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EASL 2018PS-160 SB9200(Inarigivir)治疗慢性乙型肝炎患者对免疫应   [复制链接]

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本帖最后由 StephenW 于 2018-4-3 22:52 编辑

EASL 2018 PS-160
Effects of SB9200 (Inarigivir) therapy on immune responses in
patients with chronic hepatitis B
R. Walsh1, R. Hammond1, K. Jackson1, R. Edwards1, C. Macfarlane2,
R. Iyer2, M.-F. Yuen3, H. Chan4, N. Afdhal2, S. Locarnini1. 1Victorian
Infectious Diseases Reference Laboratory, Australia; 2Spring Bank
Pharmaceuticals, United States; 3University of Hong Kong, Hong Kong;
4The Chinese University of Hong Kong, Hong Kong
Email: [email protected]
Background and Aims: Inarigivir (SB9200) is a small molecule
dinucleotide orally active HBV antiviral with both direct acting and
immune modulatory activity, stimulating the host innate antiviral
response. It binds to the cytosolic pattern recognition receptor
retinoic-acid-inducible gene (RIG-I) to enhance RIG-I binding to the
5’-epsilon region of the HBV pregenomic RNA. The ACHIEVE trial is a
double-blind placebo (PL) controlled study of ascending doses of
Inarigivir PO daily monotherapy or PL for 12 weeks, followed by a
switch to 300 mg Tenofovir daily for a further 12 weeks. We report
here the comparative effects of low dose Inarigivir monotherapy on
the anti-HBs antibody (Ab) response (HBsAg epitope profile, and
complexed Ab) on thirty-eight naive non-cirrhotic HBV patients
randomised 4:1 to twelve weeks of 25 mg or 50 mg Inarigivir or
placebo.
Method and Results: Inarigivir therapy resulted in significant
decline in HBV DNA, HBV RNA and HBcrAg levels in the majority of
treated patients with modest decline in HBsAg. Inarigivir therapy
cohorts (25 mg and 50 mg doses)were further analysed for effects on
immune responses, applying bioassays for developing Ab response
markers predictive of HBsAg clearance including development of
HBsAg clearance profile (CP) and complexed HBsAg/anti-HBs. A
decline in HBV DNA together with the development of a HBsAg CP
during the 12 weeks of Inarigivir therapy was observed in 1/16 (6%)
subjects who received 25 mg of drug, and this response increased to
4/13 (31%) of subjects receiving 50mg of drug. This relationship was
not observed in any PL subjects (n = 8) during the 12weeks treatment
period. The detection of anti-HBs Ab complexed with HBsAg,
indicative of an underlying or emerging immune response, was
enhanced from 2/16 (12%) in the 25 mg treatment cohort, to 6/13
(46%) in the 50mg Inarigivir therapy cohort during the 12 weeks of
treatment. Furthermore, the development of complexed anti-HBs
was enhanced in 6/13 (46%) of patients in the 50mg treatment cohort
compared to the PL arm with only 1/4 (25%) subjects developing
complexed anti-HBs.
Conclusion: Serum biomarkers indicative of Ab responsewere found
to display a strong trend during 12 weeks of Inarigivir therapy
compared to PL. Predictive markers of anti-HBs response were
enhanced in the 50mg versus 25mg Inarigivir therapy cohorts,
revealing a dose response relationship of nascent immune recovery
due to lowdose Inarigivir therapy, suggesting higher doses should be
further studied.

