Vertex
Reports 52% SVR 12 Rate for a 24-week Telaprevir-based Regimen in Genotype 1 Hepatitis
C Patients Who Failed Prior Treatment
73% of prior
relapsers achieved SVR12 with 24-week telaprevir-based treatment.
41% of prior
non-responders achieved SVR12 with 24-week telaprevir-based regimen.
Cambridge,
Mass., Jun 09, 2008 -- Vertex Pharmaceuticals Incorporated (Nasdaq: VRTX) today
announced positive results from a planned interim analysis of PROVE 3, an ongoing
Phase 2b study evaluating telaprevir-based treatment in patients with genotype
1 chronic hepatitis C virus (HCV) infection who did not achieve sustained virologic
response (SVR) with at least one prior pegylated interferon (peg-IFN) and ribavirin
(RBV) regimen. Vertex is developing telaprevir in collaboration with Tibotec.
In the interim analysis, 52% (60 of 115; intent-to-treat analysis) of
patients randomized to receive treatment with a 24-week telaprevir-based regimen
(12 weeks of telaprevir in combination with peg-IFN and RBV, followed by 12 weeks
of peg-IFN and RBV alone) maintained undetectable HCV RNA 12 weeks post-treatment
(SVR12).
In the interim analysis, adverse events were similar to those
commonly observed with peg-IFN and RBV including fatigue, nausea, rash, headache,
gastrointestinal disorders, and anemia, and were consistent with those previously
reported in patients being treated with telaprevir-based therapy in the PROVE
1 and 2 studies in treatment-naive subjects.
Based on these data, Vertex
and Tibotec plan to initiate a Phase 3 clinical trial in patients who have failed
prior treatment with peg-IFN and RBV. Telaprevir is the most advanced HCV protease
inhibitor in clinical development targeting treatment of chronic hepatitis C,
and is in Phase 3 clinical development in treatment-naive patients. Hepatitis
C is a disease that afflicts more than 3 million people in the United States alone,
and 170 million worldwide.
Interim Analysis
Results
PROVE 3 is a randomized, double-blind, placebo-controlled
Phase 2b study that enrolled patients who failed prior treatment with peg-IFN
and RBV. Patients enrolled in PROVE 3 included prior non-responders (including
null responders), prior relapsers, and prior breakthroughs to peg-IFN and RBV
treatment.
The interim analysis included 453 patients that were enrolled
and received at least one dose of study drug. In the interim analysis, 52% (60
of 115) of patients randomized to receive a 24-week telaprevir-based regimen (12
weeks of telaprevir in combination with peg-IFN and RBV, followed by 12 weeks
of peg-IFN and RBV alone) achieved undetectable HCV RNA (less than 10 IU/mL; Roche
TaqMan) 12 weeks post-treatment (SVR12).
Of the 115 patients, 66 were
categorized as non-responders to prior treatment (defined as patients who never
achieved undetectable HCV RNA during prior treatment, including null responders),
40 were prior relapsers (defined as patients who had undetectable HCV RNA at the
completion of prior treatment, but relapsed during follow-up), and 9 were prior
breakthroughs (defined as patients who had viral rebound during prior treatment).
Among patients receiving the 24-week telaprevir-based regimen, 41% (27
of 66) of the prior non-responders, 73% (29 of 40) of prior relapsers, and 44%
(4 of 9) of prior breakthroughs achieved SVR12.
"Patients who have
not achieved a sustained virologic response with one or more courses of prior
interferon-based therapy represent a significant unmet medical need. These patients
have few or no available treatment options and they are at increased risk for
progressive liver disease," said John McHutchison, MD, Principal Investigator
for the PROVE 3 Study and Associate Director of Duke Clinical Research Institute.
A summary of available on-treatment and post-treatment antiviral data
from the 24-week telaprevir-based regimen is presented below: Undetectable
HCV-RNA by Response to Prior Peg-IFN/RBV Treatment | | Week
12 | Week
24 (end of treatment) | SVR
12 (week 36; 12 weeks post-treatment) | | Non-responders
(n=66) | 71% | 65% | 41% | | Relapsers
(n=40) | 88% | 83% | 73% | | Breakthroughs
(n=9) | 44% | 44% | 44% | | Total
(n=115) | 75% | 70% | 52% |
In
the control arm (n=114), which is evaluating 48 weeks of peg-IFN and RBV only,
available data indicate that 8% of patients had undetectable HCV RNA at week 12,
and 30% had undetectable HCV RNA at week 36 on-treatment (intent-to-treat analysis).
In prior studies of peg-IFN and RBV in treatment-failure patients, the proportion
of patients who had undetectable HCV RNA at week 36 of treatment has been significantly
higher than the proportion who ultimately achieved SVR. End-of-treatment and post-treatment
data (including SVR rates) are not yet available for this study arm in PROVE 3.
