Showing posts with label EASL. Show all posts
Showing posts with label EASL. Show all posts

Thursday, March 31, 2011

EASL Telaprevir Improved SVR Rates in People Whose Prior Treatment For Hepatitis C Was Unsuccessful



Results From Phase 3 REALIZE Study Showed Telaprevir-Based Therapy Improved SVR Rates in People Whose Prior Treatment For Hepatitis C Was Unsuccessful


Vertex Pharmaceuticals Incorporated (Nasdaq: VRTX) today announced final
results from its pivotal Phase 3 REALIZE study that evaluated people
with genotype 1 chronic hepatitis C whose prior treatment with
pegylated-interferon and ribavirin was unsuccessful either because they
relapsed, had a partial response or had a null response. Data from the
study showed that people in each of these subgroups who were treated
with telaprevir-based combination therapy achieved statistically
significant rates of sustained viral response (SVR) compared to those
treated with pegylated-interferon and ribavirin alone.
REALIZE also evaluated whether SVR rates could be further improved by
delaying the start of telaprevir by four weeks, during which time
patients received four weeks of pegylated-interferon and ribavirin alone
(lead-in), compared to a simultaneous start. The data showed no clinical
benefit to a lead-in for people treated with telaprevir-based
combination therapy. Safety and tolerability results were consistent
with results from the prior Phase 3 studies of telaprevir. These data
were presented today at The International Liver Congress™ 2011, 46th
annual meeting of the European Association for the Study of the Liver
(EASL) in Berlin, Germany. REALIZE was conducted by Vertex’s
collaborator, Tibotec BVBA.
“These data showed higher sustained viral response rates for patients
treated with a telaprevir-based regimen compared to re-treatment with
currently available medicines,” said Stefan Zeuzem, M.D., Professor of
Medicine and Chief of the Department of Medicine at the JW Goethe
University Hospital, Frankfurt, Germany and principal investigator for
REALIZE.
Among those in the simultaneous start arm of REALIZE, 83 percent
(121/145) of prior relapsers, 59 percent (29/49) of prior partial
responders and 29 percent (21/72) of null responders achieved SVR
compared to 24 percent (16/68), 15 percent (4/27) and 5 percent (2/37),
respectively, who received pegylated-interferon and ribavirin. The SVR
rates among those in the lead-in arm were 88 percent (124/141) among
prior relapsers, 54 percent (26/48) among prior partial responders and
33 percent (25/75) among prior null responders. In a combined endpoint
analysis of the two telaprevir-based treatment arms, 86 percent
(245/286) of prior relapsers, 57 percent (55/97) of prior partial
responders and 31 percent (46/147) of prior null responders achieved SVR.
“Rates of sustained viral response among those treated with
telaprevir-based regimens were similar between the simultaneous and
delayed start arms of the study,” said Robert Kauffman, M.D., Ph.D.,
Senior Vice President and Chief Medical Officer for Vertex.
In this study, 48 percent (316/662) of patients overall had advanced
liver fibrosis or cirrhosis (scarring of the liver) and 89 percent
(586/662) of patients overall had high amounts of hepatitis C virus
(high viral load; HCV RNA ≥ 800,000 IU/mL) upon study entry.

Summary of REALIZE Results
In this study, patients were randomized 2:2:1 to two telaprevir-based
treatment arms (simultaneous or lead-in) or a control arm of 48 weeks of
pegylated-interferon and ribavirin alone. Patients in the telaprevir
treatment arms received a total of 12 weeks of telaprevir-based
combination therapy. In the lead-in arm, patients received four weeks of
pegylated-interferon and ribavirin followed by telaprevir in combination
with pegylated-interferon and ribavirin for 12 weeks followed by 32
weeks of pegylated-interferon and ribavirin alone. For those in the
simultaneous start arm, the telaprevir-based combination was followed by
an additional 36 weeks of pegylated-interferon and ribavirin alone. The
primary endpoint of the REALIZE study was SVR in each of the two
telaprevir treatment arms compared to the control arm and for the three
groups of people included in the study. The total treatment time for all
patients in REALIZE was 48 weeks.
REALIZE
SVR Results % (n)
Prior Relapsers
(n=354)*

Prior Partial Responders
(n=124)*

Prior Null Responders
(n=184)*
TVR-based
Simultaneous Start Arm+


83%

(121/145)


59%

(29/49)


29%

(21/72)
TVR-based
Lead-In Arm++


88%

(124/141)


54%

(26/48)


33%

(25/75)
Control Arm+++

24%

(16/68)


15%

(4/27)


5%

(2/37)
*The SVR rates observed were statistically significant when
compared with the control arm (p <0.001).

+Simultaneous start: 12 weeks of telaprevir (750 mg,
q8h), Pegasys® (PEG, pegylated-interferon alfa-2a) &
Copegus® (RBV, ribavirin), followed by 36 weeks of PEG
& RBV alone.

++Lead-in: 4 weeks of PEG & RBV alone followed by 12
weeks of telaprevir (750 mg, q8h), PEG & RBV, followed by 32 weeks
of PEG & RBV alone. There was no clinical benefit with the use of
a four-week lead in with no significant improvement in SVR rates
and no significant reduction in virologic failure and relapse
rates in the lead-in start arm compared to the simultaneous start
arm.

+++Control: 12 weeks of placebo, PEG & RBV, followed by
36 weeks of Peg & RBV alone.

Prior Relapser: Defined as a person
whose hepatitis C virus was undetectable at the completion of at
least 42 weeks of a prior course of therapy but whose virus became
detectable during the follow-up period.

Prior Partial Responder: Defined as a
person who achieved at least a 2 log in10 reduction in
HCV RNA at week 12, but whose hepatitis C virus never became
undetectable by week 24 of a prior course of therapy.

Prior Null Responder: Defined as a
person who achieved a less than 2 log10 reduction in
HCV RNA at week 12 of a prior course of therapy.

Safety and Tolerability Information for the Phase 3 Studies of
Telaprevir

The safety and tolerability results of the telaprevir-based combination
regimens were consistent across the Phase 3 studies. The most common
adverse events were fatigue, pruritus, nausea, headache, rash, anemia,
flu-like symptoms, insomnia and diarrhea with the majority being mild to
moderate. Rash and anemia occurred more frequently in the
telaprevir-based treatment arms compared to the control group.
Rash was primarily characterized as eczema-like, manageable and resolved
upon stopping telaprevir. More than 90 percent of rash was mild to
moderate and primarily managed with the use of topical corticosteroids
and/or antihistamines. Anemia was primarily managed by reducing the dose
of ribavirin.
Sequential discontinuation of the medicines was recommended as a
strategy to manage certain adverse events. This strategy allowed
patients to continue on pegylated-interferon and ribavirin after
stopping telaprevir. Discontinuation of all medicines due to either rash
or anemia during the telaprevir/placebo treatment phase was 1 percent to
3 percent in the telaprevir treatment arms.

About the Study
REALIZE was a pivotal Phase 3, randomized, double-blind,
placebo-controlled global study. The majority of clinical trial sites
were in Europe. The study was designed to evaluate the efficacy, safety
and tolerability of telaprevir-based combination regimens in people
infected with genotype 1 chronic hepatitis C who did not achieve SVR
after at least one course of prior treatment with interferon-based
therapy.