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发表于 2018-4-3 08:24 |只看该作者
EASL 2018 PS-160
SB9200(Inarigivir)治疗对小鼠免疫应答的影响
慢性乙型肝炎患者
R.Walsh1,R.Hammond1,K.Jackson1,R.Edwards1,C.Macfarlane2,
R. Iyer2,M.-F. Yuen3,H. Chan4,N. Afdhal2,S. Locarnini1。 1Victorian
澳大利亚传染病参考实验室; 2春联银行
制药,美国; 3香港大学,香港;
4香港中文大学,香港
电子邮件:[email protected]
背景和目的:Inarigivir(SB9200)是一种小分子
二核苷酸口服有效的HBV抗病毒药物,既有直接作用又有直接作用
免疫调节活性,刺激宿主先天性抗病毒药物
响应。它与胞质模式识别受体结合
维甲酸诱导基因(RIG-I)以增强RIG-1与其结合
HBV前基因组RNA的5'-ε区域。 ACHIEVE的审判是一个
双盲安慰剂(PL)对照研究
Inarigivir PO每日单药治疗或PL为期12周,随后是a
每天换用300 mg替诺福韦再治疗12周。我们报告
这里比较小剂量Inarigivir单药治疗对比
抗-HBs抗体(Ab)反应(HBsAg表位谱,和
复杂的Ab)对三十八名天真的非肝硬化HBV患者
随机4:1至12周的25毫克或50毫克Inarigivir或
安慰剂。
方法和结果:Inarigivir治疗导致显着
在大多数情况下,HBV DNA,HBV RNA和HBcrAg水平下降
治疗的患者HBsAg的适度下降。 Inarigivir疗法
队列(25毫克和50毫克剂量)进一步分析的影响
免疫反应,应用生物测定法开发抗体反应
预测HBsAg清除率的标记物,包括肝细胞癌的发展
HBsAg清除率(CP)和复合HBsAg /抗-HBs。一个
随着HBsAg CP的发展,HBV DNA下降
在Inarigivir治疗12周期间观察到1/16(6%)
接受25毫克药物的受试者,这种反应增加到
4/13(31%)接受50mg药物的受试者。这种关系是
在12周治疗期间在任何PL受试者(n = 8)中未观察到
期。检测与HBsAg复合的抗-HBs Ab,
指示潜在或新出现的免疫应答,是
从25mg治疗队列中的2/16(12%)增加到6/13
(46%)在50毫克Inarigivir治疗队列在12周
治疗。此外,复杂的抗-HBs的发展
在50mg治疗组的6/13(46%)患者中增强
与仅有1/4(25%)受试者发展的PL组相比
复杂的抗-HBs。
结论:发现了指示Ab反应的血清生物标志物
在12周的Inarigivir治疗中显示出强烈的趋势
与PL相比。抗-HBs应答的预测标记是
在50mg与25mg Inarigivir治疗组群中增强,
揭示新生免疫恢复的剂量反应关系
由于低剂量的Inarigivir疗法,提示应该有更高的剂量
进一步研究。

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发表于 2018-4-3 08:25 |只看该作者
等待大剂量试验数据

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发表于 2018-4-3 08:50 |只看该作者
最近数据披露进度有点慢了

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发表于 2018-4-3 22:03 |只看该作者
乙肝新药SB 9200临床出色,有望带来功能性治愈
2017-07-26 10:13
近日,位于马萨诸塞州的Spring Bank Pharmaceuticals宣布,其在研新药SB 9200在治疗慢性乙肝的2a期临床中取得了出色的成果,这也有望将这一新药推进到临床的下一个阶段。



乙肝是一种影响广泛的肝脏疾病。据世界卫生组织估计,全世界范围有2.4亿人慢性感染乙型肝炎,每年有超过78万人死于乙型肝炎并发症,包括肝硬化和肝癌。中国是一个乙肝感染大国,全国至少有1亿慢性乙型肝炎病毒(HBV)感染者,而且乙肝发病率还在持续上升。慢性乙型肝炎至今尚未找到彻底治愈的药物,严重威胁着患者的健康。然而,目前患者能使用的乙肝治疗手段却相对有限,因此,无论是患者还是业界,都热切期盼能有全新的乙肝新药上市。

