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GSK, Ionis unveil data for hepatitis B drug touted as ‘functional cure’

Dive Brief: An RNA-based shot developed by GSK and Ionis Pharmaceuticals helped wipe out hepatitis B in about a fifth of the patients who received it in a pair of clinical trials, according to study results published Thursday in the New England Journal of Medi

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Dive Brief:

  • An RNA-based shot developed by GSK and Ionis Pharmaceuticals helped wipe out hepatitis B in about a fifth of the patients who received it in a pair of clinical trials, according to study results published Thursday in the New England Journal of Medicine .
  • Called bepirovirsen, the shot could represent an important advance for people with chronic hepatitis B infections, less than 1% of whom can achieve such a “functional cure” with the help of oral antivirals. None of the participants who received a placebo hit that mark in the two trials presented Thursday.
  • The Food and Drug Administration is already reviewing an approval application for bepirovirsen, and has granted the drug “fast track” and “breakthrough therapy” designations that could speed up its evaluation. An approval decision is expected no later than Oct. 26.

Dive Insight:

Bepirovirsen is poised to become an important part of GSK’s future. The drug is one of 15 the company highlighted in January as likely to generate more than $2 billion in peak sales in the years ahead. Its results were hailed by physicians at a medical meeting Thursday as a “historic moment” and a “huge leap forward” for patients, wrote Jefferies analyst Michael Leuchten in a client note. Hepatitis B infections can be prevented with vaccination. But some 240 million people nonetheless have the kind of “chronic” infections that can fester and lead to serious health complications such as cirrhosis and liver cancer. About 1 million deaths are attributed to the disease each year, and the current treatments — like Gilead Sciences’ Vemlidy — have to be taken for life. Bepirovirsen could change that. Whereas available therapies are antivirals that only stop the virus from replicating, GSK and Ionis’ treatment is an antisense oligonucleotide that prevents spreading while also stimulating an immune response. That dual mechanism is supposed to better help the body clear out infected cells, offering the chance at a longer-term, “functional cure.” Ionis developed the therapy and licensed it to GSK in 2019. Since then, the partners have advanced it to the precipice of approval. The two trials reported Thursday, B-Well 1 and B-Well 2, enrolled 981 and 857 people with chronic hepatitis B, respectively. Two thirds were randomized to receive bepirovirsen on top of antivirals, with the remainder getting those antivirals and a placebo. Patients who got bepirovirsen were treated for 24 weeks. After 48 weeks, enrollees with undetectable disease were taken off their standard medications, too. In B-Well 1 and B-Well 2, 20% and 19% of bepirovirsen recipients achieved a functional cure compared to none of those in the placebo arms. The cure rates were higher in people who entered the trial with lower levels of a key viral protein, with 25% hitting that mark in B-Well 1 and 28% in B-Well 2. Trial enrolles receiving bepirovirsen reported more side effects, although only a small percentage discontinued or interrupted doses. Injection site reactions were the most common adverse event reported, though liver enzyme elevations were also detected. “With recent guidelines now prioritizing functional cure, these new data could represent an important advance,” said trial investigator Jinlin Hou, director of the Guangdong Institute of Hepatology in China, in a statement provided by GSK. “Combined with improved testing and diagnosis, this innovation has the potential to improve the lives of millions living with [chronic hepatitis B].” According to Leuchten, of Jefferies, the findings position GSK and Ionis’ drug as the “key backbone for combination strategies” and support “clear blockbuster potential.” “We see this data as likely to meaningfully shift the HBV treatment paradigm, particularly for patients who are already on therapy,” he wrote in that client note. Meanwhile, Leerink Partners analyst Mani Foroohar wrote that bepirovirsen may be an “under-appreciated blockbuster potential in the long term,” but cautioned that screening, monitoring and physician office capacity could lead to a slower-than-usual launch trajectory.

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Related questions

01How Real Brain Cells Respond to Artificial Neurons

Holla, who completed her PhD in Raman’s lab and is now a postdoctoral researcher studying memory at New York University in New York City, designed and ran experiments in mouse cerebellar slices. She positioned a stimulation electrode on the parallel fibers, the main pathway that excites Purkinje cells, and a recording electrode on the Purkinje cells themselves. She played recordings of the artificial neurons’ waveforms into the tissue through a standard stimulation electrode at four different speeds: 7, 60, 218, and 740 spikes per second. At every speed below 200 spikes per second, the Purkinje cells fired in response. The strongest results came at 60 spikes per second, where each artificial spike lasted 0.7 milliseconds, which is fast enough to trigger the cell but brief enough to avoid flooding the tissue with unnecessary current. Above 200 spikes per second, the cells stopped responding. They simply cannot fire that fast. The team included the 740-spikes-per-second condition on purpose to directly challenge the many engineering groups building artificial neurons that operate at those speeds. “We had to show them [740 spikes] wasn’t sufficient,” Brown said. “You can’t work that fast.” “You can see the living neurons respond to our artificial neuron,” Hersam said. But he is careful to note a caveat: The printed artificial neurons were not touching the brain tissue. The waveforms they generated were recorded and then played back into the slice through standard laboratory stimulation equipment. The next step is to prove the printed device itself can interface with living tissue.

