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Antios 因乙型肝炎安全信号引发临床暂停、终止合作而震惊 尼 [复制链接]

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发表于 2022-7-9 16:14 |只看该作者 |倒序浏览 |打印
Antios 因乙型肝炎安全信号引发临床暂停、终止合作而震惊
尼克·保罗·泰勒
2022 年 5 月 25 日晚上 10 点 42 分
Antios TherapeuticsAssembly BiosciencesArbutus BiopharmaFDA
食品和药物管理局
Arbutus 从其管道中删除了涉及 ATI-2173 的 2 期试验。 (莎拉·西尔比格/斯金格/盖蒂图片社新闻)

Antios Therapeutics 开发治愈性乙型肝炎疗法的努力遇到了动荡。 FDA 对 Antios 的一份安全报告进行了临床搁置,促使 Assembly Biosciences 终止了与这家财力雄厚的生物技术公司的临床试验合作协议。

去年,Antios 引起了轰动,获得了总额为 1.71 亿美元的背靠背融资轮次,以资助其乙肝前景 ATI-2173 的工作。候选药物是一种以肝脏为靶点的前体药物 clevudine,Pharmasset 在十多年前进入第 3 阶段,仅用于长期使用者肌肉无力的情况下停止该计划的抗病毒药物。

在两轮融资之间, Antios 与 Arbutus Biopharma 和 Assembly Bioscience 达成协议,在联合临床试验中测试 ATI-2173。 Antios 的公开交易合作伙伴是其挫折的初步信息来源。

“ATI-2173 是 Antios 的研究专有活性位点聚合酶抑制剂核苷酸,在提交安全报告后,已被美国食品和药物管理局置于临床暂停状态,”Assembly 在一份财务文件中表示。安全报告涉及一名患者,他接受了 Antios 的 ATI-2173、Assembly 的 vebicorvir 和核苷酸逆转录酶抑制剂的三重组合。

由于搁置,Assembly 终止了去年与 Antios 达成的临床试验合作协议。另外,Arbutus 更新了其公司介绍。该更新从管道中删除了涉及 ATI-2173、Arbutus 的 AB-729 和核苷酸类似物的组合的 2 期试验。 Antios 首席执行官 Greg Mayes 表示:“Arbutus 研究受到俄罗斯入侵乌克兰的影响,所有剂量均已完成,一名患者仍在长期随访中,而在 Arbutus 研究中未观察到组装研究中观察到的事件。”

Mayes 在电子邮件声明中提供了更多信息:“本研究中的第一位患者于 2022 年 4 月 27 日服用了 ATI-2173、TDF 和 vebicorvir 的三重组合。女性患者(49 岁)出现心动过缓和低血压,这似乎是服药后约 4 小时出现血管迷走神经/晕厥前事件。患者禁食 20 小时,大量抽血,并服用利尿剂(吲达帕胺)。

“我们不认为这是与治疗相关的不良事件;ATI-2173通常耐受性良好,没有令人担忧的安全信号。但是,进行该研究的研究人员认为,不良事件可能与三联疗法相关的治疗ATI-2173、TDF 和 vebicorvir。尽管我们的结论是这不是心脏毒性的信号,但 FDA 已要求对 ATI-2173 进行独立的心脏病学审查。

截至 1 月 15 日,已有 172 名受试者暴露于 ATI-2173。 Mayes 说 Antios 没有看到“与 ATI-2173 或其代谢物相关的心脏安全信号的证据”。

编者注:这篇报道于美国东部时间 5 月 25 日上午 9:27 更新,并附有 Greg Mayes 的声明。

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发表于 2022-7-9 16:15 |只看该作者
Antios rocked as hepatitis B safety signal sparks clinical hold, termination of collaboration
By Nick Paul Taylor
May 25, 2022 10:42pm
Antios TherapeuticsAssembly BiosciencesArbutus BiopharmaFDA
FDA
Arbutus removed a phase 2 trial involving ATI-2173 from its pipeline.  (Sarah Silbiger/Stringer/Getty Images News)

Antios Therapeutics’ push to develop a curative hepatitis B therapy has hit turbulence. The FDA has slapped Antios with a clinical hold over a safety report, prompting Assembly Biosciences to terminate its clinical trial collaboration agreement with the deep-pocketed biotech.

Last year, Antios made a splash, pulling off back-to-back financing rounds collectively worth $171 million to fund work on its hepatitis B prospect ATI-2173. The drug candidate is a liver-targeted prodrug form of clevudine, an antiviral that Pharmasset advanced into phase 3 more than a decade ago only for cases of muscle weakness in long-term users to stop the program.

In between the two financing rounds, Antios entered into deals with Arbutus Biopharma and Assembly Bioscience to test ATI-2173 in combination clinical trials. Antios’ publicly traded partners were the source of the initial information on its setback.

“ATI-2173, Antios’s investigational proprietary active site polymerase inhibitor nucleotide, has been placed on clinical hold by the U.S. Food and Drug Administration following submission of a safety report,” Assembly said in a financial filing. The safety report involved a patient who received a triple combination of Antios’ ATI-2173, Assembly’s vebicorvir and a nucleotide reverse transcriptase inhibitor.

Assembly terminated the clinical trial collaboration agreement it formed with Antios last year because of the hold. Separately, Arbutus updated its corporate presentation. The update removed a phase 2 trial of a combination involving ATI-2173, Arbutus’ AB-729 and a nucleotide analog from the pipeline. Antios CEO Greg Mayes said "the Arbutus study was impacted by the Russian invasion of Ukraine and all dosing was completed and one patient remains in long term follow-up and the event observed in the Assembly study was not observed in the Arbutus study."

Mayes provided more information in an emailed statement: "The first patient in this study was dosed the triple combination of ATI-2173, TDF, and vebicorvir on April 27, 2022. Female patient (49 years old) experienced bradycardia and hypotension which appeared to be a vasovagal/presyncope event about 4 hours post dose. The patient was fasting for 20 hours, had high volume blood draws, and taken a diuretic (indapamide).

"We do not believe this to be a treatment-related adverse event; ATI-2173 was generally well-tolerated with no concerning safety signals. However, the investigator conducting the study believes the adverse event may have been treatment related to the triple combination regimen of ATI-2173, TDF and vebicorvir. Despite our conclusion that this is not a signal for cardiotoxicity, the FDA has requested an independent cardiology review of ATI-2173."

As of Jan. 15, 172 subjects had been exposed to ATI-2173. Mayes said Antios has seen "no evidence of cardiac safety signals associated with ATI-2173 or its metabolites."

Editor's note: This story was updated at 9:27 a.m. ET May 25 with a statement from Greg Mayes.

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发表于 2022-7-9 18:10 |只看该作者
又一款药折戟沉沙啊~~

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发表于 2022-7-15 13:03 |只看该作者
本帖最后由 tim889 于 2022-7-14 21:03 编辑

这例是和assembly bioscience合并用药的trial里出现的,并不一定是ATI-2173的问题。

这药比较神奇的是停药之后病毒载量不怎么反弹  https://mp.weixin.qq.com/s/2Wv7AHyE18vAepSXc-207w

不过Cledvudine本身并不怎么行,副作用风险大一点,耐药率很高,所以只能做成pro-drug和替诺连用

让子弹再飞一会儿
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