Status of Telaprevir Regulatory Applications
The safety and efficacy of telaprevir for the treatment of chronic
hepatitis C is still under investigation. Authorization to market
telaprevir has not yet been obtained.
The regulatory applications for the approval of telaprevir have been
granted Priority Review by the U.S. Food and Drug Administration (FDA)
and Health Canada and accelerated assessment by the European Medicines
Agency for the treatment of people with genotype 1 chronic hepatitis C.
The FDA has scheduled its Antiviral Drugs Advisory Committee to discuss
the New Drug Application for telaprevir on April 28, 2011. A target
response date of May 23, 2011 is set under the Prescription Drug User
Fee Act (PDUFA). The applications include data from three registration
studies, ADVANCE, ILLUMINATE and REALIZE, which evaluated telaprevir in
combination with pegylated-interferon and ribavirin in people with
hepatitis C who were new to treatment as well as those who did not
achieve SVR after treatment with currently available medicines. For
complete information on the telaprevir clinical trials or a fact sheet
on the trial designs visit: www.vrtx.com/press.cfm.

About the Telaprevir Development Program
Telaprevir is an investigational, oral inhibitor that acts directly on
the HCV protease, an enzyme essential for viral replication. 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 studies. Together, these studies enrolled people with
genotype 1 chronic hepatitis C who had not been treated for their
disease previously as well as people who had been treated before but did
not achieve SVR.
Vertex is developing telaprevir in collaboration with Tibotec BVBA and
Mitsubishi Tanabe Pharma. Vertex has rights to commercialize telaprevir
in North America. Through its affiliate, Janssen, 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 Hepatitis C
Hepatitis C is a serious liver disease caused by the hepatitis C virus,
which is spread through direct contact with the blood of infected people
and ultimately affects the liver.1 Chronic hepatitis C can
lead to serious and life-threatening liver problems, including liver
damage, cirrhosis, liver failure or liver cancer.1 Though
many people with hepatitis C may not experience symptoms, others may
have symptoms such as fatigue, fever, jaundice and abdominal pain.1
Approximately 60 percent of people who undergo treatment with an initial
48-week regimen of pegylated-interferon and ribavirin, the currently
approved medicines for genotype 1 hepatitis C, do not achieve SVR.2,3,4 If treatment is not successful and a person does not achieve SVR,
they remain at an increased risk for progressive liver disease.5,6
Approximately 250,000 people in Canada have chronic hepatitis C and more
than a third of them do not know they are infected.7 Three
provinces account for 80 percent of hepatitis C infections in Canada:
Ontario (42 percent), British Columbia (22 percent) and Quebec (16
percent).8 Each year up to 5,000 people are newly infected
with hepatitis C, and in 2007 alone, nearly 8,000 people were infected.7,8 In 2010, the annual cost of hepatitis C due to medical treatment
and lost productivity in Canada was estimated to reach $1 billion.9 By
2022, the number of hepatitis C-related deaths is expected to increase
by one-third.10
PEGASYS® and COPEGUS® are registered trademarks of
Hoffmann-La Roche.

Special Note Regarding Forward-Looking Statements
This press release contains forward-looking statements as defined in the
Private Securities Litigation Reform Act of 1995, including statements
regarding (i) the date of the scheduled meeting of the FDA’s Antivirial
Advisory Committee and (ii) the FDA's target review date for the
telaprevir NDA. While the company believes the forward-looking
statements contained in this press release are accurate, there are a
number of factors that could cause actual events or results to differ
materially from those indicated by such forward-looking statements.
Those risks and uncertainties include, among other things, that Vertex
could experience unforeseen delays in obtaining approval to market
telaprevir; that there may be varying interpretations of the data from
the telaprevir clinical trials; that future outcomes from clinical
trials of telaprevir may not be favorable; that future scientific,
clinical, competitive or other market factors may adversely affect the
potential for telaprevir-based therapy and the other risks listed under
Risk Factors in Vertex's annual report and quarterly reports filed with
the Securities and Exchange Commission and available through Vertex's
website at http://cts.businesswire.com/ct/CT?id=smartlink&url=http%3A%2F%2Fwww.vrtx.com&esheet=6666721&lan=en-US&anchor=www.vrtx.com&index=2&md5=d53c1c8d6041bf3eaecb178f6ea93eb7.
Vertex disclaims any obligation to update the information contained in
this press release as new information becomes available.

About Vertex
Vertex creates new possibilities in medicine. Our team aims to discover,
develop and commercialize innovative therapies so people with serious
diseases can lead better lives.
Vertex scientists and our collaborators are working on new medicines to
cure or significantly advance the treatment of hepatitis C, cystic
fibrosis, epilepsy and other life-threatening diseases.
Founded more than 20 years ago in Cambridge, MA, we now have ongoing
worldwide research programs and sites in the U.S., U.K. and Canada.
For more information and to view Vertex's press releases, please visit
 http://cts.businesswire.com/ct/CT?id=smartlink&url=http%3A%2F%2Fwww.vrtx.com&esheet=6666721&lan=en-US&anchor=www.vrtx.com&index=3&md5=dd851198a0dbb74dfd8798b5f297076e.
1 Centers for Disease Control and Prevention. Hepatitis C
Fact Sheet: CDC Viral Hepatitis. Available at: http://cts.businesswire.com/ct/CT?id=smartlink&url=http%3A%2F%2Fwww.cdc.gov%2Fhepatitis%2FHCV%2FPDFs%2FHepCGeneralFactSheet.pdf&esheet=6666721&lan=en-US&anchor=http%3A%2F%2Fwww.cdc.gov%2Fhepatitis%2FHCV%2FPDFs%2FHepCGeneralFactSheet.pdf&index=4&md5=dc3c8b2fe5bf684b55a8ceb8470468a3.
Accessed March 21, 2011.
2 Manns MP, McHutchison JG, Gordon SC, et al. Peginterferon
alfa-2b plus ribavirin compared with interferon alfa-2b plus ribavirin
for initial treatment of chronic hepatitis C: a randomised trial. Lancet.
2001;358:958-965.
3 Fried MW, Shiffman ML, Reddy KR, et al. Peginterferon
alfa-2a plus ribavirin for chronic hepatitis C virus infection. N
Engl J Med.
2002;347:975-982.
4 McHutchison JG, Lawitz EJ, Shiffman ML, et al; IDEAL Study
Team. Peginterferon alfa-2b or alfa-2a with ribavirin for treatment of
hepatitis C infection. N Engl J Med. 2009;361:580-593.
5 Morgan TR, Ghany MG, Kim HY, Snow KK, Lindsay K, Lok AS.
Outcome of sustained virological responders and non-responders in the
Hepatitis C Antiviral Long-Term Treatment Against Cirrhosis (HALT-C)
trial. Hepatology. 2008;50(Suppl 4):357A (Abstract 115).
6 Veldt BJ, Heathcote J, Wedmeyer H. Sustained virologic
response and clinical outcomes in patients with chronic hepatitis C and
advanced fibrosis. Annals of Internal Medicine. 2007; 147: 677-684.
7 Public Health Agency of Canada. Hepatitis C: Get the facts.
You could have it and not know it.
 http://cts.businesswire.com/ct/CT?id=smartlink&url=http%3A%2F%2Fwww.phac-aspc.gc.ca%2Fhepc%2Fpubs%2Fgetfacts-informezvous%2Findex-eng.php&esheet=6666721&lan=en-US&anchor=http%3A%2F%2Fwww.phac-aspc.gc.ca%2Fhepc%2Fpubs%2Fgetfacts-informezvous%2Findex-eng.php&index=5&md5=d046c720dd223371205d42fbab7c4c80.
Updated September 21, 2010. Accessed January 18, 2011.
8 Public Health Agency of Canada. Modeling the incidence of
prevalence of hepatitis C infection and its sequelae in Canada, 2007.
http://cts.businesswire.com/ct/CT?id=smartlink&url=http%3A%2F%2Fwww.phac-aspc.gc.ca%2Fsti-its-surv-epi%2Fmodel%2Fresults-eng.php&esheet=6666721&lan=en-US&anchor=http%3A%2F%2Fwww.phac-aspc.gc.ca%2Fsti-its-surv-epi%2Fmodel%2Fresults-eng.php&index=6&md5=8c2dbe3c50e9784b253c754d1b6beab9.
Updated October 20, 2010. Accessed January 18, 2011.
9 Public Health Agency of Canada. A renewed public health
response to address hepatitis C: A summary report of the
priority-setting process and strategic framework to action.
 http://cts.businesswire.com/ct/CT?id=smartlink&url=http%3A%2F%2Fwww.phac-aspc.gc.ca%2Fhepc%2Fsr-rs%2Fpdf%2Fsrhepc-eng.pdf&esheet=6666721&lan=en-US&anchor=http%3A%2F%2Fwww.phac-aspc.gc.ca%2Fhepc%2Fsr-rs%2Fpdf%2Fsrhepc-eng.pdf&index=7&md5=8ab9adb03ca74f5b5608c2c8d50680a0.
Updated June 2009. Accessed January 2011.
10 Sherman M, Sharfran S, Burak K, et al. Management of
chronic hepatitis C consensus guidelines. Can J Gastroenterol.
2007;21 (Suppl C):25C-34C.


