InterMune
Reports Results from Triple Combination Study of HCV Protease Inhibitor ITMN-191
Given
the side effects and suboptimal efficacy of standard
interferon-based therapy for chronic hepatitis
C, especially for patients with hard-to-treat HCV
genotype 1, researchers have explored a variety of directly-targeted drugs
--collectively referred to as "STAT-C"
-- that interfere with different steps of the viral lifecycle. Several
such agents are currently moving through the research pipeline, including the
HCV NS3/4A
protease inhibitor ITMN-191 (also known as R7227) being jointly developed
by InterMune and Roche. Below
is an edited excerpt from a recent InterMune press release announcing results
from a Phase 1b study of ITMN-191 in combination with pegylated
interferon alfa-2a (Pegasys) plus ribavirin in previously untreated genotype
1 hepatitis C patients. InterMune
Reports Results from Triple Combination Study of ITMN-191
Q12h and Q8h Regimens
Deliver Robust Antiviral Effects and Strong Safety Profile
Phase2b Study Anticipated
to Begin in Q2 2009
Brisbane,
Calif. -- January 12, 2008 -- InterMune, Inc. today reported top-line results
from all six completed dosage cohorts of its Phase 1b clinical trial of ITMN-191
(R7227) in combination with standard-of-care Pegasys (peginterferon alfa-2a) and
Copegus (ribavirin) for 14 days of treatment in hepatitis C virus (HCV) treatment-naive
patients infected with HCV genotype 1. ITMN-191 is being developed in collaboration
with Roche. Viral kinetic performance and safety results were reported for three
cohorts each of ITMN-191 given every 12 hours (q12h) and every eight hours (q8h).
Viral
Kinetic Performance
After 14 days of triple combination therapy, the
median change in HCV RNA from baseline exceeded 5 logs in five of the six cohorts
and was -5.4 log and -5.7 log in the best performing q12h and q8h cohorts, respectively.
Considering all cohorts, HCV RNA was below the limit of quantification in nearly
three-quarters (71%, or 32 of 45) of patients who received treatment with ITMN-191
after only 14 days of treatment. In all q12h and q8h cohorts, reductions in HCV
RNA occurred rapidly and there was no evidence of viral rebound during ITMN-191
treatment.
Safety and Tolerability Profile ITMN-191was
generally safe and well tolerated. There were no serious adverse events (SAEs)
or Grade 4 adverse events (AEs) during treatment with ITMN-191. AEs reported during
study treatment (ITMN-191 or placebo) were predominantly mild to moderate in severity,
typically consistent with the well-described AE profile of standard of care (SOC)
and none led to treatment discontinuation.
Only four Grade 3 AEs were
reported during study treatment, two of which (sciatica and back pain) were deemed
by the investigator to be unrelated to ITMN-191. The other two were neutropenia
and indirect bilirubin elevation. Neutropenia occurred with a similar pattern,
frequency, and severity in the placebo and ITMN-191 groups. Minor and transient
elevations in indirect bilirubin levels were observed in a small number of placebo
and ITMN-191 patients and were deemed not clinically significant by the investigator.
There were no other laboratory or ECG findings during study treatment that were
attributable to ITMN-191. A
chart of the median log10 HCV RNA changes from baseline to Day 14 for each dose
cohort is available on the investor relations
page of InterMune's corporate website.
Dr. Stefan Zeuzem, Professor
of Medicine, Chief of the Department of Medicine at the J.W. Goethe University
Hospital in Frankfurt, Germany and protocol chair of this study said, "Based
on the totality of the viral kinetic data, in particular BLQ [Below Limit of Quantification],
a robust predictor of virologic outcome, the q12h and q8h regimens delivered very
convincing viral kinetic results and appeared to perform very comparably in this
14-day study. The safety and tolerability profile of ITMN-191 in both the earlier
monotherapy study and in the present triple combination study was also encouraging,
as no issues of concern were observed. We look forward to the completion of the
planned Phase 2b study to determine if the very promising profile of ITMN-191
observed will be confirmed."
Dan Welch, Chairman, Chief Executive
Officer and President of InterMune said, "We are very pleased to report that
in this 14-day study, both the q12h and q8h regimens of ITMN-191 delivered viral
kinetic performance that we believe is very competitive with that reported to
date for other protease inhibitors in similar experiments. In addition, the strong
safety and tolerability profile of ITMN-191 observed in prior Phase 1 experiments
was reinforced in this study, even in the presence of standard-of-care therapy
and at doses significantly higher than those used in monotherapy."
Mr.
Welch continued, "We believe that the viral kinetic and safety results reported
today provide evidence that ITMN-191 has the potential to deliver superior sustained
virologic response (SVR) rates on an intent-to-treat basis. In pursuit of this
goal, our Phase 2b study, anticipated to begin in the second quarter of 2009,
will study both q12h and q8h regimens and both 12 and 24-week treatment durations."
Phase 1b Triple Combination Trial Design
The Phase 1b randomized,
double-blind, placebo-controlled, 14-day triple combination study in treatment-naive
patients chronically infected with HCV genotype 1 was designed to inform the dose
selection and study design of the ITMN-191 Phase 2 program. The study objectives
were to assess the safety, pharmacokinetic and viral kinetic effects of various
doses and regimens of ITMN-191 for 14 days in combination with Pegasys and Copegus
compared to treatment with Pegasys and Copegus alone. Patient follow-up continues
for 30 days following the completion of study treatment.
INFORM-1 Progress
(All-oral STAT-C study)
In November 2008, Roche, InterMune and Pharmasset
initiated the first
all-oral combination study of direct anti-virals in the absence of interferon
or ribavirin, known as the INFORM-1 study. That study has completed the first
dose cohort. Results of INFORM-1 are expected to be reported at a major medical
conference in the second quarter of this year.
About InterMune
InterMune
is a biotechnology company focused on the research, development and commercialization
of innovative therapies in pulmonology and hepatology. InterMune has a pipeline
portfolio addressing idiopathic pulmonary fibrosis (IPF) and hepatitis C virus
(HCV) infections. The pulmonology portfolio includes the Phase 3 program, CAPACITY,
which is evaluating pirfenidone as a possible therapeutic candidate for the treatment
of patients with IPF and a research program focused on small molecules for pulmonary
disease. The hepatology portfolio includes the HCV protease inhibitor compound
ITMN-191 (referred to as R7227 at Roche) in Phase 1b, a second-generation HCV
protease inhibitor research program, and a research program evaluating new targets
in hepatology.
For additional information about InterMune and its R&D
pipeline, please visit www.intermune.com. |
1/16/09
Source InterMune,
Inc. InterMune Reports Results from Triple Combination Study of ITMN-191. Press
release. January 12, 2009.
|