Below is an excerpt from an Idenix press release explaining
the latest developments in the company's HCV drug development
program.
Idenix
Provides Update on HCV Clinical Development Activities
Cambridge,
Mass. -- September 7, 2010 -- Idenix Pharmaceuticals, Inc. (Nasdaq:
IDIX), a biopharmaceutical company engaged in the discovery
and development of drugs for the treatment of human viral diseases,
today announced that the company received verbal notice on Friday,
September 3, 2010 from the U.S. Food and Drug Administration
(FDA) that the IDX184 and IDX320 programs have been placed on
clinical hold. A clinical hold is an order issued by the FDA
to the sponsor to delay a proposed clinical investigation or
to suspend an ongoing investigation. This decision was made
after Idenix notified the FDA of three serious adverse events
that occurred during a drug-drug interaction study of the combination
of IDX184 and IDX320 in healthy volunteers. These observed serious
adverse events were elevated liver function tests detected in
three subjects during post exposure safety visits. The liver
function tests have returned to nearly normal levels in all
three subjects during follow-up. All planned studies of IDX184
and IDX320 to date have been completed and there are currently
no healthy volunteers or patients receiving IDX184 or IDX320.
Idenix will submit full data to the FDA from recently completed
preclinical and clinical studies, including 3-month chronic
toxicology studies of IDX184, a 14-day study of IDX184 in combination
with pegylated interferon/ribavirin (PegIFN/RBV), a 3-day proof-of-concept
study of IDX320 in hepatitis C (HCV) infected patients, and
the IDX184 and IDX320 drug-drug interaction study in healthy
volunteers in order to assess next steps in the development
of both compounds.
"We have not yet received a formal letter from the FDA,
nor has the agency had an opportunity to review the safety and
efficacy data from recently completed clinical trials with IDX184
and IDX320. Based upon our discussions with the agency, we are
primarily focused on three cases of elevated liver function
tests observed during our drug-drug interaction study of the
combination of IDX184 and IDX320 in healthy volunteers,"
said Jean-Pierre Sommadossi, PhD, Idenix Chairman and Chief
Executive Officer. "Based upon the safety and antiviral
activity we observed in the IDX184 14-day study and the IDX320
3-day proof-of-concept study, both in HCV-infected patients,
we remain committed to the future potential of these drug candidates.
We will work closely with independent experts and our external
safety committee to better understand the cause of these serious
adverse events in the combination study of IDX184 and IDX320
and to provide the FDA with more information in order to expedite
their review and resolve this matter as quickly as possible."
Full data presentations of IDX184, IDX320 and IDX375 studies
will be presented at the annual meeting of the American Association
for the Study of Liver Diseases (AASLD), which will be held
at the end of October in Boston.
Phase I: IDX184/IDX320 Combination
Idenix completed a two-week Phase I, randomized, double-blind,
placebo-controlled study to evaluate the safety and pharmacokinetic
drug-drug interaction between IDX320 and IDX184 in healthy volunteers.
Two cohorts were evaluated in the study with 10 subjects in
each cohort randomized eight to active drug and two to placebo.
Subjects in the first cohort received 400 mg once-daily of IDX320
for the first week, subsequently adding 100 mg once-daily of
IDX184 for the second week. Subjects in the second cohort received
100 mg once-daily of IDX184 plus placebo for the first week,
subsequently adding 400 mg once-daily of IDX320 for the second
week. The combination of IDX184 and IDX320 was generally safe
and well tolerated during the 14 days of treatment. Liver function
abnormalities deemed to be serious adverse events were detected
in three subjects during the post exposure safety visits. Liver
function tests in these subjects have returned to nearly normal
during follow-up. Pharmacokinetic drug-drug interactions between
IDX184 and IDX320 were not considered to be clinically significant.
Neither the plasma exposure of IDX184 and its metabolite, 2'-methylguanosine,
nor IDX320 plasma exposure explain these three serious adverse
events.