Contacts
Vertex Pharmaceuticals Incorporated
Media:
Dawn Kalmar
Amy
Pasqua
Zachry Barber
617-444-6992 or mediainfo@vrtx.com
or
Investors:
Michael
Partridge, 617-444-6108
or
Lora Pike, 617-444-6755
or
Matthew
Osborne, 617-444-6057

Telaprivir beats HCV standard care

Friday 1st April 2011

Telaprevir-based regimens are significantly better than standard care for treatment-experienced hepatitis C patients, research suggests.

Tibotec Virco-Virology BVBA has announced that a significantly greater proportion of patients who have previously failed treatment for chronic genotype 1 hepatitis C virus (HCV) achieved a sustained viral response (SVR) with 12 week telaprevir combination regimens than with the current standard of care, pegylated-interferon and ribavirin, alone.

Telaprevir is an investigational DAA (Direct Acting Antiviral) being co-developed by Tibotec and Vertex Pharmaceuticals.

Final data from the REALIZE trial were presented today at the 46th annual meeting of the European Association for the Study of the Liver (EASL) in Berlin.

SVR, which means the virus remains undetectable in patients' blood six months after completion of treatment, is the goal of HCV treatment and is considered a cure.

An estimated 170 million people globally suffer from chronic HCV and approximately 10-20 percent of these people will develop cirrhosis and liver failure.

Chronic infection with HCV can lead to liver cancer and other serious and fatal liver diseases, and HCV is the most common cause of liver transplant in Europe.

"These groundbreaking data show that a telaprevir combination regimen significantly improves cure rates for patients with genotype 1 HCV, the most common form of the virus, who have failed previous treatment," said lead investigator Professor Stefan Zeuzem, Chief of the Department of Medicine, Johann Wolfgang Goethe University Hospital, Frankfurt, Germany.

"Significant advancements in treatment such as this will make a real difference in reducing the burden of HCV."

Wednesday, March 30, 2011

EASL; Presidio's PPI-461, a novel HCV NS5A inhibitor preliminary results

Mar. 30, 2011 (Business Wire) -- Presidio Pharmaceuticals, Inc. announced today positive preliminary results from a Phase 1b clinical trial of PPI-461, a novel HCV NS5A inhibitor for the treatment of patients with chronic hepatitis C.


The PPI-461 phase 1b clinical trial reported here is a multiple ascending dose, randomized, blinded, placebo-controlled study in treatment-naïve adult hepatitis C patients with HCV genotype-1 infection; this trial is presently ongoing in the U.K., Denmark, and the United States. The study objectives are to assess the safety, tolerability, pharmacokinetics, and initial antiviral effects of PPI-461 during once-daily (QD) dosing at three dosing levels (50, 100, and 200 mg/day) for three days. Each dosing cohort

of 8 patients is randomized 6 (PPI-461):2 (placebo). Two dosing groups have completed study treatment to date; the third (200 mg) dosing group is ongoing.


The interim Phase 1b trial results indicate that PPI-461 has been well-tolerated, with no serious or severe adverse events and no modifications or premature discontinuations of study treatment. Among PPI-461 recipients there have been only transient clinical adverse events, of non-specific types commonly seen in clinical trials, with no dose-related or treatment-related patterns of specific adverse events or laboratory abnormalities.

Pharmacokinetic (PK) analyses of patients’ PPI-461 blood levels indicate that substantial blood levels of PPI-461 have been achieved rapidly and are dose proportional. Importantly, blood levels that are inhibitory for HCV replication have been maintained throughout the 24-hr inter-dose periods in the study patients.

Virologic data from the first two dosing groups indicate rapid and marked reductions in patients’ serum viral loads (HCV RNA levels), in both dosing groups, in the first two days of treatment. The 50 mg dosing group achieved a mean maximal HCV RNA reduction of 3.1 log10 IU/mL (5 of 6 patients), while the 100 mg group achieved a mean maximal HCV RNA reduction of 3.7 log10 IU/mL (6 of 6 patients). The mean maximal HCV RNA reduction for 4 Placebo treated patients was 0.3 log10 IU/mL. One patient in the 50 mg cohort had a negligible response to PPI-461(0.4 log10 IU/mL HCV RNA reduction). This patient entered the study with highly resistant virus, as evidenced by NS5A resistance substitutions (L31M, Y93N, L28F, R30N) detected at high levels in pre-treatment sera. Such a patient would be expected to have minimal efficacy with any NS5A inhibitor, since these agents share common key resistance mutations, as will be reported in a Presidio presentation at the 2011 annual meeting of the European Association for the Study of Liver Disease (EASL) in Berlin on April 2nd (R. Colonno et al., poster #1199).

Efficacy data for individual patients receiving active PPI-461 treatment in the first two dosing cohorts in the Phase 1b trial are presented in Table 1:

Table 1
HCV RNA Reduction log10 IU/mL

Dose\Patient .........1....... 2....... 3 .........4......... 5........ 6

50 mg,
.................... 0.4*......... 2.6 .....2.7..... 3.3 ....3.4..... 3.5

100 mg ..........2.6.......... 3.7..... 3.7..... 3.8..... 4.0..... 4.1



*Four NS5A-specific linked mutations in 100% of virus population at study entry ..

“These positive clinical data for PPI-461 in hepatitis C patients further support the inclusion of NS5A inhibitors in clinical development of novel combination therapies. Such future combination therapies are expected to substantially improve patient outcomes and should help stem the rising incidence of HCV-associated severe liver disease and premature mortality,” said Nathaniel A. Brown, M.D., Presidio’s Chief Medical Officer.


The final results of the completed Phase 1b trial of PPI-461 will be submitted for presentation at a scientific meeting later this year.

About Presidio’s HCV NS5A Inhibitors

Inhibitors of the HCV NS5A protein represent an exciting, highly potent class that is mechanistically distinct from other classes of direct-acting HCV antivirals that target the viral protease or replicase (polymerase).

