The goal of this clinical trial is to learn about the action of Imdusiran (AB-729) in the liver of people with chronic hepatitis B. The main questions it aims to answer are:
* how well is it working in the liver
* how does Imdusiran affect the hepatitis B virus
Participants will receive injections of Imdusiran, one injection every 8 weeks, for a total of 4 doses. They will also undergo 2 liver biopsies: one with the first dose of Imdusiran, and the second 8 weeks after the last dose of Imdusiran.

开始日期2024-07-25

申办/合作机构

University of Maryland Baltimore

[+1]

NCT06245291 / Withdrawn临床2期

A Phase 2a, Open-Label Multiple Dose Study Evaluating the Safety, Tolerability, and Pharmacodynamics of Imdusiran (AB-729) in Combination With Intermittent Dosing of Durvalumab, a PD-L1 Monoclonal Antibody, in Subjects With Chronic HBV Infection

This is a phase 2a, open-label, multicenter study investigating the safety, tolerability, and antiviral activity of durvalumab administered at targeted times during a 48-week treatment period of imdusiran in virologically-suppressed CHB subjects

开始日期2024-05-01

申办/合作机构

Arbutus Biopharma Corp.

ACTRN12622000317796 / Active, not recruiting临床2期

A Phase 2a, Randomized, Blinded, Multicenter Study Investigating a Combination of AB-729 and VTP-300 to evaluate their safety and reactogenicity in Virologically-Suppressed Chronic Hepatitis B Participants.

开始日期2022-06-02

申办/合作机构

Arbutus Biopharma Corp.

[+1]

100 项与 Imdusiran 相关的临床结果

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100 项与 Imdusiran 相关的转化医学

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100 项与 Imdusiran 相关的专利（医药）

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项与 Imdusiran 相关的文献（医药）

2024-10-11·ACS Infectious Diseases

Control of Hepatitis B Virus with Imdusiran, a Small Interfering RNA Therapeutic

Article

作者: Cuconati, Andrea ; Paratala, Bhavna ; Thi, Emily P. ; Graves, Ingrid E. ; Ye, Xin ; McClintock, Kevin ; Rijnbrand, Rene ; Micolochick Steuer, Holly M. ; Espiritu, Christine ; Sofia, Michael J. ; Lee, Amy C. H. ; Harasym, Troy ; Jarosz, Agnes ; Snead, Nicholas M. ; Teng, Xiaowei ; Abbott, Cory ; Ardzinski, Andrzej ; Lam, Angela M.

Chronic hepatitis B is a global health concern with a high risk of end-stage liver disease. Current standard-of-care agents have low cure rates, and new therapies are needed. Small interfering RNAs (siRNAs) that target viral RNAs fulfill a gap not addressed by standard-of-care agents and may contribute to a functional cure. Here, we describe the preclinical characterization of imdusiran (AB-729), a novel, pan-genotypic siRNA therapeutic that effectively reduces HBsAg, viral antigens, and viral replication in chronic hepatitis B patients and is currently in Phase 2 clinical studies. In hepatitis B virus (HBV) cell-based systems, imdusiran possessed pan-genotypic nanomolar potency and retained activity against HBV target site polymorphisms. Imdusiran was active against nucleos(t)ide analogue- and capsid assembly modulator-resistant HBV isolates, and combination with standard-of-care agents was additive. In an HBV adeno-associated virus mouse model, HBsAg was reduced up to 3.7 log₁₀ after a single imdusiran dose, with sustained suppression for 10 weeks. Imdusiran did not intrinsically stimulate cytokine release in healthy donor human whole blood, supportive of its mechanism of action as a direct acting RNA interference antiviral. Taken together, these data support imdusiran in combination treatment approaches toward chronic hepatitis B functional cure.

Hepatology communications

Measuring hepatitis B pgRNA stability using an updated automated HBV pgRNA assay with increased sensitivity

Article

作者: Anderson, Mark ; Thi, Emily P. ; Stec, Michael ; Mbanya, Dora ; Picchio, Gaston ; Cloherty, Gavin

Background::

HBV pregenomic RNA (pgRNA) is a circulating biomarker for covalently closed circular DNA activity in HBV-infected individuals and has been studied for treatment efficacy, disease staging, and off-therapy outcomes; however, data on the stability are scarce. Increasing HBV pgRNA assay sensitivity may improve its predictive value and provide additional insights at low viral levels.

