You have reached the HIVandHepatitis.com legacy site. Please visit our new site at hivandhepatitis.com

Addition of HCV Protease Inhibitor Telaprevir Can Shorten Interferon-based Treatment

SUMMARY: Adding the investigational hepatitis C virus (HCV) protease inhibitor telaprevir (formerly known as VX-950) to standard hepatitis C therapy using pegylated interferon plus ribavirin can potentially shorten treatment from 48 to 24 weeks for people with hard-to-treat HCV genotype 1, Vertex Pharmaceuticals announced this week. In the Phase 3 ILLUMINATE trial, previously untreated patients who showed good virological response at weeks 4 and 12 of therapy did just as well with a 6-month course of treatment as with the standard 12-month duration, reaching a sustained virological response rate of 92%. Vertex plans to file for Food and Drug Administration (FDA) approval of telaprevir during the fourth quarter of this year.


Below is an edited excerpt from a Vertex press release describing the study and its findings.


Phase 3 ILLUMINATE Study Supports 24-Week Telaprevir-Based Therapy Within a Response-Guided Regimen for People with Hepatitis C Who Had Not Received Prior Treatment

Viral cure rates of 92% and 88% with 24 and 48-week regimens,
respectively, in people who met certain response criteria

Safety and tolerability results were similar to those
seen in the Phase 3 ADVANCE study

Cambridge, Mass. -- August 10, 2010 -- Vertex Pharmaceuticals Incorporated (Nasdaq: VRTX) today announced results from the Phase 3 ILLUMINATE study, which was designed to evaluate whether there was any benefit to extending therapy from 24 to 48 weeks in people whose hepatitis C virus (HCV) was undetectable at weeks 4 and 12 of treatment (extended rapid viral response or eRVR). People in the trial who met these eRVR criteria and who remained on treatment were then randomized at week 20 to receive 24 or 48 weeks of total treatment. People who did not meet these criteria were assigned to 48 weeks of pegylated interferon and ribavirin therapy.

Sustained viral response (SVR or viral cure) rates of 92% and 88% were observed in the randomized 24 and 48-week telaprevir-based treatment groups, respectively. 72% of all 540 people treated with telaprevir in the study achieved a viral cure. The safety and tolerability profile of the telaprevir-based regimen was consistent with results reported previously from the pivotal Phase 3 ADVANCE study.

"The viral cure rates seen in ILLUMINATE showed that there was no benefit to extending telaprevir-based therapy to 48 weeks for the majority of people," said Kenneth Sherman, MD, PhD, Professor of Medicine at the University of Cincinnati College of Medicine, Director of the Division of Digestive Diseases for UC Health and Principal Investigator of the trial. "Patients who had a rapid response to telaprevir-based regimens at weeks 4 and 12 had a high likelihood of achieving a cure with 24 weeks of total treatment, which may provide important information to motivate people to continue therapy."

"Data from ILLUMINATE and ADVANCE support our belief that the use of 24-week telaprevir-based therapy within a response-guided regimen may provide an important future treatment option for people with hepatitis C," said Robert Kauffman, MD, PhD, Senior Vice President and Chief Medical Officer for Vertex.

Telaprevir is an investigational, oral inhibitor of HCV protease, an enzyme essential for viral replication, and is being developed by Vertex Pharmaceuticals in collaboration with Tibotec Pharmaceuticals and Mitsubishi Tanabe Pharma. Results from the ILLUMINATE study are expected to supplement data obtained from ADVANCE and REALIZE -- the two pivotal Phase 3 studies of telaprevir -- as part of a New Drug Application submission to the U.S. Food and Drug Administration planned for the fourth quarter of 2010.

Efficacy Results from ILLUMINATE

Primary analysis for people who met certain response criteria*:

24-week telaprevir-based treatment regimen:

- SVR Rate: 92% (149/162)
- Relapse Rate: 5.7% (9/159)

48-week telaprevir-based treatment regimen:

- SVR Rate: 88% (140/160)
- Relapse Rate: 1.9% (3/154)

*Reflects people whose hepatitis C virus was undetectable (< 25 IU/mL and undetectable by Roche COBAS Taqman HCV test) at weeks 4 and 12 (eRVR) and who remained on treatment through week 20.