PPI-461 is the first in a series of novel and selective HCV NS5A inhibitors discovered by Presidio Pharmaceuticals. Presidio’s NS5A candidates are selected from numerous internal discovery leads, based on their potent activity against all major HCV genotypes and their potential for once-daily dosing with good tolerance. A Presidio presentation at the 2011 annual meeting of EASL in Berlin on April 2nd (R. Colonno et al., Poster #1200) will highlight the preclinical profile of three other novel NS5A inhibitors in development by Presidio, which derive from distinct chemical series.

About Presidio
Presidio Pharmaceuticals, Inc. is a San Francisco-based clinical stage specialty pharmaceutical company dedicated to the discovery and development of small-molecule antiviral therapeutics for novel and validated targets. For more information, please visit our website at: http://www.presidiopharma.com/ .

Presidio Pharmaceuticals, Inc.

Omar K. Haffar, PhD, 415-655-7561

omar@presidiopharma.com

Achillion ACH-1625 hepatitis drug shows promise in mid-stage trial

UPDATE 2-Achillion hepatitis drug shows promise in mid-stage trial

Wed Mar 30, 2011 8:52am EDT

* Says 75-81 pct patients showed anitviral activity

* Plans to start a trial testing ACH-1625, ACH-2928 in 2012

* Shares up 4 pct in pre-market trade (Adds background, updates share movement)

March 30 (Reuters) - Achillion Pharmaceuticals Inc said its experimental lead drug to treat chronic hepatitis C infection showed strong antiviral activity in a mid-stage trial, sending its shares up 4 percent in pre-market trade.

The company said 75-81 percent patients who took ACH-1625 in combination with current standard of care (SoC)-- Roche Holding AG's Pegasys and generic antiviral pill ribavirin -- showed potent antiviral activity in the fourth week.

The drug showed a promising safety and tolerability profile, Achillion said.

Worldwide, more than 170 million people are suffering from HCV and the American Association of Liver Disease estimates that up to 80 percent of individuals become chronically infected following exposure to the virus.

The mid-stage trial involving 64 patients tested three doses of ACH-1625 given once daily or a dummy drug in combination with current SoC treatment for four weeks.

"We look forward to selecting two of these doses and beginning the second segment of the trial, dosing ACH-1625 with SoC over 12 weeks," Chief Medical Officer Elizabeth Olek said.

The company expects to report complete early virology response data from this trial by the end of this year.

Also, it expects to start a trial evaluating ACH-1625 in combination with its other HCV drug ACH-2928 in 2012.

Shares of the company were up 30 cents at $7.35 in pre-market trade. They closed at $7.05 on Tuesday on Nasdaq. (Reporting by Anand Basu in Bangalore; Editing by Don Sebastian; Editing by Maju Samuel)


http://www.reuters.com/article/2011/03/30/achillion-idUSL3E7EU1OT20110330?feedType=RSS&feedName=governmentFilingsNews

Tuesday, March 29, 2011

Investigational hepatitis C protease inhibitor TMC435 Will Be Presented At EASL

Tibotec Advances Global Clinical Research Program for TMC435 in HCV; Will Present Four Abstracts Evaluating Safety and Efficacy at EASL

-Company Recently Launched Phase III Studies of TMC435 in Treatment-Naive HCV Patients in 12 Countries-

CORK, Ireland, March 29, 2011 /PRNewswire/ -- Tibotec Pharmaceuticals announced today that four abstracts reporting research findings with TMC435, the company's investigational hepatitis C protease inhibitor, have been accepted for presentation at the 46th Annual Meeting of the European Association for the Study of the Liver (EASL) in Berlin, Germany, March 30 to April 3, 2011.

The four abstracts for TMC435 support Tibotec's continued efforts to advance its research and development program for the treatment of HCV. TMC435 highlights at the meeting include one oral presentation and one late-breaker poster presentation:

Analysis of the predictive nature of IL28B genotype and pretreatment serum IP-10 in treatment-naive HCV patients from phase IIb PILLAR study on TMC435 administered with pegIFN/ribavirin

Results from interim 24 week data of the international phase IIb randomized, double-blind, placebo-controlled ASPIRE study on efficacy, tolerability, safety, and pharmacokinetics of TMC435 administered with pegIFN/ribavirin in treatment-experienced HCV patients

"Tibotec is committed to developing innovative new treatment options that may offer better treatment outcomes and that may decrease the duration of treatment for patients with chronic hepatitis C infection," said Brian Woodfall M.D., Vice President of Global Clinical Development at Tibotec. "The company's presence at this year's EASL meeting and the recent launch of the phase 3 clinical trial program for TMC435 reinforce the value of this investigational agent in our growing HCV pipeline."

The titles of the abstracts and times for Tibotec's presentations on TMC435 appear below – full abstracts can also be accessed at www.easl.eu.

Oral Presentation:

"Impact of IL28B genotype and pretreatment serum IP-10 in treatment-naive genotype-1 HCV patients treated with TMC435 in combination with peginterferon alpha-2a and ribavirin in PILLAR study" – Thursday, March 31, 2011 from 17:00 to 19:00

Poster Presentations:

Late-breaker "The ASPIRE trial: TMC435 in treatment-experienced patients with genotype-1 HCV infection who have failed previous PEG/RBV treatment" – Thursday, March 31, 2011 to Saturday, April 2, 2011

"Pharmacokinetics of TMC435 in subjects with moderate hepatic impairment" – Thursday, March 31, 2011 from 09:00 to 18:00

"Treatment outcome and resistance analysis in HCV genotype-1 patients previously exposed to TMC435 monotherapy and re-treated with TMC435 in combination with pegIFNalpha-2a/ribavirin" – Saturday, April 2, 2011 from 09:00 to 18:00

About HCV

HCV is a blood-borne infectious disease that affects the liver. With an estimated 170 million people infected worldwide and three to four million people newly infected each year, HCV puts a significant burden on patients and society. Chronic infection with HCV can lead to liver cancer and other serious and fatal liver diseases, and is the most common cause of liver transplant worldwide. The current standard of care for HCV, pegylated interferon combined with ribavirin, causes serious side effects and only cures 40 to 50 percent of genotype 1 patients. The development of new therapies, particularly direct antivirals with different modes of action, may allow HCV patients to undergo a shorter and more effective treatment regimen.

About Tibotec Pharmaceuticals

Tibotec Pharmaceuticals is a global pharmaceutical and research development company and one of the companies that compose the Janssen Pharmaceutical Companies of Johnson & Johnson. The Company's main research and development facilities are in Beerse, Belgium with offices in Titusville, NJ and Cork, Ireland. Tibotec is dedicated to the discovery and development of innovative HIV/AIDS and hepatitis C drugs, and anti-infectives for diseases of high unmet medical need.



SOURCE Tibotec Pharmaceuticals

Saturday, March 26, 2011

Personalized medicine ; Genetic variants associated with HCV treatment response


Personalized medicine ; Genetic variants associated with HCV treatment response

What Is Personalized Medicine?

Defined By Duke;
Personalized medicine is a concept in which a patient’s genetic information is used to identify the best courses of treatment, as well as to identify diseases the patient is more predisposed toward and to work toward preventing those diseases...Read the basics on personalized medicine

Today this blog has compiled a few links from Duke University, EASL, New England Journal Of Medicine , the journal Nature and including other sources related to the science of personalized medicine, in particular the genetic research pertaining to HCV therapy. Research has determined that variations in the IL28B gene have been linked to better treatment response among people with chronic hepatitis C virus. In 2009 we began hearing about a genetic test which could predict such a response when a study from Duke was published in the peer-reviewed journal Nature and followed in the media.

