- First presentation of results from this investigational interferon-, ribavirin- and ritonavir-free regimen
- Phase III development anticipated to begin in 2014
- Triple DAA regimen is one of multiple daclatasvir-based regimens in development to help address unmet needs of diverse HCV patient population
Bristol-Myers
Squibb Company (NYSE: BMY) today announced for the first time Phase
II data demonstrating that the 12-week Triple DAA treatment regimen of
daclatasvir (DCV), asunaprevir (ASV), and BMS-791325 achieved sustained
virologic response 12 weeks post-treatment (SVR12) in 94%
(15/16) of treatment-naïve, genotype 1 chronic hepatitis C patients. The
remaining one patient had undetectable viral load at the end of
treatment and was lost to follow-up until approximately 24 weeks
post-treatment; in preliminary data, this patient has achieved SVR24.
The Phase II results from this interferon-, ribavirin- and
ritonavir-free investigational regimen combining three different classes
of direct-acting antivirals (DAAs) – an NS5A replication complex
inhibitor (DCV), an NS3 protease inhibitor (ASV) and an NS5B
non-nucleoside polymerase inhibitor (BMS-791325) – were presented today
at the American Association for the Study of Liver Diseases congress in
Boston.
One serious adverse event was reported in this study and was determined
by the investigator to be unrelated to study drug. There were no
discontinuations due to adverse events. Headache was the most common
adverse event in the study (31%, 10/32).
“We are encouraged that this 12-week daclatasvir-based regimen with
compounds in different classes of DAAs achieved SVR12 in a
majority of patients without the use of interferon, ribavirin or
ritonavir,” said Brian
Daniels, MD, senior vice president, Global Development and Medical
Affairs, Research
and Development, Bristol-Myers Squibb. “The development of regimens
for hepatitis C with the potential to avoid the use of ribavirin and
ritonavir is an important approach in this therapeutic area, and we look
forward to studying it further.”
Phase II studies of this investigational Triple DAA regimen are ongoing.
Phase III development is anticipated to begin in 2014.
Daclatasvir is the first NS5A replication complex inhibitor to be
investigated in HCV clinical trials and is currently in Phase III
development. Asunaprevir is an oral, NS3 protease inhibitor in Phase III
development with daclatasvir. BMS-791325 is a non-nucleoside inhibitor
of the NS5B polymerase, currently in Phase II development for hepatitis
C as a component of daclatasvir-based treatment regimens.
Study Design and Results
This open-label, two-part Phase II study is designed to evaluate the
safety and antiviral activity of the investigational hepatitis C
treatment regimen of DCV, ASV and BMS-791325 in treatment-naïve patients
with genotype 1 chronic hepatitis C infection. The primary endpoint of
the study is viral load below the lower limit of quantitation (LLOQ; HCV
RNA <25 IU/mL) at 12 weeks post-treatment (SVR12).
Data presented at AASLD are from an interim analysis of Part 1 of the
study. In Part 1, 32 patients were randomized 1:1 (n=16/arm) into two
groups.
-
Group 1: 24 weeks of treatment with DCV 60 mg QD, ASV 200 mg BID,
BMS-791325 75 mg BID
-
Group 2: 12 weeks of treatment with DCV 60 mg QD, ASV 200 mg BID,
BMS-791325 75 mg BID
In Part 2 of the study, patients were assigned to the same DAA regimen
for 24 or 12 weeks, with BMS-791325 dosed at 150 mg BID (Groups 3 and 4,
respectively). Part 2 is ongoing and results are not yet available.
Virologic Response
-
Group 1 (24 week treatment): 94% (15/16) achieved undetectable viral
load by the end of treatment and sustained through SVR4.
Two patients discontinued study drugs prior to the protocol-defined
last treatment visit, one due to inability to comply with study
procedures (poor venous access) who achieved SVR4, and one
withdrew consent and is lost to follow up.
-
Group 2 (12 week treatment): 100% (16/16) achieved undetectable viral
load by the end of treatment and 94% (15/16) achieved SVR12.
The remaining one patient was lost to follow-up after completing
treatment but did return approximately 24 weeks post treatment and in
preliminary data, has achieved SVR24. One patient
discontinued study drugs prior to the protocol-defined last treatment
visit (due to poor/non-compliance) and achieved SVR12.
