Baraclude
(Entecavir) Data Continue To Demonstrate Low Incidence Of Resistance Through Five
Years Of Treatment In Nucleoside-Naive Chronic Hepatitis B Patients Data
Indicate Pre-existing Lamivudine Resistance Predisposes Patients to Higher Rates
of BARACLUDE Resistance
(PRINCETON, NJ, March 24, 2008) - New BARACLUDE
(entecavir) data presented today demonstrated a continued low incidence of resistance
in nucleoside-naive patients through five years of treatment.
In the nucleoside-naive
chronic hepatitis B patients analyzed, no additional patient developed resistance
in the fifth year (n=108). Through five years of treatment, the cumulative probability
of developing mutations in the virus that confer resistance to BARACLUDE (also
called genotypic resistance) was 1.2 percent. Bristol-Myers Squibb Company (NYSE:
BMY) announced the results at the 18th Conference of the Asia-Pacific Association
for the Study of the Liver (APASL) in Seoul, Korea. In
lamivudine-refractory patients who received BARACLUDE after treatment with lamivudine
failed, the cumulative probability of genotypic BARACLUDE resistance was 51 percent
through the fifth year. This finding is consistent with prior observations that
the pre-existence of lamivudine-resistant mutations results in an increase in
the rate of BARACLUDE resistance. "Many
chronic hepatitis B patients require long-term treatment. Unfortunately, the initial
benefits of therapy can be lost after the development of resistance. These five-year
BARACLUDE data that demonstrate long-term minimal resistance at 1.2 percent in
nucleoside-naive patients can be of great importance for patients," said
Professor Ching-Lung Lai, Chief, Division of Gastroenterology and Hepatology,
University of Hong Kong. Drug
resistance occurs when the hepatitis B virus (HBV) mutates, thereby avoiding the
effects of the medication. This can decrease the efficacy of the current medication
and may compromise future treatment options. To date, studies have shown that
multiple mutations are required to develop BARACLUDE (entecavir) resistance. "These
long-term BARACLUDE data continue to support the observations seen in the first
years of treatment and are reflective of BARACLUDE's high genetic barrier to resistance,"
said Helena Brett-Smith, MD, Group Director of Clinical Research at Bristol-Myers
Squibb. "More importantly, we believe the data support BARACLUDE as an important
initial treatment choice for chronic hepatitis B, which is a disease that results
in a large global health burden." About
the Analysis More
than 700 patients across six studies initiated therapy on BARACLUDE and were monitored
for treatment response and resistance. The
year five analysis expands upon previous analyses, adding in information on patients
who received treatment with BARACLUDE during the fifth year of follow-up (n=108
for patients in nucleoside-naïve studies and n=33 for patients in lamivudine-refractory
studies). In
this comprehensive analysis, all patients enrolled in Bristol-Myers Squibb clinical
trials ETV-014, -015, -022, -027, -026 and -901 who experienced a virologic breakthrough
[Virologic breakthrough is defined as a greater than or equal to 1 log increase
in HBV DNA from nadir, as measured by the polymerase chain reaction or PCR assay]
or whose virus had not yet reached undetectable levels [Undetectable viral load
is defined as HBV DNA levels less than 300 copies/mL, as measured by PCR assay]
at weeks 48, 96, 144, 192, 240 or end of dosing, were sequenced to determine if
any changes occurred in the genetic code of the virus that would result in resistance
or loss of effectiveness of BARACLUDE. Nucleoside-naive
patients in this analysis were initially treated with BARACLUDE 0.5 mg in studies
ETV-022 and -027 and continued treatment with BARACLUDE 1 mg by enrolling in study
ETV-901 with a treatment gap of less than or equal to 35 days. Lamivudine-refractory
patients in this analysis initiated therapy on BARACLUDE 1 mg in studies ETV-014,
-015, and -026 and continued treatment in study ETV-901 with a treatment gap of
less than or equal to 35 days. Viral
load reduction in chronic hepatitis B patients treated with BARACLUDE (entecavir)
in nucleoside-naïve and lamivudine-refractory studies was also evaluated.
Data Results
Results
from these studies prior to this year five analysis were previously announced
on April 14, 2007. Nucleoside-naive
data
The incidence of BARACLUDE resistance in patients in nucleoside-naïve studies
over time is low, with a cumulative probability of genotypic BARACLUDE resistance
of 1.2 percent through five years.
No nucleoside-naive patient developed
resistance (n=108) in year five.
