-520 had an average nadir decline, or maximum decrease, of -39% (range -22% to -57%) at post-dose day 43, with a mean change of -31% at day 85 (range -14% to -39%),
    In Cohort 2, the average nadir reduction was -51% (range -46% to -59%) at post-dose day 57, with a mean change of -22% at day 85 (range -7% to -40%).
    In Cohort 2, the percent reduction in HBsAg was statistically significant compared to placebo through day 43.

A previous Phase 1 study found that ARC-520 had a favorable safety profile in 54 healthy HBV-uninfected people receiving doses of 0.01 to 4 mg/kg. There were no apparent dose-limiting toxicities. 1 person taking ARC-520 experienced flushing and 1 developed hives; however, no one pre-treated with oral antihistamine showed evidence of hypersensitivity. There were no observed differences in adverse events, vital signs, physical exams, or electrocardiograms between ARC-520 and placebo recipients.

In the Phase 2a study, ARC-520 again appeared to be safe and well-tolerated at the doses tested. There were no serious adverse events, no dose-limiting toxicities, and no early discontinuations due to adverse events. All reported adverse events were deemed unrelated or unlikely to be related to the study drug. Abnormal laboratory values were uncommon.

"A single injection of ARC-520 resulted in significant reduction in HBsAg for up to 43 days," the researchers concluded. "This is the first time that a reduction in HBsAg mediated through RNA interference has been shown in chronic HBV patients."

12/23/14

Reference

M Yuen, H Chan, B Given, et al. Phase II, dose-ranging study of ARC-520, a siRNA-based therapeutic, in patients with chronic hepatitis B virus. American Association for the Study of Liver Diseases (AASLD) Liver Meeting. Boston, November 7-12, 2014. AbstractLB-21.

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