Excerpted from the New York Times 2009 article;

"A Duke University team has now uncovered the principal reason for the disparity between the races. It lies not in differing compliance to the treatment or access to health care, as some have assumed, but in genetics.

Using a genetic test called a genome-wide association study, the Duke team, led by David B. Goldstein and John McHutchison, found that the coding at a single site on the DNA, out of the three billion sites in the human genome, made all the difference in people’s response to the treatment.

The site is close to the gene for a special kind of interferon, known as interferon-lambda-3, and may help control the gene’s activity. Some people have the DNA unit T at this site, and others have C. Since a person inherits two copies of the genome, one from each parent, individuals may have T’s on both copies, C’s on both, or one T and one C.

People with the CC version, or allele, respond much better to the standard hepatitis treatment than do those with the TT allele. The C versions are more common in Europeans than in Africans, and this explains half of the difference in the response between the two races, the Duke team said in a report released Sunday on the Web site of the journal Nature.
The C versions are even more common among East Asians, about 75 percent of whom respond well to the standard treatment, compared with 55 percent of European-Americans and 25 percent of African-Americans.

People with the CC versions may produce more interferons, which are virus-fighting substances produced by cells, than those with TT, though the exact mechanism has yet to be worked out.
Dr. Goldstein, a population geneticist, said the different frequencies of the T and C versions were the result of natural selection, which is particularly effective in the case of disease resistance.
“We have clearly had very strong selection in the human population for resistance to different infectious agents, which have been of different importance in different parts of the world,” he said.

People who have a lower chance of benefiting from the grueling treatment because they have the TT allele might decide to wait until better drugs become available, especially if their liver damage is not severe. On the other hand, African-Americans with the CC allele might be more confident in accepting the treatment, Dr. McHutchison said." Continue reading...

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What Are Alleles?

Alleles are corresponding pairs of genes located at specific positions in the chromosomes. Together, alleles determine the genotype of their host organism.
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For example, the alleles for eye color are found on chromosomes 15 and 19, and depending on which alleles someone has, he or she may have blue, brown, green, gray, or hazel eyes, and sometimes a mixture of these traits is present.
Source

What Are "C" and "T" Alleles ?

As mentioned above a person inherits two copies of each gene; one from each parent to make up each allele. The IL28B rs12979860 SNP has two alleles or variations which are regonized as "C" and "T".
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Then What Is C/C or "CC" ?
In Hepatitis C patients who have the C/C pattern simply means that they have two copies of the "C" allele.
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Then What Is T/T or "TT" ?
The same is true in Hepatitis C Patients who have the T/T pattern or two "T" alleles .
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What Does This Mean To The Hepatitis C Patient?
Hepatitis C Patients With The C/C pattern or two "C" alleles have the best response to HCV therapy.
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As for the T/T pattern or two "T" alleles they have the least response to therapy.
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What If A Person Has The C/T pattern?
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The C/T pattern would mean the person has one copy of each allele. These people would fall somewhere in between.
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Summarize All Of This Please
TT - Poorest response to Hepatitis C treatment
CC - Best response to Hepatitis C treatment.
CT- Somewhere in between TT and CC alleles.
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For an easy to understand article see the 2010 issue of HCV Advocates Newsletter;
The Gene that Predicts— By Alan Franciscus, Editor-in-Chief.
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Poster Sessions To Be Presented At This Months EASL

The data presented at the EASL should be considered preliminary until it has been reviewed and published in a peer-reviewed publication.

EASL Site Links;
Upcoming Oral Presentations
Abstracts/Poster Sessions

P3.14: Category 14: IL28b Polymorphism

Category 14: IL28b Polymorphism:
http://www1.easl.eu/easl2011/program/Posters/Abstract1195.htm
http://www1.easl.eu/easl2011/program/Posters/Abstract1196.htm
http://www1.easl.eu/easl2011/program/Posters/Abstract1197.htm
http://www1.easl.eu/easl2011/program/Posters/Abstract1198.htm
http://www1.easl.eu/easl2011/program/Posters/Abstract1199.htm
http://www1.easl.eu/easl2011/program/Posters/Abstract1200.htm
http://www1.easl.eu/easl2011/program/Posters/Abstract1201.htm
http://www1.easl.eu/easl2011/program/Posters/Abstract1202.htm
http://www1.easl.eu/easl2011/program/Posters/Abstract1203.htm
http://www1.easl.eu/easl2011/program/Posters/Abstract1203.htm
http://www1.easl.eu/easl2011/program/Posters/Abstract1204.htm
http://www1.easl.eu/easl2011/program/Posters/Abstract1205.htm
http://www1.easl.eu/easl2011/program/Posters/Abstract1206.htm
http://www1.easl.eu/easl2011/program/Posters/Abstract1207.htm
http://www1.easl.eu/easl2011/program/Posters/Abstract1208.htm
http://www1.easl.eu/easl2011/program/Posters/Abstract1209.htm
http://www1.easl.eu/easl2011/program/Posters/Abstract1210.htm
http://www1.easl.eu/easl2011/program/Posters/Abstract1211.htm
http://www1.easl.eu/easl2011/program/Posters/Abstract1212.htm
http://www1.easl.eu/easl2011/program/Posters/Abstract1213.htm
http://www1.easl.eu/easl2011/program/Posters/Abstract1214.htm
http://www1.easl.eu/easl2011/program/Posters/Abstract1215.htm
http://www1.easl.eu/easl2011/program/Posters/Abstract1216.htm
http://www1.easl.eu/easl2011/program/Posters/Abstract1217.htm
http://www1.easl.eu/easl2011/program/Posters/Abstract1218.htm
http://www1.easl.eu/easl2011/program/Posters/Abstract1219.htm
http://www1.easl.eu/easl2011/program/Posters/Abstract1220.htm
http://www1.easl.eu/easl2011/program/Posters/Abstract1221.htm
http://www1.easl.eu/easl2011/program/Posters/Abstract1222.htm
http://www1.easl.eu/easl2011/program/Posters/Abstract1223.htm
http://www1.easl.eu/easl2011/program/Posters/Abstract1224.htm
http://www1.easl.eu/easl2011/program/Posters/Abstract1225.htm
http://www1.easl.eu/easl2011/program/Posters/Abstract1226.htm
http://www1.easl.eu/easl2011/program/Posters/Abstract1227.htm
http://www1.easl.eu/easl2011/program/Posters/Abstract1228.htm
http://www1.easl.eu/easl2011/program/Posters/Abstract1229.htm
http://www1.easl.eu/easl2011/program/Posters/Abstract1230.htm

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Nature Reviews Genetics

12, 266-275 (April 2011)
doi:10.1038/nrg2951
Focus on: Stem cells

Investigating monogenic and complex diseases with pluripotent stem cells

Hao Zhu1,2, M. William Lensch2, Patrick Cahan2 & George Q. Daley2

Hepatogenesis and liver disease.