Source: www.medscape.com ↗
02Lifestyle Matters: How do environmental and lifestyle factors influence Alzheimer’s disease?

Dr. Harrison and Finnish neuroscientist Dr. Miia Kivipelto explore the complex interplay between genetics and lifestyle in Alzheimer's development. Learn how the groundbreaking FINGER study demonstrates potential prevention strategies, and discover the latest evidence on how environmental factors, diet, and chronic conditions influence Alzheimer's risk.

Source: www.biopharmadive.com ↗
03China: Threat or opportunity?

One of the biggest biotech news stories of recent years is China’s continued rise as a biotech and life sciences powerhouse. China conducts a quarter of all clinical trials and drug development and has almost 1,500 new drugs in development.¹ Many China-based biotechs have benefitted from government funds, out-licencing deals with large pharmas and venture capital funding. However, policymakers in the US and EU have concerns about the possible threat to their region’s biosecurity and competitiveness as centres for health and life science research. Given China’s increased importance, ICON Biotech conducted the same biotech sector survey with 100 China-based biotech leaders. The results show that Chinese biotechs face many of the same challenges as biotechs located elsewhere. They share the same funding challenges and burdens associated with increasingly complex clinical trials and regulations.

Source: www.biopharmadive.com ↗
04What Comes Next

With data expected in the fourth quarter of 2026, we are prioritizing histology alongside patient-reported outcomes using the Celiac Disease Symptom Diary, one of only two instruments developed in line with U.S. Food and Drug Administration (FDA) guidance, to capture changes in symptoms such as abdominal pain and nausea. Ultimately, the broader aim is to give gastroenterologists and patients a therapeutic option for a disease that has long been managed without one. The future of drug development will not be defined by statistical significance alone, but by whether new therapies also improve the daily burden of living with celiac disease. “The first therapy to cross the line could change the field,” Geller concluded. “It would help establish celiac as a serious medical condition with options beyond a restrictive diet and open the door for what comes next.” Dr. Paul Lizzul is chief medical officer at First Tracks Biotherapeutics, a clinical ‑ stage biotechnology company advancing antibody therapeutics that modulate immune pathways implicated in autoimmune and inflammatory diseases. Marilyn Geller serves as an advisor to First Tracks Bio. Footnotes Abadie V, Jabri B. IL-15: a central regulator of celiac disease immunopathology. Immunol Rev . 2014;260(1):221-234. https://doi.org/10.1111/imr.12191. Yokoyama S, Watanabe N, Sato N, et al. Antibody-mediated blockade of IL-15 reverses the autoimmune intestinal damage in transgenic mice that overexpress IL-15 in enterocytes. Proc Natl Acad Sci U S A . 2009;106(37):15849-15854. https://doi/full/10.1073/pnas.0908834106. Anthony S, Schluns KS. Emerging roles for IL-15 in the activation and function of T-cells during immune stimulation. Research and Reports in Biology . 2015;6:25-37. https://doi.org/10.2147/RRB.S57685.

Source: www.biopharmadive.com ↗
05Why Muscle Cells Might Do Some Heavy Lifting

Brown was studying gene therapy in the 1990s when he designed a technology to turn mRNA expression on or off in different cells. For the new mouse study, published in Nature Biotechnology , he adapted the technology to turn off mRNA expression in dendritic cells, muscle cells, or liver cells. The researchers then vaccinated the mice with each version, delivering the vaccines both intravenously and intramuscularly. “The results were pretty stunning,” Brown said. When mRNA expression was turned off in muscle cells, T-cell response went down, suggesting muscle cells play a role in immunity. When expression was turned off in liver cells, T-cell expression tripled — indicating liver cells dampen immunity. Turning off expression in dendritic cells had no effect on T-cell activation, though it did reduce the number of killer T cells by as much as half. (Interestingly, no such reduction occurred when the antigen was SARS-CoV-2 spike. Brown is now investigating why different antigens had varying effects.) Knowing all this is crucial for designing effective mRNA vaccines and therapies. That’s because different mRNA therapies require different strategies. Cancer vaccines must boost tumor-fighting killer (CD8+) T cells. For genetic disease treatments, scientists want to avoid triggering the immune system to prevent killing the very cells the mRNA is meant to modify. “Understanding the immunology is extremely important for this class of drug,” Brown said. The finding doesn’t mean dendritic cells aren’t important for mRNA vaccines to work. “It just means that the mRNA doesn’t have to get into those cells to induce an immune response,” Brown said. Instead, the antigen can be transferred to those dendritic cells.

Source: www.medscape.com ↗
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Peptide Therapy Guide Editorial Team

Editorial team for Peptide Therapy Guide.

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