Phase IIa: IDX184, a liver-targeted HCV nucleotide prodrug
This 14-day, Phase IIa clinical trial evaluated 50 to 200 mg
doses of IDX184 in combination with PegIFN/RBV in treatment-naive
HCV genotype 1-infected patients. At Day 14, mean (+/- standard
deviation) viral load reductions were 1.5 (+/- 1.3) logs for
placebo (n=16), 2.7 (+/- 1.3) logs for 50 mg IDX184 QD [once-daily](n=16),
4.0 (+/- 1.7) logs for 50 mg IDX184 BID [twice-daily](n=8),
4.2 (+/- 1.9) logs for 100 mg QD (n=8), 4.1 (+/- 1.2), for 150
mg QD (n=15), 4.1 (+/-1.4) logs for 100 mg BID (n=8) and 3.7
(+/- 1.2) logs for 200 mg QD (n=8). In the cohorts of 100 mg,
150 mg, and 200 mg daily doses in combination with PegIFN/RBV,
50%, 40% and 25%, respectively, of patients achieved undetectable
virus levels (< 15 IU/mL) by Day 14. Liver injury parameters
(ALT and AST) improved with all doses of IDX184. The side effect
profile of the three drug combination was consistent with the
known side effect profile of PegIFN/RBV alone. The most common
adverse events reported were fatigue, myalgia, headache and
nausea.
Phase I/II: IDX 320, an HCV protease inhibitor
This randomized, parallel-arm, double-blind, placebo-controlled
proof-of-concept trial evaluated the safety, tolerability, antiviral
activity and pharmacokinetics of IDX320 in treatment-naive HCV
genotype 1-infected patients. Thirty patients were randomized
equally and received placebo, 50, 100, 200 or 400 mg of IDX320
orally once-a-day for three days. One cohort of eight patients
was randomized to receive 200 mg IDX320 BID or placebo. At Day
3, mean (+/- standard deviation) viral load reductions were
0.1 (+/- 0.15) logs for placebo (n=5), 2.6 (+/-0.49) logs for
50 mg IDX320 QD (n=5), 3.1 (+/- 0.29) logs for 100 mg QD (n=6),
3.1 (+/- 0.41) logs for 200 mg QD (n=6) and 3.3 (+/- 0.28) logs
for 400 mg QD (n=7). At daily doses of placebo, 50, 100, 200,
and 400 mg, 0%, 20%, 67%, 67% and 86%, respectively, of patients
achieved greater than or equal to 3 log reduction in HCV RNA
at the end of treatment. In the 200 mg IDX 320 BID cohort at
Day 3, mean (+/- standard deviation) viral load reductions were
3.8 (+/- 0.52) logs and all patients (100%) achieved greater
than or equal to 3 log reduction in HCV RNA. In the 3-day proof-of-concept
study, IDX320 was generally safe, well tolerated, and demonstrated
potent, dose-related HCV antiviral activity.
Phase I: IDX375, an HCV non-nucleoside polymerase inhibitor
Idenix has an ongoing Phase I clinical trial in healthy volunteers
evaluating single doses of the free acid form of IDX375 ranging
from 200 to 1200 mg per day. Overall, IDX375 achieved pharmacologically
relevant drug exposure and was well tolerated for doses up to
1200 mg for one day in healthy subjects. In the fourth quarter
of 2010, Idenix plans to initiate a 3-day proof-of-concept trial
in treatment-naive genotype 1 HCV-infected patients.
About Idenix
Idenix Pharmaceuticals, Inc., headquartered in Cambridge, Massachusetts,
is a biopharmaceutical company engaged in the discovery and
development of drugs for the treatment of human viral diseases.
Idenix's current focus is on the treatment of patients with
chronic hepatitis C infection. For further information about
Idenix, please refer to www.idenix.com.
9/10/10
Source
Idenix
Pharmaceuticals. Idenix Provides Update on HCV Clinical Development
Activities. Press release. September 7, 2010.