Methods::

Modifications to a fully automated first (v1) generation HBV pgRNA assay improved sensitivity up to 15-fold over the previous assay. Flexible sample input volumes yielded lower limits of quantitation of 10 and 22 copies/mL for 0.6 and 0.2 mL assays, respectively. Results are standardized to secondary standards that are traceable to the WHO HBV DNA standard, and internal and external controls are included.

Results::

Comparison between v1 and modified v2 assays showed increased sensitivity from 152 copies/mL with v1 to 10 (0.6 mL) and 22 (0.2 mL) copies/mL with v2, respectively. Quantitated v2 results were indistinguishable from v1, indicating that comparisons can be made to previous studies. Single timepoint treatment-naive blood donors or longitudinal draws from patients with chronic hepatitis B on AB-729, an investigational siRNA therapy, showed improved detection and quantifiable pgRNA with v2 compared with v1. Stability testing demonstrated excellent HBV pgRNA plasma stability after 3 freeze-thaw cycles, for at least 7 days at 25–37 °C and at least 30 days at 4°C, with ≤0.25 Log U/mL decrease.

Conclusion::

HBV pgRNA v2 assays with increased sensitivity and flexible input volumes demonstrated increased detection and quantitation of low viral titer samples. Highly sensitive HBV pgRNA assays may be useful in refining predictive treatment outcomes based on this marker. HBV pgRNA was stable under multiple conditions, which increases the reliability of this marker.

AIDS reviews4区 · 医学

Hepatitis B Gene Therapy Coming to Age.