To better understand conditions that affect the liver, Rashid et al. established a protocol to differentiate human iPSCs into hepatocytes that recapitulate the adult phenotypes of three distinct liver diseases in vitro15. These iPSC-derived hepatocytes shared marker-expression, morphological and physiological features of normal human hepatocytes. The iPSC-derived hepatocytes made from cells taken from patients with α1-antitrypsin deficiency showed the characteristic accumulation of α1-antitrypsin polymers. Of importance, the authors noted little variability in polymer accumulation among multiple iPSC lines derived from the same patient but greater variability among iPSC lines derived from different patients, indicating reproducibility of the phenotype within individual genotypes. In addition, proteosome inhibitor treatment of the cells exacerbated the phenotype, possibly permitting the detection of small but relevant functional differences in genotype; similarly, the assay might detect the impact of environmental modifiers and potentially be used in toxicity studies for the analysis of primary and/or secondary metabolites. This report opens the door to studying more subtle genetic disorders of the liver in vitro. More generally, testing drug–genotype interactions in specific cell types will expedite the efforts of personalized medicine and pharmacogenomics, especially for common variants....Continue reading....

Read Full Text @ Nature

You may have to register to read full text. Click here for free registration. If you choose to "subscribe" for full access to the site there is a yearly cost.

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Review Article Genomic Medicine

W. Gregory Feero, M.D., Ph.D., Editor, Alan E. Guttmacher, M.D., Editor Genomics and Drug Response Liewei Wang, M.D., Ph.D., Howard L. McLeod, Pharm.D., and Richard M. Weinshilboum, M.D. N Engl J Med 2011; 364:1144-1153

March 24, 2011

Another pharmacogenomic example involving agents used to treat infectious diseases concerns the treatment of chronic infection with hepatitis C virus (HCV), which develops in approximately 80% of patients who are infected with the virus and is a major cause of liver failure.53,54 Successful treatment of chronic HCV infection involves a sustained virologic response, which is defined by an undetectable level of HCV RNA in plasma. Unfortunately, only 40 to 50% of patients who are infected with HCV genotype 1 have a sustained virologic response when receiving the current standard of care for the treatment of chronic HCV infection — injections of pegylated interferon alfa together with oral ribavirin for 48 weeks.53,54 The ability to identify patients with a differential response to pegylated interferon alfa is important in the current era of new anti-HCV drugs because pegylated interferon alfa remains the backbone of therapy, to which many of these new agents are added. Recently, in three independent genomewide association studies55-57 involving patients with chronic HCV infection who were treated with pegylated interferon alfa and ribavirin, there was an association between a variant in IL28B, the gene encoding interleukin-28B, and the drug response. In one of these studies, peripheral-blood mononuclear cells from patients carrying the variant allele that was associated with a poor response had comparatively low levels of IL28B expression.56 IL28B encodes a protein that is thought to be involved in suppressing the replication of a number of viruses, including HCV.55-58 This example shows how pharmacogenomic genomewide association studies not only have identified biomarkers of response to pegylated interferon alfa but also have provided insights that might be used to determine therapeutic approaches to this chronic infection and to select a drug target for therapeutic development...Continue Reading.....

(Read Full Text @ NEJM; New England Journal Of Medicine)

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IL28B Gene Predicts Treatment Outcome for Liver Transplantation Patients
ScienceDaily (Mar. 2, 2011) —
German researchers have found a significant association of IL28B genotypes to interferon-based antiviral treatment outcome, and to graft inflammation caused by hepatitis C virus (HCV). The study determined that the presence of G-allele serves as a marker for severe HCV-induced graft inflammation, as well as a predictor for unsuccessful treatment.....Continue Reading...

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PDF IL28B & HCV: A step closer to personalized medicine?
File Format: PDF/Adobe Acrobat -
Jan 28, 2011 ...
Under The Presentation Archive See; Journal Club: Liver 1 - "IL28B & Hepatitis C: A Step Closer to Personalized Medicine?" After clicking on the PDF the file will download to your computer.

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Editorial

Genome Medicine: past, present and future

Charles Auffray1*†, Timothy Caulfield2†, Muin J Khoury3†, James R Lupski4,5†, Matthias Schwab6,7† and Timothy Veenstra8

31 January 2011
The field of genomic medicine continues to expand, driven by the efforts of numerous researchers around the world. To celebrate Genome Medicine's 2nd anniversary, we asked our Section Editors what they felt were the most exciting breakthroughs in research in the past 2 years and what the future of genomic medicine might hold. Transformational effect of systems medicineSince we discussed systems medicine as the future of medical genomics and healthcare in the inaugural issue of Genome Medicine [1] , the field has witnessed transformational changes that have brought the prospect and promises of personalized medicine closer to reality. The exponential increase in DNA sequencing capabilities, together with the rapidly declining associated costs, has made whole-genome sequencing accessible to small laboratories, and will soon transform it into a low cost analytical assay. These advances have enabled the emergence of medical systems genetics studies, an approach in which the genetic determinants of diseases are investigated through sequencing of the complete genome of family relatives. For example, sequencing and analysis of the genomes of two siblings and their parents made possible the direct measurement of the inter-generational mutation rate and identified genes potentially associated with two Mendelian disorders [2] ; the gene causing one of these disorders was precisely identified through further exome sequencing in additional diseased patients [3] . Another telling example of both the power and current limitations of the next-generation sequencing approaches is their application to the characterization of the genome, epigenome and transcriptome of monozygotic twins discordant for multiple sclerosis, which failed to uncover significant differences associated with the disease [4] . With several thousand genomes now being completed, and tens of thousands anticipated in the coming year, the limitation is already to a large extent, and will increasingly be, on the side of data analysis, as the collection, storage and analysis of the large datasets generated requires the combined expertise of a wide variety of scientists, engineers and physicians [5] . Fortunately, the software, databases and computing power required for these community efforts are now becoming available through computer grids and cloud computing infrastructures, offering an affordable alternative for genome and translational bioinformatics [6,7] . Combined together, genome sequencing and cloud computing will contribute to bridging the gap between systems biology and medicine by opening the way to the precise and low cost assays that are necessary for systems medicine to become a practical alternative to traditional reactive medicine [8] ... Continue Reading...

(Read Full Text @ Genome Medicine)

Related 2010; Musings on genome medicine: Hepatitis
C David G Nathan, Stuart H Orkin Genome Medicine 2010, 2:4 (27 January 2010)
Abstract Full text PDF PubMed Editor’s summary
Recent advances in our understanding of the genetics of response to interferon treatment are intriguing, but further research is necessary before we can achieve a true cure for hepatitis C.



Thursday, March 24, 2011

Hepatitis C;EASL Boceprevir A Highlight and A List Of Peer-Reviewed Journals

Greetings,
As we know the FDA Panel will be reviewing the two experimental hepatitis C virus protease inhibitors ; Merck-Boceprevir, Vertex-Telaprevir in late April. Today on the blog boceprevir is in the spotlight with the help of NATAP, EASL and HIV and hepatitis.

Just as a side note; Merck has registered the name Victrelis® as their trademark and has used it in the press release to announce their posters/abstracts which will be presented at the EASL meeting this month.
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As noted previously on the blog, because the EASL has a media embargo in place until all data is presented and reviewed by attendees/physicians, I have provided my readers with a few direct links to some of the "Boceprevir" posters available to the public through the EASL website.
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Today, with the wealth of information on the internet the HCV patient is educated and has become their own advocate. However, the majority of journals provided online are not "peer reviewed" and these patients hunger for substantial credible information. Although the liver meeting provides the HCV community with clinical data, this data presented at the EASL should be considered preliminary until it has been reviewed and published in a peer-reviewed publication. ( See below for a list of peer-reviewed journals.)

These links will help you navigate your way through the EASL website.