-
Viral load declined rapidly in both groups and was below LLOQ in all
patients (32/32) by week 4.
-
There was no viral breakthrough during treatment and no post-treatment
relapse.
Safety
There were no deaths, discontinuations due to adverse events (AEs), or
serious adverse events (SAEs) due to study drugs. Most AEs were mild to
moderate in severity. The most common AEs (≥10% total) were headache
(Group 1: 25%, 4/16; Group 2: 38%, 6/16), diarrhea (Group 1: 13%, 2/16;
Group 2: 38%, 6/16), and asthenia (Group 1: 13%, 2/16; Group 2: 19%,
3/16).
No Grade 3-4 elevations in liver enzymes (ALT/AST) or bilirubin were
observed. One grade 3 AE (headache) resolved after seven days with
continued study treatment and one grade 3–4 laboratory abnormality
(lymphopenia) was recorded in Group 2 at a single study visit
concomitant with influenza. All other AEs were grade 1 or 2.
About Bristol-Myers Squibb’s Commitment to Liver Disease
Bristol-Myers Squibb is studying a portfolio of compounds that aims to
address unmet medical needs across the liver disease continuum,
including hepatitis C, hepatitis B and liver cancer. The Company’s
hepatitis C pipeline includes compounds with different mechanisms of
action, pursuing both biologics as well as small molecule direct-acting
antivirals. These compounds are being studied as part of multiple
treatment regimens with the goal of increasing SVR rates across diverse
patient types and geographies.
Daclatasvir is an NS5A replication complex inhibitor that is being
extensively studied as a key component of potential DAA-based hepatitis
C treatment regimens. Studied in more than 3,000 patients to date,
daclatasvir is in Phase III development. Asunaprevir is an NS3 protease
inhibitor in Phase III development for hepatitis C as a component of
daclatasvir-based treatment regimens, and has been studied in more than
1,200 patients to date. BMS-791325 is a non-nucleoside inhibitor of the
NS5B polymerase, currently in Phase II development for hepatitis C as a
component of daclatasvir-based treatment regimens.
About Hepatitis C
Hepatitis C is a virus that infects the liver and is transmitted through
direct contact with infected blood and blood products. An estimated 170
million people worldwide are infected with hepatitis C, with genotype 1
being the most prevalent genotype. Up to 90 percent of those infected
with hepatitis C will not clear the virus and will become chronically
infected. Twenty percent of people with chronic hepatitis C will develop
cirrhosis and, of those, up to 25 percent may progress to liver cancer.
About Bristol-Myers Squibb
Bristol-Myers Squibb is a global biopharmaceutical company whose mission
is to discover, develop and deliver innovative medicines that help
patients prevail over serious diseases. For more information, please
visit http://www.bms.com
or follow us on Twitter at http://twitter.com/bmsnews.
Bristol-Myers Squibb Forward Looking Statement
This press release contains “forward-looking statements” as that term
is defined in the Private Securities Litigation Reform Act of 1995,
regarding the research, development and commercialization of
pharmaceutical products. Such forward-looking statements are
based on current expectations and involve inherent risks and
uncertainties, including factors that could delay, divert or change any
of them, and could cause actual outcomes and results to differ
materially from current expectations. No forward-looking
statement can be guaranteed. Among other risks, there can be no
guarantee that clinical trials of these compounds will support
regulatory filings, or that the compounds will receive regulatory
approvals or, if approved, that they will become commercially successful
products. Forward-looking statements in this press release should be
evaluated together with the many uncertainties that affect Bristol-Myers
Squibb’s business, particularly those identified in the cautionary
factors discussion in Bristol-Myers Squibb’s Annual Report on Form 10-K
for the year ended December 31, 2011, in our Quarterly Reports on Form
10-Q, and our Current Reports on Form 8-K. Bristol-Myers Squibb
undertakes no obligation to publicly update any forward-looking
statement, whether as a result of new information, future events, or
otherwise.
Bristol-Myers SquibbMedia:Cristi Barnett, 609-252-6028cristi.barnett@bms.comSonia Choi, 609-252-5132sonia.choi@bms.comorInvestors:John Elicker, 609-252-4611john.elicker@bms.comRanya Dajani, 609-252-5330ranya.dajani@bms.comRyan Asay, 609-252-5020ryan.asay@bms.com