Human Genome Sciences Announces Albuferon(R) Meets Primary Endpoint In Phase 3 Trial In Chronic Hepatitis C
09 Dec 2008
Human Genome Sciences, Inc. (Nasdaq: HGSI) announced that Albuferon(R) (albinterferon
alfa-2b) met its primary endpoint of non-inferiority to peginterferon
alfa-2a (Pegasys) in ACHIEVE 2/3, a Phase 3 clinical trial of Albuferon in
combination with ribavirin in treatment-naive patients with genotypes 2 and
3 chronic hepatitis C (p=0.0086). Albinterferon alfa-2b is being developed
by HGS and Novartis under an exclusive worldwide co-development and
commercialization agreement entered into in June 2006.
"We are pleased that Albuferon met its primary endpoint in the ACHIEVE 2/3
trial. These Phase 3 data show that the efficacy of Albuferon was comparable
to Pegasys, with half the injections," said H. Thomas Watkins, President and
Chief Executive Officer, HGS. "We look forward to having the results of
ACHIEVE 1, our other Phase 3 trial of Albuferon, in March 2009. If ACHIEVE 1
is successful, we believe Albuferon could become the market-leading
interferon for the treatment of chronic hepatitis C, and we expect that
global marketing applications will be filed by fall 2009."
David Nelson, M.D., Professor of Medicine, Medical Director of Liver
Transplantation, and Chief of the Hepatobiliary Disease Section, University
of Florida, said, "Chronic hepatitis C represents a significant unmet
medical need. These Phase 3 results suggest that albinterferon alfa-2b has
the potential to become an important new treatment option for patients with
chronic hepatitis C. Albuferon requires half as many injections as the
pegylated interferons, and clinical results to date suggest that it may
offer comparable efficacy, with no difference in clinically significant
adverse events. The observed variation in response by geography is an
unexpected finding and requires further analysis. We look forward to results
from the ACHIEVE 1 trial, which is evaluating albinterferon alfa-2b in the
treatment of patients with genotype 1 hepatitis C."
In the randomized, multi-center, active-controlled non-inferiority Phase 3
trial, 933 treatment-naive patients with genotypes 2 and 3 chronic hepatitis
C were initially assigned to one of three treatment groups, including two
groups that received albinterferon alfa-2b once every two weeks at doses of
900-mcg or 1200-mcg, and an active control group that received peginterferon
alfa-2a once weekly at a dose of 180-mcg - with all patients receiving oral
ribavirin daily at 800-mg in two divided doses. In January 2008, a dose
modification was made and patients originally assigned to receive the
1200-mcg dose of albinterferon alfa-2b had their dose reduced to 900-mcg
albinterferon alfa-2b every two weeks. The dose modification was recommended
by the independent Data Monitoring Committee (DMC) for the Albuferon Phase 3
trials, following their observation during a routine review of unblinded
data from both trials that serious pulmonary adverse events were higher in
the 1200-mcg Albuferon treatment group. Following the dose modification, the
study continued to follow all patients randomized into the trial on an
intention-to-treat (ITT) basis according to their original dose assignment.
The primary data analysis compares the 900-mcg albinterferon alfa-2b
treatment group to the peginterferon alfa-2a treatment group. The trial
included 24 weeks of treatment, and the primary efficacy endpoint was
non-inferiority to peginterferon alfa-2a, based on a comparison of the rate
of SVR, defined as undetectable viral load (HCV RNA < 10 IU/mL) at Week 48
(24 weeks following completion of treatment).
"We are encouraged that albinterferon alfa-2b met the primary efficacy
endpoint of non-inferiority to peginterferon alfa-2a in the ACHIEVE 2/3
study," said David C. Stump, M.D., Executive Vice President, Research and
Development, HGS. "These data show that the rate of sustained virologic
response was comparable for the treatment group receiving the 900-mcg dose
of albinterferon alfa-2b every two weeks, versus the treatment group
receiving the standard dose of peginterferon alfa-2a once weekly.
Importantly, the number of serious and severe adverse events, including
pulmonary adverse events, was also comparable. When we have ACHIEVE 1
results in March, we will be in a position to assess the full therapeutic
potential of albinterferon alfa-2b."
Key Findings from ACHIEVE 2/3
The topline ACHIEVE 2/3 results include the following key findings:
Treatment Group Receiving Albinterferon Alfa-2b 900-mcg Every Two Weeks, vs.
Treatment Group Receiving Peginterferon Alfa-2a 180-mcg Every Week
-- Based on an ITT analysis of the treatment group assigned to receive
900-mcg albinterferon alfa-2b every two weeks, the topline results
demonstrate that albinterferon alfa-2b met its primary efficacy endpoint of
non-inferiority to peginterferon alfa-2a, with 79.8% (249/312) of patients
achieving SVR in the 900-mcg albinterferon alfa-2b treatment group, vs.
