Vertex and Tibotec Start Phase 3 Study of Telaprevir for Treatment-Naive Genotype
1 Hepatitis C Patients
On
March 13, Vertex Pharmaceuticals and Tibotec announced the initiation of a new
Phase 3 trial, called ADVANCE, which will evaluate the experimental
oral HCV protease inhibitor telaprevir (VX-950) in previously untreated patients
with genotype 1 chronic hepatitis C virus (HCV) infection.
Below
is an excerpt from the companies' press release describing the new study:
Vertex
Pharmaceuticals and Tibotec Announce Start of Phase 3 'ADVANCE' Study with Telaprevir
in Treatment-Naive, Genotype 1 HCV Patients
--
First hepatitis C protease inhibitor to begin Phase 3 clinical development --
Trial designed to confirm potential of telaprevir to increase sustained viral
response (SVR) rates with 24-week treatment duration
CAMBRIDGE,
Mass., Mar 13, 2008 -- Vertex Pharmaceuticals Incorporated (Nasdaq: VRTX) and
Tibotec today announced that patient screening has begun in the ADVANCE study,
a pivotal Phase 3 clinical study with the hepatitis C virus (HCV) protease inhibitor
telaprevir in combination therapy for treatment-naive patients with chronic HCV
infection. Telaprevir is the most advanced HCV protease inhibitor in clinical
development targeting treatment of hepatitis C, a disease that afflicts more than
3 million people in the United States alone, and 170 million worldwide.
The
ADVANCE trial will enroll 1,050 treatment-naive genotype 1 HCV patients and will
evaluate two 24-week telaprevir-based regimens in comparison to a 48-week control
arm. The primary endpoint of the study is sustained viral response (SVR), defined
as undetectable HCV RNA (<10 IU/mL) 24 weeks after the completion of treatment.
In this study, rapid viral response (RVR) criteria will be used to determine which
telaprevir patients can stop all treatment at 24 weeks.
"This is
the first Phase 3 study conducted to evaluate whether an investigational medicine
for HCV may be able to both increase the rate of sustained viral response and
shorten the duration of therapy to 24 weeks in patients with genotype 1 HCV infection
compared to current treatment of 48 weeks. This is important given the expectation
that approximately 40 to 50 percent of people with genotype 1 HCV who undergo
treatment with current therapies achieve SVR," said John McHutchison, MD,
Associate Director, Duke Clinical Research Institute and a principal investigator
for the ADVANCE study. "We're interested to see whether this trial will confirm
the encouraging results seen thus far in Phase 2 studies of telaprevir. This study
is another important step forward in the evaluation of novel medicines for the
treatment of HCV."
"Following discussions with the U.S. FDA
in January, we have been able to rapidly finalize the Phase 3 pivotal trial protocol
and begin patient screening at the first sites," said John Alam, MD, Executive
Vice President, Medicines Development and Chief Medical Officer of Vertex. "The
initiation of the ADVANCE trial underscores our commitment to evaluating the potential
for telaprevir to address significant unmet medical needs in HCV."
The
ADVANCE Study
The ADVANCE study (A New Direction in HCV
Care: A Study of Treatment-Naive Hepatitis C Patients with telaprevir) will be
conducted at more than 100 centers in the U.S., [European Union] and certain other
countries. Patient recruitment is being initiated in the U.S., while sites in
other countries will start recruitment as national Clinical Trial Applications
(CTAs) for each country are approved. The study arms will include:
24 weeks of therapy, with telaprevir dosed at 750 mg every eight hours (q8h) for
12 weeks in combination with standard doses of pegylated interferon alfa-2a (peg-IFN)
[Pegasys] and ribavirin (RBV) for 12 weeks, then continuing for another 12 weeks
with peg-IFN and RBV alone;
24 weeks of therapy, with telaprevir dosed at 750 mg every eight hours (q8h) for
8 weeks in combination with standard doses of peg-IFN and RBV for 8 weeks, then
continuing for another 16 weeks with peg-IFN and RBV alone; and
A control arm with standard doses of peg-IFN and RBV dosed for 48 weeks.
Patients
in both telaprevir arms who achieve RVR, defined in this study as undetectable
(less than 10 IU/mL) HCV RNA levels by the end of week 4, and who stay undetectable
at week 12 will receive 24 weeks of treatment. Patients in these treatment arms
who do not meet these RVR criteria but are undetectable at week 24 will continue
on peg-IFN and RBV for a total duration of 48 weeks.
Updates on the status
of Vertex and Tibotec's clinical trials of telaprevir are available at www.clinicaltrials.gov.
About Telaprevir
Telaprevir
(VX-950) is an investigational oral inhibitor of HCV protease, an enzyme essential
for viral replication, and is one of the most advanced investigational antiviral
agents in development that specifically targets HCV. The types of adverse events
that have been commonly observed with peg-IFN and RBV were seen across all treatment
arms in Phase 2b trials of telaprevir. The most common adverse events, regardless
of treatment assignment, were fatigue, rash, headache, and nausea, with rash being
the most common reason for treatment discontinuation. Gastrointestinal disorders,
skin adverse events (rash, pruritus) and anemia were more common in the telaprevir
arms compared to the control arm over the dosing period.
Source Vertex
Pharmaceuticals. Vertex Pharmaceuticals and Tibotec Announce Start of Phase 3
'ADVANCE' Study with Telaprevir in Treatment-Naive, Genotype 1 HCV Patients. Press
release. March 13, 2008.