由Spring Bank研发的SB 9200是一款全新的小分子核酸杂交(small molecule nucleic acid hybrid)化合物,它有潜力激活RIG-I蛋白与NOD2蛋白,并在被病毒感染的细胞内启动干扰素介导的抗病毒免疫反应。此外,它还能抑制病毒的聚合酶合成核酸。因此,吃吃吃有望能作为单独疗法或联合疗法,治疗慢性乙肝。



▲SB 9200的作用机理(图片来源:Spring Bank)

在一项2a期临床试验中,研究人员评估了SB 9200的疗效与安全性。试验里,研究人员招募了20名初治,尚未出现肝硬化的慢性乙肝患者,并将他们随机分为两组,一组每日接受25毫克 SB 9200的治疗,另一组则接受安慰剂。整个试验时长为12周。

结果表明,与安慰剂相比,SB 9200在总体上显著降低了乙肝的DNA水平。而在降低乙肝表面抗原(HBsAg)水平的评估中,接受SB 9200的患者有31%出现了降低,对照组中则无一人出现降低。此外,它的总体安全性良好。在为期12周的试验中,没有出现任何严重的副作用。



▲Spring Bank的首席医学官Nezam Afdhal博士(图片来源:TED)

“SB 9200的安全性结果以及在低剂量下的抗病毒能力让我们感到非常振奋,”Spring Bank的首席医学官Nezam Afdhal博士说:“这些结果进一步表明SB 9200有望成为一种慢性乙肝的新疗法,并带来功能性上的治愈。我们已经开始招募这项2a期临床试验的第二组患者,希望它能在今年第四季度带来好结果。”

“我们的病毒学研究表明SB 9200参与到了一种全新的免疫反应中,并能通过靶向RIG-I,直接起抗病毒的作用,”这项临床试验的主要负责人Stephen Locarnini博士说:“这不但能减少乙肝病毒的DNA,还能减少乙肝表面抗原,以及乙肝病毒的pgRNA。”

按Spring Bank官方提供的信息,清除乙肝表面抗原,就意味着乙肝感染得到了功能性的治愈。我们期待听到这款乙肝新药的更多好结果,并祝愿患者们能得到更多治疗乙肝的出色方案。

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发表于 2018-4-3 22:04 |只看该作者
口服的药物,据说效果和聚乙二醇干扰素类似。那很牛了。

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发表于 2018-4-3 22:07 |只看该作者
Arrowhead and Spring Bank Announce Clinical Collaboration for ARC-520 and SB 9200 in Chronic Hepatitis B
Oct 6, 2016 at 7:30 AM EDT
PASADENA, Calif. & HOPKINTON, Mass. --(BUSINESS WIRE)-- Arrowhead Pharmaceuticals Inc. ( NASDAQ : ARWR) and Spring Bank Pharmaceuticals, Inc. ( NASDAQ : SBPH), a clinical-stage biopharmaceutical company developing novel therapeutics for the treatment of viral infections, cancer, and inflammatory
Arrowhead and Spring Bank Announce Clinical Collaboration for ARC-520 and SB 9200 in Chronic Hepatitis B
PASADENA, Calif. & HOPKINTON, Mass.--(BUSINESS WIRE)-- Arrowhead Pharmaceuticals Inc. (NASDAQ: ARWR) and Spring Bank Pharmaceuticals, Inc. (NASDAQ: SBPH), a clinical-stage biopharmaceutical company developing novel therapeutics for the treatment of viral infections, cancer, and inflammatory diseases, today announced an agreement to perform collaborative studies on Arrowhead's ARC-520 and Spring Bank's SB 9200, for the treatment of chronic Hepatitis B (HBV). The companies plan to first conduct preclinical models with both agents together and then study the agents clinically in a cohort to be added to Arrowhead's ongoing MONARCH Phase 2b study, in which patients will receive a dosing regimen that includes ARC-520, SB 9200, and an oral direct-acting antiviral.