84.8% (263/310) in the peginterferon alfa-2a treatment group (p=0.0086 for
non-inferiority).
-- By region, SVR rates were
-- North America: 82.5% (85/103) for 900-mcg albinterferon alfa-2b, vs.
81.5% (88/108) for peginterferon alfa-2a;
-- Asia: 79.8% (75/94) for 900-mcg albinterferon alfa-2b, vs. 95.5% (85/89)
for peginterferon alfa-2a;
-- Europe: 78.1% (64/82) for 900-mcg albinterferon alfa-2b, vs. 81.7%
(67/82) for peginterferon alfa-2a;
-- Other regions: 75.8% (25/33) for 900-mcg albinterferon alfa-2b, vs. 74.2%
(23/31) for peginterferon alfa-2a.
-- Patients receiving 900-mcg albinterferon alfa-2b had comparable rates of
serious adverse events, severe adverse events, and discontinuations due to
adverse events, vs. peginterferon alfa-2a.
-- The incidence of severe and/or serious adverse events was comparable
between the two groups, with 17.3% (54/313) in the albinterferon alfa-2b
900-mcg treatment group, vs. 17.5% (54/309) in the peginterferon alfa-2a
treatment group.
-- The incidence of severe and/or serious pulmonary adverse events was also
comparable between these groups: severe and/or serious pulmonary infections
were 0.6% (2/313) for 900-mcg albinterferon alfa-2b, vs. 0.6% (2/309) for
peginterferon alfa-2a; and severe and/or serious respiratory, thoracic or
mediastinal disorders were 1.0% (3/313) for 900-mcg albinterferon alfa-2b,
vs. 1.3% (4/309) for peginterferon alfa-2a.
-- Overall, adverse events observed were those typically associated with
interferon therapy, and the rate of discontinuations due to adverse events
was comparable: 4.8% (15/313) for 900-mcg albinterferon alfa-2b, vs. 3.6%
(11/309) for peginterferon alfa-2a.
Treatment Group Originally Randomized to Receive Albinterferon Alfa-2b
1200-mcg Every Two Weeks and Reduced to 900-mcg Following January 2008 Dose
Modification, vs. Treatment Group Receiving Peginterferon Alfa-2a 180-mcg
Every Week
Due to the dose modification announced in January 2008, patients in the
treatment group originally randomized to receive albinterferon alfa-2b
1200-mcg every two weeks had their dose modified to 900-mcg albinterferon
alfa-2b every two weeks. All patients had completed at least 12 weeks of
treatment at the time of the dose modification. Data from all three
treatment groups in the ACHIEVE 2/3 study were analyzed according to the
original dose assignment. The following topline results for the treatment
group originally randomized to receive 1200-mcg albinterferon alfa-2b every
two weeks did not impact the primary analysis comparing the 900-mcg
albinterferon alfa-2b treatment group to the peginterferon alfa-2a treatment
group.
-- Based on an ITT analysis of results for the treatment group originally
randomized to receive 1200-mcg albinterferon alfa-2b every two weeks, 80.0%
(248/310) of patients in this treatment group achieved SVR, vs. 84.8%
(263/310) in the peginterferon alfa-2a treatment group, which statistically
demonstrated non-inferiority (p=0.0059).
-- The incidence of severe and/or serious adverse events was comparable
between the two groups, with 16.8% (52/310) in the treatment group
originally randomized to receive 1200-mcg albinterferon alfa-2b every two
weeks, vs. 17.5% (54/309) in the peginterferon alfa-2a treatment group.
-- The incidence of severe and/or serious pulmonary adverse events was also
comparable between these groups: severe and/or serious pulmonary infections
were 1.3% (4/310) in the treatment group originally randomized to receive
1200-mcg albinterferon alfa-2b, vs. 0.6% (2/309) in the peginterferon
alfa-2a treatment group; severe and/or serious respiratory, thoracic or
mediastinal disorders were 1.6% (5/310) in the treatment group originally
randomized to receive 1200-mcg albinterferon alfa-2b, vs. 1.3% (4/309) in
the peginterferon alfa-2a treatment group.
-- Overall, adverse events observed were those typically expected with
interferon therapy. The incidence of discontinuations due to adverse events
was 5.5% (17/310) in the treatment group originally randomized to receive
1200-mcg albinterferon alfa-2b every two weeks, vs. 3.6% (11/309) in the
peginterferon alfa-2a treatment group.
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