93 percent of the nucleoside-naive patients
taking BARACLUDE were able to achieve and maintain an undetectable viral load
(HBV DNA <300 copies/mL) through year five (n=108).
Lamivudine
refractory data
The results in lamivudine-refractory patients in years one through five were consistent
with the finding that the pre-existence of lamivudine-resistant substitutions
resulted in an increase in the emergence of BARACLUDE resistance, with a cumulative
probability of genotypic resistance of 51 percent through five years.
In year five, 43 percent of lamivudine-refractory patients had virologic breakthrough
with BARACLUDE resistance (n=33).
During this resistance monitoring program,
72 of the 187 lamivudine-refractory patients achieved undetectable viral load
(<300 copies/mL) and of these, three patients subsequently developed genotypic
resistance to BARACLUDE.
Indication
and Important Safety Information About BARACLUDE (entecavir) 0.5 mg/ 1 mg Tablets
BARACLUDE
(entecavir) is a prescription medicine used for chronic infection with hepatitis
B virus (HBV) in adults where the virus is multiplying and damaging the liver.
BARACLUDE does not cure HBV or stop the spread of HBV to others. People should
not take BARACLUDE if they are allergic to it or any of its ingredients. BARACLUDE
has not been studied in children and is not recommended for anyone less than 16
years of age. People
taking BARACLUDE should tell their healthcare provider right away if they feel
very weak or tired, have unusual muscle pain, have trouble breathing, have stomach
pain with nausea and vomiting, feel cold -- especially in their arms and legs,
feel dizzy or lightheaded, or have a fast or irregular heartbeat, as they may
be signs of a serious condition called lactic acidosis (buildup of an acid in
the blood). Lactic acidosis is a medical emergency and must be treated in the
hospital. Some people who have taken medicines like BARACLUDE have developed serious
liver problems called hepatotoxicity. This may occur with liver enlargement (hepatomegaly)
and fat in the liver (steatosis). People
should call their healthcare provider right away if they get any of the following
signs of liver problems: yellowing (jaundice) of the skin or the white part of
the eyes, darkening of the urine, lightening in the color of bowel movements (stools),
not feeling like eating food for several days or longer, feeling sick to the stomach
(nausea), or having lower stomach pain. Lactic acidosis and hepatotoxicity have
happened in some people taking medicines like BARACLUDE. For
people taking BARACLUDE who have or get HIV (the virus that can cause AIDS) and
are not taking medicines for HIV at the same time, some HIV treatments that they
may take in the future may be less likely to work. People are advised to get an
HIV test before starting to take BARACLUDE and anytime that there is a chance
they were exposed to HIV. BARACLUDE will not help HIV infection. In
some people, hepatitis B symptoms may get worse or become very serious when they
stop taking BARACLUDE. People should not stop BARACLUDE without talking to their
healthcare provider. Healthcare providers will need to follow their patients and
do blood tests to check the liver when BARACLUDE is stopped. People should tell
their healthcare provider if have or develop kidney problems because their healthcare
provider may want to do tests to see if a lower dose is needed. Because
BARACLUDE (entecavir) is removed from the body through the kidneys, a dose adjustment
may be required. Healthcare providers may want to perform tests to determine whether
a patient needs a lower dose or should take BARACLUDE less often than once a day.
It is not known
if BARACLUDE is safe to use during pregnancy. It is not known if BARACLUDE helps
to prevent a pregnant mother from passing HBV to her baby. A pregnant woman and
her healthcare provider will need to decide if BARACLUDE is right for her. A woman
should not breastfeed if she is taking BARACLUDE. People
should discuss with their healthcare provider all prescription and non-prescription
medicines, vitamins, herbal supplements, and other health preparations they are
taking or plan to take. BARACLUDE may interact with medicines that leave the body
through the kidneys. The safety and effectiveness of BARACLUDE in liver transplant
recipients is unknown. The most common side effects of BARACLUDE in clinical studies
were headache, tiredness, dizziness, and nausea. This
list of side effects is not complete at this time because BARACLUDE is still under
study. People should report any new or continuing symptom to their healthcare
provider. BARACLUDE should be taken once daily on an empty stomach (at least two
hours after a meal and two hours before the next meal). To learn more about BARACLUDE
and for Full Prescribing Information, including boxed WARNINGS, please visit http://www.bms.com.
Bristol-Myers
Squibb is a global biopharmaceutical and related health care products company
whose mission is to extend and enhance human life. Visit Bristol-Myers Squibb
at www.bms.com. |