Upcoming Oral Presentations
Abstracts/Poster Sessions

Boceprevir;
P3.08D: Category 08d: Viral Hepatitis C: Clinical (new compounds, resistance)
http://www1.easl.eu/easl2011/program/Posters/Abstract4.htm
http://www1.easl.eu/easl2011/program/Posters/Abstract216.htm
http://www1.easl.eu/easl2011/program/Posters/Abstract225.htm
http://www1.easl.eu/easl2011/program/Posters/Abstract229.htm
http://www1.easl.eu/easl2011/program/Posters/Abstract235.htm
http://www1.easl.eu/easl2011/program/Posters/Abstract240.htm
http://www1.easl.eu/easl2011/program/Posters/Abstract255.htm
http://www1.easl.eu/easl2011/program/Posters/Abstract256.htm
http://www1.easl.eu/easl2011/program/Posters/Abstract259.htm
http://www1.easl.eu/easl2011/program/Posters/Abstract273.htm
http://www1.easl.eu/easl2011/program/Posters/Abstract283.htm
http://www1.easl.eu/easl2011/program/Posters/Abstract288.htm
http://www1.easl.eu/easl2011/program/Posters/Abstract291.htm
http://www1.easl.eu/easl2011/program/Posters/Abstract1072.htm
http://www1.easl.eu/easl2011/program/Posters/Abstract1118.htm


NATAP has put together this great information on Boceprevir that you'll find easy to understand;

Simplified Explanation of the Phase 3 Studies of HCV Protease Inhibitor Boceprevir
Boceprevir is a HCV protease inhibitor for patients with genotype 1, the more difficult to treat type of patients, that is expected to be publicly reviewed at an FDA hearing in April, approved and in the pharmacy by June this year 2011 and will be added to pegylated interferon/ribavirin as part of a 3 drug combination therapy; up until now standard-of-care therapy has been only peginterferon+ribavirin.

With triple-drug therapy response rates are greatly increased.

Early responses (called Response Guided Therapy) will allow many patients to be able to cut the duration of therapy significantly by a number of months from the current 48 weeks to 28 or 36 weeks.

A new pill developed by Merck for chronic hepatitis C virus (HCV) genotype 1, the hardest to treat form, significantly improves virologic cure rates when added to standard therapy and shortens treatment time for up to half of patients by three to five months.

The pill, called boceprevir, is to be used in combination with standard therapy. The combination has been shown in two major studies to be significantly more effective than standard therapy for people undergoing HCV treatment for the first time as well as for people who previously did not attain a virologic cure by standard therapy alone (nonresponders).

The combination of boceprevir and standard therapy also offers patients the opportunity to individually tailor how long they undergo treatment based on early responses to the drugs. This represents an approach to treating HCV, called response-guided therapy (RGT)....continue reading.............

Also from NATAP & HIV and Hepatitis ; Conference on Retroviruses and Opportunistic Infections - CROI 2011

Boceprevir Improves SVR With PegIFN/RBV After Failure or Relapse With HCV-1
Mark Mascolini

Adding the HCV-NS3 protease inhibitor boceprevir to pegylated interferon plus ribavirin (PegIFN/RBV) significantly improved sustained virologic response (SVR) rates in HCV genotype 1-infected people with a history of nonresponse or relapse with PegIFN/RBV [1]. SVR rates were higher among relapsers than nonresponders, though 40% to 50% of nonresponders attained SVR with boceprevir plus PegIFN/RBV...continue reading.....



From HIV and Hepatitis

HCV Protease Inhibitor Boceprevir Improves Response for Treatment-Naive and Non-responders

SUMMARY: Merck's investigational hepatitis C virus (HCV) protease inhibitor boceprevir improved sustained response rates when combined with pegylated interferon plus ribavirin in both previously untreated patients and those who were non-responders or relapsers after prior therapy, according to 2 Phase 3 studies presented at the 18th Conference on Retroviruses and Opportunistic Infections (CROI 2011) this month in Boston...continue reading.....

Looking For HCV Information Online

Hint;
Look for web sites that end in .gov or .org rather than .com

From HCV Advocate
The Internet as a Source for information

The Internet is a valuable tool. However, like any tool, one needs to know how to use it well. The following are some suggestions for how to use the Internet more effectively:

Find out if the information comes from independent and not-for-profit sources, particularly from the U.S. federal government (e.g., National Institutes of Health (NIH), FDA), a general medical society (e.g., American Medical Association) or specialty or disease society (e.g., American Association for the Study of Liver Diseases) is likely to be reliable.
Commercial sources (e.g.,pharmaceutical companies) may be scientifically accurate, but may emphasize the positive aspects of a drug for marketing purposes...continue reading......

A Few Of My Favorite Peer Reviewed Medical Journals

The Lancet
You are able to search for articles on hepatitis C and are able to view the abstracts free of charge; full text articles can be viewed for a fee.

The New England Journal of Medicine
Many abstracts and full text articles to view without a fee.
Specialties & Topics ;
Infectious Disease
Gastroenterology

The World Journal of Gastroenterology
Abstracts, and full text articles to view, again without a fee.


List Of All Peer-Reviewed Journals

ACS Publications
Accounts of Chemical Research
ACS Chemical Biology
Analytical Chemistry
Biochemistry
Bioconjugate Chemistry
Biomacromolecules
Chemical Research in Toxicology
Chemical Reviews
Chemistry of Materials
Crystal Growth & Design
Energy & Fuels
Environmental Science & Technology
Industrial & Engineering Chemistry Research Inorganic Chemistry
Journal of Agriculture and Food Chemistry
Journal of the American Chemical Society
Journal of Chemical & Engineering Data
Journal of Chemical Information and Modeling
Journal of Chemical Theory and Computation
Journal of Combinatorial Chemistry
Journal of Medicinal Chemistry
Journal of Natural Products
The Journal of Organic Chemistry
The Journal of Physical Chemistry A
Journal of Proteome Research
Langmuir
Macromolecules
Molecular Pharmaceutics
Nano Letters
Organic Letters
Organic Process Research & Development
Organometallics
Alcohol
Acupuncture in Medicine
Alcoholism: Clinical and Experimental Research
American Association of Pharmaceutical Scientists Journals
Pharmaceutical
Research
PharmSci Tech
AHA Scientific Publishing
Arteriosclerosis, Thrombosis, and Vascular Biology
Circulation
Circulation Research
Hypertension
Stroke
AMA Publications
Archives of Internal Medicine
Archives of Neurology
Archives of Ophthalmology
Archives of Otolaryngology-Head & Neck Surgery
Archives of Pediatrics & Adolescent Medicine
Archives of Surgery
JAMA
The American Institute of Physics Online Journal Service
The American Journal of Clinical Nutrition
American Journal on Mental Retardation
American Physical Society Journals
Physical Review Letters
Other APS Research Journals
American Society of Nephrology Journals
Journal of the American Society of Nephrology
Clinical Journal of the American Society of Nephrology
Annals of Emergency Medicine
Annals of Internal Medicine The Annals of Thoracic
Surgery
-->
Annual Review of Biochemistry
Arthritis Research
BioScience
BMJ
Breast Cancer Research