This Smart News Release features multimedia. View the full release here: http://www.businesswire.com/news/home/20161006005402/en/

"The MONARCH Phase 2b combination study was specifically designed to be iterative in nature, allowing us to seamlessly add cohorts when additional novel agents are available to study in combination with ARC-520," said Bruce Given, M.D., chief operating officer and head of R&D at Arrowhead. "We see ARC-520, which is designed to silence the production of all HBV gene products, as a potential backbone therapy for combinations. Spring Bank's SB 9200 is a promising immunomodulatory agent with an interesting mechanism that we think has significant therapeutic potential in combination with ARC-520 and a NUC."

"Our collaboration with our colleagues at Arrowhead Pharmaceuticals will be the first study of two completely novel agents in HBV, both focused on delivering a functional cure," said Nezam Afdhal, M.D., chief medical officer at Spring Bank Pharmaceuticals. "We believe combining SB 9200 with Arrowhead's ARC-520, along with an approved nucleotide(side) polymerase inhibitor, has the potential to lead to a functional cure. Together, we hope to demonstrate in the MONARCH trial that triple therapy can increase HBV functional cure rates with a more favorable tolerability profile and perhaps a shorter duration of treatment relative to current standard of care with interferon-based regimens."

About SB 9200

SB 9200 is Spring Bank's novel small molecule, orally-available selective immunomodulator compound being developed as both monotherapy and combination therapy as a backbone for the treatment of chronic HBV and other viral diseases. SB 9200 is currently being studied in the ACHIEVE Phase II global trial. Part A of the ACHIEVE study is a placebo-controlled, sequential cohort, double blind trial to evaluate increasing doses of SB 9200 as monotherapy for 12 weeks followed by tenofovir disoproxil fumarate 300mg (Viread Gilead Sciences Inc.) for a further 12 weeks. Part B of the ACHIEVE study will evaluate SB 9200 in combination with tenofovir and as monotherapy versus tenofovir monotherapy after the optimal doses of SB 9200 are determined in Part A.

About ARC-520

Arrowhead's ARC-520 is being investigated for its potential to produce functional cures in patients with chronic hepatitis B virus (HBV) infection. ARC-520 intervenes upstream of the reverse transcription process where current standard-of-care nucleotide and nucleoside analogs act, and is designed to silence the production of all HBV gene products. The small interfering RNAs (siRNAs) in ARC-520 engage the body's normal cellular RNAi machinery and direct specific cleavage of HBV RNA transcripts, thereby reducing the levels of HBV proteins and the RNA template used to produce viral DNA. Arrowhead is investigating ARC-520 specifically to determine if significantly reducing circulating and non-circulating viral proteins and RNA will allow for re-constitution of an effective host immune response and ultimately HBsAg seroclearance resulting in functional cure. As many as 350-400 million people worldwide are chronically infected with the hepatitis B virus, which can lead to cirrhosis of the liver and is responsible for 80% of primary liver cancers globally. Arrowhead is currently conducting Phase 2b multiple dose and combination studies in chronic HBV patients. In clinical studies to date, the most common reported adverse events in all subjects completing treatment were upper respiratory infection and headache.

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发表于 2018-4-3 22:08 |只看该作者

箭头和春季银行宣布临床协作弧- 520和某人9200年慢性乙型肝炎
2016年10月6日,美国东部时间7:30点
加州帕萨迪纳市&数据质量。 ——(业务线)箭头制药有限公司(纳斯达克:ARWR)和春季银行制药、有限公司(纳斯达克:SBPH),临床分期生物制药公司开发新疗法治疗病毒感染,癌症和炎症
箭头和春季银行宣布临床协作弧- 520和某人9200年慢性乙型肝炎
加州帕萨迪纳市&数据质量。 ——(业务线)箭头制药有限公司(纳斯达克:ARWR)和春季银行制药、有限公司(纳斯达克:SBPH),临床分期生物制药公司开发新疗法治疗病毒感染,癌症和炎症性疾病,今天宣布一项协议来执行协作研究箭头的弧- 520年和520年银行的某人春天,治疗慢性乙肝(HBV)。 公司计划首先进行临床前模型与代理商一起然后研究临床队列添加到箭头的君主2 b期研究,患者将接受给药方案,包括弧- 520,某人9200年,口服直接的抗病毒药物。

