Adding Boceprevir to HCV Combination Therapy Doubles Success Rate
Boceprevir eliminated Hep C virus in unprecedented number of patients
Patients that received a 48-week boceprevir regimen achieved a 75 per cent SVR rate, nearly twice the efficacy rate provided by current standard therapies
KIRKLAND, QC, May 26 /CNW/ – Schering-Plough Canada announced today that final results of the HCV SPRINT-1 (HCV Serine Protease Inhibitor Therapy-1) study showed boceprevir – its investigational oral hepatitis C protease inhibitor – in combination with PEGETRON(R) (peginterferon alfa-2b and ribavirin), significantly increased sustained virologic response (SVR)(1) rates with either 28- or 48-week therapy regimens in treatment-naive genotype 1 patients, compared to current standard of care, peginterferon and ribavirin (P/R) for 48 weeks.
When boceprevir was added to PEGETRON(R), 75 per cent (77/103) of hepatitis C patients assigned to a 48-week regimen had undetectable levels of virus after treatment completion. That was nearly double the 38 per cent (39/104) response rate of patients who only received current standard of care treatment (p(less than)0.0001)(2).
“I am very excited about the response. The response rates from this study are extremely encouraging, especially when you consider the challenges associated with hepatitis C management and the difficult nature of the hepatitis C virus genotype 1 infection in this study’s patient population,” said Dr. Frank Anderson MD FRCP(C), one of the SPRINT-1 Investigators and presentation co-author. “I believe that the findings of this study will help further develop and improve hepatitis C treatment. The Phase III boceprevir studies are currently underway in naive and treatment failure patients, both
are fully enrolled.”
The results from this Phase II study – involving 595 patients who were infected with the virus but had not previously been treated – were presented at the 44th European Association for the Study of the Liver 2009 Annual Meeting in Copenhagen, Denmark(3).
“Each HCV-infected patient responds differently to treatment. The results of the SPRINT-1 study shed important light on response-guided therapy with boceprevir,” said Dr. Jenny Heathcote MD FRCP(C), Professor of Medicine at University of Toronto and Toronto Western Hospital and a SPRINT-1 study investigator. “Importantly, the results of SPRINT-1 show how one may best individualize treatment duration based on the patients’ week 4 and week 12 responses to boceprevir therapy. Based on the rate of response observed in SPRINT-1, the majority of G1-infected treatment naive patients may have the potential to be treated for a total of 28 weeks.”
The HCV SPRINT-1 study was a randomized, controlled, multinational study conducted at sites across the United States, Canada and Europe. The study enrolled trial participants infected with HCV genotype 1, the most common and hardest to treat form of hepatitis C, as well as patients with severe liver disease, including cirrhosis.
Boceprevir works through a novel mechanism, by inhibiting the function of a viral protein called ‘protease’ that the virus needs to replicate. Hepatitis C is a serious and potentially life-threatening chronic liver disease caused by the hepatitis C virus (HCV). An estimated 250,000 individuals are infected with HCV in Canada(4) and there are 3,200 to 5,000 newly infected individuals each year(5). It is the leading cause of liver transplants in Canada(6).
ABOUT THE HCV SPRINT-1 STUDY
During the first month of the study, all patients received PEGETRON(R), which is a combination therapy of the two standard hepatitis C treatments: a long-acting form of interferon called peginterferon alfa-2b and the anti-viral pill ribavirin. Some patients also received PEGETRON(R) in combination with boceprevir from the beginning of the study.
After four weeks, one group of PEGETRON(R)-only patients then added boceprevir for 44 weeks and another group added boceprevir for 24 weeks.
Patients who received a 48-week boceprevir regimen achieved a 75 per cent SVR rate (n=77/103) in patients who received four weeks of (P/R) followed by the addition of boceprevir for 44 weeks (boceprevir P/R lead-in regimen). This represents a near doubling of the 38 per cent SVR rate (n=39/104) for patients in the control group (p(less than)0.0001). In a 28-week boceprevir P/R lead-in regimen 56 per cent of patients (n=58/103) achieved SVR (p=0.005)(2).
In the HCV SPRINT-1 study, anemia occurred in approximately half of the patients in the boceprevir arm and over a third of patients in the control arm. A key finding of the HCV SPRINT-1 study is that treatment-emergent anemia appeared to be associated with higher SVR, with anemic patients (hemoglobin decreasing to less than 10 g/dL) having higher SVR rates than those without anemia (hemoglobin did not decrease to less than 10 g/dL). Anemia is a known adverse event with combination therapy for hepatitis C and this association with higher SVR has been seen in other clinical studies with peginterferon and ribavirin, including the IDEAL study(7). Boceprevir is associated with about a 1 g/dL incremental decrease in hemoglobin. Erythropoietin (EPO) supplementation was allowed in the study at the discretion of the investigator and was used by 26 per cent of patients in the control arm and 39 to 51 per cent of patients in the boceprevir arms with standard-dose ribavirin.
Schering-Plough Canada Inc. is a country operation of Schering-Plough Corporation that employs more than 950 people across Canada. Schering-Plough Canada Inc.’s web site is WWW.SCHERING-PLOUGH.CA.
Schering-Plough is an innovation-driven, science-centered global health care company. Through its own biopharmaceutical research and collaborations with partners, Schering-Plough creates therapies that help save and improve lives around the world. The company applies its research-and-development platform to human prescription, animal health and consumer health care products. Schering-Plough’s vision is to “Earn Trust, Every Day” with the doctors, patients, customers and other stakeholders served by its colleagues around the world. The company is based in Kenilworth, N.J., and its Web site is WWW.SCHERING-PLOUGH.COM.
- SVR, the protocol specified primary efficacy endpoint, is defined as achievement of undetectable HCV-RNA at 24 weeks after the end of treatment. Per protocol, if a patient does not have a 24-week post-treatment assessment, the patient’s 12-week post-treatment assessment will be utilized.
- Intention-To-Treat (ITT) analysis – includes any patient who has taken at least one dose of any study drug.
- Kwo P, Lawitz E, McCone J, et al. HCV SPRINT-1 Final Results: SVR 24 from a Phase 2 study of Boceprevir Plus PegIntron (Peginterferon alfa-2b)/Ribavirin in Treatment-Naive Subjects with Genotype.
- Health Canada. http://www.phac-aspc.gc.ca/hepc/index-eng.php Accessed April 27, 2009.
- Health Canada. http://www.hc-sc.gc.ca/hl-vs/iyh-vsv/diseases-maladies/hepc-eng.php. Accessed April 29, 2009.
- Canadian Liver Foundation. http://www.liver.ca/Liver_Disease/ Accessed April 27, 2009.
- Sulkowski M, Shiffman M, Afdhal N, et al. Hemoglobin decline isassociated with SVR among HCV genotype 1 infected persons treatedwith peginterferon (PEG)/ribavirin (RBV): Analysis from the IDEALStudy. 44th European Association for the Study of the Liver (EASL)2009 Annual Meeting; April 22-26, Copenhagen, Denmark; oralpresentation, Abstract No. 126.
For further information: Media Contact: Mona Aubin, Schering-Plough Canada, [email protected], (514) 428-8833; Julia Alter, Edelman, (416) 979-1120 ext. 340, [email protected]; Schering-Plough Canada Inc., 16 750, route Transcanadienne, Kirkland, QC, H9H 4M7, www.schering-plough.ca
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