Overall efficacy analysis for all patients treated with telaprevir in ILLUMINATE (ITT or intent-to-treat analysis):

- SVR Rate: 72% (388/540)
- Relapse Rate: 7.7% (36/469)
- Rapid Viral Response (RVR) Rate: 72% (389/540)
- Extended RVR (eRVR): 65% (352/540)

Safety & Tolerability Results from ILLUMINATE

The safety and tolerability profile of the telaprevir-based regimen in the ILLUMINATE study was similar to results reported from the Phase 3 ADVANCE study. The most common adverse events reported in the ILLUMINATE study, in order of frequency, were fatigue, pruritus, nausea, anemia, rash and headache. The majority of these adverse events were mild or moderate. Adverse events leading to discontinuation of all study drugs during the 12-week telaprevir dosing period occurred in 6.9% of people in the study. Treatment discontinuation of all drugs due to anemia and rash occurred in 1.1% and 0.6% of people in the study, respectively, during the telaprevir dosing period. Like in ADVANCE, the use of erythropoiesis-stimulating agents (ESAs) was not allowed in this study.

Data from ILLUMINATE have been submitted for presentation at the 2010 Annual Meeting of the American Association for the Study of Liver Diseases.

About the ILLUMINATE Trial


ILLUMINATE was a Phase 3, supplemental, open-label, randomized study in people infected with genotype 1 chronic hepatitis C, the most common form of the virus in the U.S. and Europe, who had not been previously treated (treatment-naive). In this study, people who met protocol-defined response criteria of achieving eRVR were randomized at week 20 to receive 24 or 48 weeks of total treatment. The primary endpoint of the study was the proportion of patients who achieved SVR in the randomized treatment groups, and evaluated by a non-inferiority analysis. Based on this analysis, the study achieved its primary endpoint of non-inferiority with respect to SVR rates in the randomized 24 and 48-week telaprevir-based arms. The trial enrolled people at 76 clinical trial sites in the U.S. and Europe. A greater proportion of people in the ILLUMINATE study (approximately 90%) were enrolled at U.S. sites compared to the proportion in ADVANCE. As in all studies evaluating telaprevir-based regimens, patients received no more than 12 weeks of triple therapy (telaprevir, pegylated-interferon and ribavirin) followed by pegylated-interferon and ribavirin only, as part of either 24 or 48 weeks of total treatment, as noted in the trial design.

About the Telaprevir Development Program

To date, more than 2,500 people with hepatitis C have received telaprevir-based therapy as part of Phase 2 studies and the Phase 3 ADVANCE, ILLUMINATE and REALIZE trials. Together, these studies enrolled people with genotype 1 hepatitis C who had not been treated for their disease previously as well as people who had been treated before but did not achieve a viral cure. The telaprevir clinical development program is the largest conducted to date for any investigational direct-acting antiviral hepatitis C therapy.

Phase 3 ADVANCE Trial


The pivotal Phase 3 ADVANCE study evaluated telaprevir-based response-guided regimens in 1,095 treatment-naive patients. Data from this trial has been accepted for presentation at the 2010 Annual Meeting of the American Association for the Study of Liver Diseases.

Phase 3 REALIZE Trial

The second pivotal Phase 3 study, REALIZE, which is being conducted by Vertex's collaborator Tibotec, is evaluating telaprevir-based regimens in approximately 650 people who did not achieve a viral cure with a prior pegylated-interferon based treatment. REALIZE is the only current Phase 3 study of an investigational hepatitis C therapy to enroll a difficult-to-treat population that includes patients who had a null response and failed to achieve a viral cure with a prior course of hepatitis C therapy. Topline data from REALIZE are expected in September 2010.

Vertex retains commercial rights to telaprevir in North America. Tibotec has rights to commercialize telaprevir in Europe, South America, Australia, the Middle East and certain other countries. Mitsubishi Tanabe Pharma has rights to 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, cystic fibrosis, inflammation, autoimmune diseases, epilepsy, cancer, and pain. Vertex co-discovered the HIV protease inhibitor, Lexiva, with GlaxoSmithKline.

For more information, see http://www.vrtx.com.

8/13/10

Source
Vertex Pharmaceuticals. Phase 3 ILLUMINATE Study Supports 24-Week Telaprevir-Based Therapy Within a Response-Guided Regimen for People with Hepatitis C Who Had Not Received Prior Treatment. Press release. August 10, 2010.


 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


 Google Custom Search
FDA-approved Combination Therapies for Chronic HCV Infection
Pegasys + Copegus
PEG-Intron + Rebetol
Intron A + Rebetol
Roferon A + Ribavirin
 
Experimental Treatments
Treatment Guidelines

HCV Articles by Topic

Cirrhosis
Fibrosis
Hepatocellular Carcinoma
Liver Transplantation
Liver Biopsy

Steatosis
Anemia
Children / Infants / Women
Drug Abuse
Experimental Treatments
FAQs About Hepatitis C
Genotypes
Insulin Resistance / Diabetes
Sustained Viral Response (SVR)
Tests for HCV
Vaccines for HCV

From Paper to Practice:
Clinical Application of EASL Guidelines for Optimal Management

From Paper to Practice:
Clinical Application of AASLD Guidelines for Optimal Management