Hepatitis B, Chronic Clinical Trial
Official title:
Therapeutic Safety and Efficacy of Combination Treatment With REP 2139-Ca and Pegasys in Patients With Chronic Hepatitis B
The REP 201 protocol is a small exploratory study assessing the antiviral effects and tolerability of REP 2139-Ca when used with a full course of pegylated interferon (48 weeks) in treatment naive patients or in patients already receiving entecavir and continuing entecavir with treatment.
Chronic hepatitis B is a long term condition caused by infection of the body with the
hepatitis B virus (HBV). This infection often results in inflammation or scarring of the
liver and can eventually lead to liver cirrhosis and liver failure. These infections are also
one of the major causes of the development of hepatocellular carcinoma (liver cancer).
Although some drugs have been approved to treat chronic hepatitis B infections, they do not
provide a complete cure except in rare cases (a cure generally means that a person loses the
hepatitis B virus from the blood and the liver and develops a durable immunological control
of subsequent HBV infection). However, these drugs do significantly decrease the risk of
liver damage and liver cancer arising from the presence of a chronic liver infection by
slowing or stopping the production of infectious virus. Thus the primary problem associated
with currently available drugs is the lack of clearance of the virus from the hepatocytes
which necessitates long term treatment with these drugs. There is clearly a need to identify
new drugs that can benefit patients with chronic hepatitis B infections. Nucleic acid-based
polymers (NAPs) are a new class of broad-spectrum antiviral compounds which act against HBV
infection by blocking the release of the surface antigen protein (HBsAg) from infected
hepatocytes.
Current interim data analysis from the REP 102 assessing the activity of the NAP REP 9AC'
(REP 2139, given as a calcium chelate complex [REP 2139-Ca]) in patients with chronic HBV
infection indicates the following:
1. REP 2139-Ca is generally well tolerated and patients tolerate short term combined
treatment (13-26 weeks) of pegylated interferon and / or thymosin alpha
2. REP 2139-Ca has achieved serum HBsAg reduction or clearance 9 of 9 patients receiving
combined therapy.
3. Appearance of substantial titers of serum anti-HBs occur with the addition of
immunotherapy.
4. After all treatment is withdrawn, 8 / 9 patients achieved HBV DNA < 116 copies / ml
(LLOQ of the Roche Cobas platform) and sustained suppression of viremia (HBV DNA < 1000
cpm, HBsAg < 1 IU / ml) for a period of greater than 1 year was observed in four
patients.
This exploratory study is designed to examine if REP 2139-Ca can be safely combined with a
full course of pegylated interferon in treatment naive patients and in patients with previous
and continuing therapy with entecavir and that similar antiviral effects can be observed as
in the previous REP 101 and 102 protocols.
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