Canadian Association of Radiologists Journal
Canadian Journal of Rural Medicine
Canadian Journal of Surgery
Canadian Medical Association Journal (CMAJ)
Cancer
Catheterization and Cardiovascular Interventions
Chinese Science Bulletin
Cell Press
Cancer Cell
Cell
Chemistry & Biology
Current Biology
Developmental Cell
Molecular Cell
Structure
Immunity
Neuron
CHEST
Cold Spring Harbor Laboratory Press
Genes and Development
Genome Research
Learning & Memory
Conservation Biology
Critical Care
Current Research in Social Psychology
Drug and Alcohol Dependence
Deutsches Ärzteblatt International
Electronic Journal of Biotechnology
Endocrine-Related Cancer
European Journal of Enocrinology
Federation of American Societies for Experimental Biology
Frontline Gastroenterology
Gastroenterology
Hand Surgery
IEEE Intelligent Systems
Intellectual and Developmental Disabilities
International Journal of Modern Physics A Internet Archaeology
Investigative Ophthalmology & Visual Science
JAMA
The Journal of Biological Chemistry
Journal of Biological Systems
Journal of Clinical Investigation
Journal of Clinical Oncology
Journal of Endocrinology
The Journal of Intelligent Systems
Journal of Molecular Endocrinology
Journal of Neurosciencee
Journal of Psychiatry & Neuroscience
Journal of the National Cancer Institute Journal of International
Wildlife Law & Policy

Journal of Rehabilitation Research and Development
Journal of Vascular and Interventional Radiology
Journal of Vision
Journal of Young Investigators
The Lancet

Liebert Publications
AIDS Patient Care and STDs
AIDS Research and Human Retroviruses
Alternative & Complementary Therapies
Antioxidants & Redox Signaling
ASSAY and Drug Development Technologies
Astrobiology
Bariatric Nursing and Surgical Patient Care
Biosecurity and Bioterrorism: Biodefense Strategy, Practice, and Science
Biotechnology Law Report
Breastfeeding Medicine
Cancer Biotherapy & Radiopharmaceuticals
Cell Preservation Technology
Cloning and Stem Cells
CyberPsychology & Behavior
Diabetes Technology & Therapeutics
Disease Management
DNA and Cell Biology
Election Law Journal
Environmental Engineering Science
Foodborne Pathogens and Disease
Gaming Law Review
Genetic Testing
Genetic Engineering & Biotechnology News
High Altitude Medicine & Biology
Human Gene Therapy
Hybridoma
Industrial Biotechnology
Journal of Aerosol Medicine
Journal of Alternative and Complementary Medicine
Journal of Child and Adolescent Psychopharmacology
Journal of Computational Biology
Journal of Endourology
Journal of Gynecologic Surgery
Journal of Interferon & Cytokine Research
Journal of Laparoendoscopic & Advanced Surgical Techniques
Journal of Medicinal Food
Journal of Neurotrauma
Journal of Ocular Pharmacology and Therapeutics
Journal of Palliative Medicine
Journal of Women's Health
Lymphatic Research and Biology
Medical Acupuncture
Metabolic Syndrome and Related Disorders
Microbial Drug Resistance
Obesity Management
Oligonucleotides
OMICS: A Journal of Integrative Biology
Pediatric Asthma, Allergy & Immunology
Photomedicine and Laser Surgery
Rejuvenation Research
Stem Cells and Development
Surgical Infections
Sustainability: The Journal of Record
Telemedicine and e-Health
Thyroid
Tissue Engineering, Parts A, B, C
Vector-Borne and Zoonotic Diseases
Viral Immunology
Zebrafish
Planned Giving Mentor
Planned Giving Today
Molecular Biology of the Cell
Modern Physics Letters A
Modern Physics Letters B
Nature
Neurology
New England Journal of Medicine
NRC Research Press
Canadian Journal of Forest Research
Canadian Journal of Physics
The Ohio Academy
of Science
-->
Physiological Genomics
Population Council
Population and Development Review
Studies in Family Planning
Proceedings of the National Academy of Sciences
Reproduction
Respiratory Research
Science
World Journal of Gastroenterology

List can be found at; http://www.eurekalert.org/links.php?jrnl=A

Wednesday, March 23, 2011

Hepatitis; PSI-938 and PSI-7977 Breaking Down The Media Frenzy

Last week we had a sneak peek at a small study being presented at this months EASL.

According to the recent media frenzy Pharmassets two oral drugs in development "PSI-938 and PSI-7977" showed in early-stage data that 15 out of 16 patients achieved an early/promising antiviral response after 14 days on treatment.

The HCV community, although excited about a regimen of "interferon free" therapy, keep it all in perspective and wait until Pharmasset conducts their phase II study of " interferon-free combinations" with an SVR endpoint, expected in mid-2011. For this community the bottom line is SVR.

You can look at "all" the abstracts that will be presented at the EASL by clicking here

The controversy

The EASL has an embargo in place until the data is presented at the meeting. However, a few investment websites released the data early, breaking the media embargo.

The Study Can Be Found At The EASL Website

"ONCE DAILY DUAL-NUCLEOTIDE COMBINATION OF PSI-938 AND PSI-7977"

You can view the abstract here.

What Study are we talking about, whats the big deal ?

The study included treatment-naïve, non-cirrhotic patients with HCV Genotype 1. The two drugs "PSI-938 AND PSI-7977" were tested in four different cohorts (see below) without using "interferon" over fourteen days. The study was deemed ; NUCLEAR Study .
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From the Nov "2010" Press Release;

This is the first clinical study combining a purine (PSI-938) and a pyrimidine (PSI-7977) nucleotide analog for HCV, and is designed to evaluate once daily doses of PSI-7977 and PSI-938 in patients with HCV who have not been treated previously.

"We are excited to be initiating this combination study with two proprietary nucleotide analogs for HCV," stated Michelle Berrey, MD, MPH, Pharmasset's Chief Medical Officer. "Based on our in vitro data, we believe the combination of two nucleotide analogs could provide potent antiviral activity across multiple HCV genotypes and could also have a higher barrier to resistance compared to other DAA combinations. We believe nucleotide analogs have a number of key attributes that may make them ideal partners for other DAA combinations, in addition to a 'nuc-nuc' combination."

About the Phase 1 Trial - Part 1, Part 2

Part 1 of the Phase 1 multiple ascending dose study of PSI-938, suppression of HCV RNA below the limit of detection (LOD, less then 15 IU/mL) was observed in over half of the patients who received PSI-938 at daily doses of 200 mg or 300 mg for seven days.

Part 2 of the study is designed to evaluate the combination of PSI-938 and PSI-7977.

The primary objective is to assess the safety, tolerability and pharmacokinetics of PSI-938 administered alone for 14 days, and in combination with PSI-7977 for 7 to 14 days.

The secondary objective is to evaluate viral kinetics of HCV RNA during monotherapy (no interferon) and combination nucleotide dosing.

The Four Cohorts;

Approximately forty patients are expected to be enrolled into four cohorts as follows:

PSI-938 QD administered as monotherapy for 14 days, followed by;

PSI-938 QD for 7 days followed by PSI-938 plus PSI-7977 QD for 7 days and

PSI-7977 QD for 7 days followed by PSI-938 plus PSI-7977 QD for 7 days,

followed by; PSI-938 plus PSI-7977 QD for 14 days

We expect to report preliminary results from Part 2 of this Phase 1 study during the first quarter of calendar year 2011.

From the EASL ; Preliminary results , the public is welcome to view the abstract

The company is expected to initiate a Phase 2 study of PSI-938 in combination with PSI-7977 during mid-2011.

This Phase 2 study proposes to explore durations of PSI-938 and PSI-7977 in "interferon-free combinations" with an SVR endpoint.
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