这个智能多媒体新闻发布功能。 查看完整版本:http://www.businesswire.com/news/home/20161006005402/en/

”女王2 b相结合研究是专门设计的迭代性质,使我们能够无缝地添加额外军团当小说代理可用来研究结合电弧- 520,”布鲁斯说,医学博士 研发主管,首席运营官和箭头。 “我们看到弧- 520,其目的是沉默所有乙肝病毒基因产物的生产,作为一个潜在的治疗组合支柱。 9200年春天银行的某人是一个有前途的免疫调节代理和一个有趣的机制,我们认为具有显著的治疗潜力结合电弧- 520和NUC。”

“我们的合作与我们的同事在箭头制药将成为第一个两个全新的特工在乙肝病毒的研究中,都专注于交付功能治愈,“说Nezam Afdhal,医学博士 春季银行首席医疗官制药业。 “我们相信结合某人9200与箭头的弧- 520,以及一个批准的核苷酸聚合酶抑制剂(侧),有可能导致功能治愈。 在一起,我们希望在君主试验证明,三联疗法可以提高乙肝病毒功能治愈率更良好的耐受性,也许更短时间的治疗与interferon-based相对于目前的标准治疗方案。”

某人9200

某人9200年春季银行的新型小分子,orally-available选择性免疫调制剂复合开发作为单药治疗和联合治疗作为治疗慢性乙肝病毒的骨干和其它病毒性疾病。 某人9200目前在全球实现第二阶段试验进行研究。 部分实现的研究是一种安慰剂对照,顺序队列,双盲试验来评估增加剂量的某人9200年作为单药治疗12周之后,泰诺福韦disoproxil延胡索酸酯300毫克(韦吉里德科技公司)进一步12周。 B部分实现的研究将评估某人9200结合替诺福韦和单一疗法与替诺福韦单药治疗后的最佳剂量某人9200部分决定。

对弧- 520

箭头的arc - 520正在调查可能产生功能性治愈患者的慢性乙型肝炎病毒(HBV)感染。 arc - 520介入上游的逆转录过程中目前的标准治疗核苷酸和核苷类似物行为,沉默,旨在HBV基因产品的生产。 小干扰RNA(siRNAs)弧- 520年参与人体的正常细胞RNAi机械和直接具体的乙型肝炎病毒RNA转录乳沟,从而减少乙肝病毒的水平蛋白质和RNA模板用于制造病毒DNA。 箭头正在调查arc - 520专门确定显著减少循环和非流通股病毒蛋白质和RNA将允许推进有效的宿主免疫反应,最终HBsAg seroclearance导致功能性治愈。 全世界多达350 - 400人慢性乙型肝炎病毒感染,可导致肝硬化和负责全球原发性肝癌的80%。 箭头目前正在进行第二阶段b多个剂量与组合研究慢性乙肝病毒的病人。 在临床研究到目前为止,最常见的不良事件报告在所有受试者完成治疗上呼吸道感染和头痛。

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发表于 2018-4-3 22:12 |只看该作者
sb9200 最近好像蛮火的,原来他们早就在2016年就已经开始和箭头公司合作了
说明,箭头的专家们其实很明白,sb9200这个药物的免疫调节作用是比较强的,关键用药简单,口服就行了,也没有特别报道这个药的副作用,所以还是蛮有前景的,不过好像上面和箭头的试验也没有消息了520也被抛弃,所以说明效果未必很好。

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发表于 2018-4-3 22:16 |只看该作者
不错的思路。
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