In addition to the 24-week telaprevir-based regimen that includes ribavirin
and the 48 week control arm described above, two other treatment regimens are
being evaluated in PROVE 3: a 24-week telaprevir treatment arm without ribavirin,
and a 48-week treatment arm that includes 24 weeks of telaprevir dosing in combination
with peg-IFN and RBV.
The interim analysis supports the inclusion of ribavirin
in future studies of telaprevir-based regimens in treatment-failure patients,
similar to what has been observed in treatment-naive subjects. In addition, available
on-treatment results suggest that additional dosing of telaprevir beyond 12 weeks
does not confer additional benefit to patients.
Patient dosing has now
been completed in PROVE 3 and all patients are now being followed post-treatment.
Vertex anticipates that PROVE 3 data will be the subject of a presentation at
a medical conference later in 2008.
"These are the first data to
show the potential of a STAT-C agent to have this degree of antiviral response
in patients -- including both non-responders and relapsers -- who did not achieve
SVR with prior treatment. The interim data suggest that a telaprevir-based regimen
could be an important future treatment option for genotype 1 hepatitis C patients
who have failed a prior course of treatment," said John Alam, MD, Executive
Vice President, Medicines Development, and Chief Medical Officer of Vertex. "We
are now planning to begin a Phase 3 clinical trial with telaprevir in patients
who failed prior peg-IFN and ribavirin treatment."
In the interim
analysis, adverse events were similar to those commonly observed with peg-IFN
and RBV including fatigue, nausea, rash, headache, gastrointestinal disorders,
and anemia, and were also consistent with those previously reported in patients
being treated with telaprevir-based therapy in the PROVE 1 and 2 studies in treatment-naive
subjects.
Thirteen patients (11%) receiving the 24-week telaprevir based
treatment regimen (12 weeks of telaprevir in combination with peg-IFN and RBV,
followed by 12 weeks of peg-IFN and RBV alone) discontinued treatment due to adverse
events. The most common reason for discontinuation among patients receiving this
24-week telaprevir-based treatment regimen was rash (7% of patients). In the control
arm, 5 patients (4%) discontinued treatment prior to week 36 due to adverse events.
Phase 3 Study in Patients Who Failed Prior
Treatment
Vertex and Tibotec plan to initiate a Phase 3
clinical trial in genotype 1 HCV patients who have failed prior treatment with
peg-IFN and RBV in the third quarter, which will be led by Tibotec. The randomized,
double-blind and placebo-controlled study will focus on regimens of 48 weeks total
treatment duration, in which telaprevir is administered for 12 weeks, with a goal
of maximizing SVR rates. The study is planned to be conducted at more than 50
centers in the U.S., European Union (E.U.), and certain other countries.
Updates
on the status of Vertex and Tibotec's clinical trials of telaprevir are available
at www.clinicaltrials.gov.
About PROVE 3
PROVE
3 is an ongoing, four-arm, Phase 2b clinical trial of 453 genotype 1 HCV patients
who did not achieve an SVR with a prior course of peg-IFN and RBV treatment. The
study includes patients with compensated cirrhosis. The study is assessing patients
who receive telaprevir-based treatment regimens of 24 and 48-week total duration,
compared to a 48-week control arm of peg-IFN and RBV. PROVE 3 is being conducted
at 50 clinical centers in the U.S. and the E.U.
About
Telaprevir (VX-950)
Telaprevir (VX-950) is an investigational
oral inhibitor of HCV protease, an enzyme essential for viral replication, and
is the most advanced investigational agent in development that specifically targets
HCV. Telaprevir is the first hepatitis C protease inhibitor in Phase 3 clinical
trials.
The Phase 3 ADVANCE trial is expected to 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. Vertex is also conducting a global Phase
2b clinical development program of telaprevir, including PROVE 1 and PROVE 2 in
treatment-naive genotype 1 HCV patients, and PROVE 3 in genotype 1 HCV patients
who have not achieved SVR with a prior course of pegylated interferon-based therapy.
Vertex retains commercial rights to telaprevir in North America. Vertex
and Tibotec are collaborating to develop and commercialize telaprevir in Europe,
South America, Australia, the Middle East, and other countries. Vertex is collaborating
with Mitsubishi Pharma to develop and commercialize telaprevir in Japan and certain
Far East countries.
About Vertex
Vertex
Pharmaceuticals Incorporated is a global biotechnology company committed to the
discovery and development of breakthrough small molecule drugs for serious diseases.
The Company's strategy is to commercialize its products both independently and
in collaboration with major pharmaceutical companies. Vertex's product pipeline
is focused on viral diseases, inflammation, autoimmune diseases, cancer, pain
and cystic fibrosis. Vertex co-discovered the HIV protease inhibitor, Lexiva [fosamprenavir],
with GlaxoSmithKline.
For further information on Vertex Pharmaceuticals
Incorporated, see www.vpharm.com. |