4区 · 医学

Review

作者: Soriano, Vicente

The major pandemics caused by chronic viral infections is produced by HIV, hepatitis C virus (HCV), and hepatitis B virus (HBV), with estimates of 38, 70, and 250 million people worldwide, respectively (Fig. 1). During the last couple of years, the advent of direct oral antivirals has allowed pursuing global HCV eradication. In an unprecedented manner, these drugs cure more than 95% of hepatitis C patients when given for only 2-3 months. The enthusiasm on HCV has renewed the interest for curative strategies for both HIV and HBV. However, important biological differences between all three viruses may preclude envisioning a similar rapid success for either HIV or HBV than for HCV infection. As shown in figure 1, once infection of targeted cells has occurred, the viral genetic material only replicates in the cytosol for HCV whereas it enters the nucleus and integrates into the chromosomes as provirus for HIV or is converted in a circular covalently closed form (cccDNA) for HBV (Fig. 1). Blocking viral nucleic acid replication for a minimum lag of time allows definitive clearance of HCV infection, with degradation of residual cytoplasmic HCV-RNA strands. In contrast, blocking viral replication has only a transient effect on HIV or HBV, as mRNA expression resumes following treatment discontinuation, given the stability of the HIV provirus or the HBV cccDNA, respectively. The European Liver meeting took held in Paris on April 2018. A relatively large number of presentations addressed distinct new hepatitis B therapeutic strategies. Table 1 summarizes some of the molecules that have been investigated so far with more promising results, grouping them into distinct drug classes (Soriano et al. Exp Op Inv Drugs 2017;26:843-51), based on their distinct mechanism of action and targeted steps in the HBV life cycle (Fig. 2). Considering the pros and cons of novel HBV therapeutic candidates, it has become apparent new HBV gene therapies among the most attractive. Several advances have contributed to position gene therapy in front within the experimental HBV armamentarium. First, progresses in delivery systems, including the use of polymers and nanoformulations have allowed developing easier forms of administration that now are becoming subcutaneous and monthly. Second, the synthetic production of oligonucleotide formulations has reduced costs. Third, the specificity against HBV is higher than for other experimental agents, as immune modulators that enhance innate immunity, such as TLR agonists (i.e., GS-9620) or checkpoint inhibitors (i.e., nivolumab). Fourth, significant declines in serum hepatitis B surface antigen (HBsAg) are demonstrated during gene therapy, which have never been seen using the most potent polymerase inhibitors (i.e., tenofovir or entecavir). Finally, unanticipated significant reductions in cccDNA are seen with HBV gene therapy, most likely as prove of an indirect benefit of waning the immunosuppressive effect of large over amounts of HBsAg released by infected hepatocytes that contributes to T-cell exhaustion. In a pioneering study, Roche was the first to publish the potent effect of an oral small molecule that blocked HBV gene expression (Mueller et al. J Hepatol 2018;68:412-20). The drug belonged to the dihydroquinolizinone class, and directly or indirectly modified viral RNAs, promoting their degradation. This posttranscriptional silencing was accompanied by rapid drops in HBV-DNA and more importantly in serum HBsAg in the humanized mice. However, Roche decided to discontinue any further clinical development of the drug. Nowadays, two major groups of agents are being developed as HBV gene therapies. At this time, interference RNA (iRNA) molecules and nucleic acid polymers (NAPs) are the most promising. Overall, iRNA is double-stranded RNA molecules, 20 nucleotides long. One strand matches a segment of specific HBV mRNA and induces its degradation. Several iRNA molecules have entered into Phase II clinical trials (Flisiak et al. Exp Op Biol Ther, in press), including ARB-1467 and AB-729 (Arbutus), ARO-HBV (Arrowhead), ALN-HBV (Alnylam), and IONIS-HBVRx (Ionis). In most cases, they are tested as part of combination therapy with nucleos(t)ide analogs and/or peginterferon. NAPs are phosphorothioate 40 length oligonucleotides that no map any HBV sequence. However, they interact with a liver host target protein (apolipoprotein-like) and result in specific inhibition of HBV mRNAs. This is followed by rapid suppression of HBsAg release (Roehl et al. Mol Ther Nuc Acids 2017;8:1-12). In a pilot study with intravenous REP-2139, investigators from Replicor demonstrated strong reductions in HBV-DNA along with significant drops in HBsAg and seroconversion in some patients. More interestingly was the recognition of significant reductions in hepatic cccDNA, most likely a result of an indirect effect following the removal of large amounts of HBsAg from the bloodstream that contributes to impaired T-cell responses in chronic hepatitis B patients (Bazinet et al. EASL, Paris 2018; abstract FRI-343). An improved NAP, named REP-2165 and subcutaneous administration are currently being tested.

129

项与 Imdusiran 相关的新闻（医药）

2024-11-08

·同写意

慢性乙型肝炎病毒感染的最佳管理实践和长期治愈前景

乙型肝炎病毒（hepatitis B virus, HBV）是肝硬化(cirrhosis)和肝细胞癌（hepatocellular carcinoma, HCC）的主要病因。目前，全球约有超20亿人感染过HBV，其中2.96亿人（约占总人口3.7%）患有慢性HBV感染，每年可导致全球约82万人死于肝硬化和HCC并发症。即使有预防性的疫苗，每年仍有约150万例新发感染。世界卫生组织设定了到2030年消除HBV的目标，即与2015年相比，HBV相关死亡率降低65%，发病率降低90%。当前，临床治疗中关于HBV的疗法已取得显著进展，为实现慢性乙肝（Chronic hepatitis B，CHB）的功能性治愈（乙肝表面抗原（HBsAg）消失）和完全治愈（清除共价闭合环状DNA（cccDNA）和整合HBVDNA）提供了希望。劲帆医药结合现有及自主研发的肝脏特异性启动子，成功开发了rAAV-HBV1.3-mer WT replicon和rAAV-1.2×HDV系列造模病毒产品，另外还与武汉大学合作开发了一系列AAV-HBV-1.04乙肝造模病毒产品，通过ATR介导DNA损伤（DDR）形成HBV cccDNA，使乙肝表面抗原HBsAg和HBV子代产生，实现更好地模拟病毒复制过程。以上产品具备成模率高、稳定性好、适用范围广等优势，加速推进了乙肝/丁肝病毒复制机制的研究及抗乙肝/丁肝药物的研发进程。此外，劲帆医药还拥有专业的体内外药效评价团队，可提供肝脏疾病药物筛选、药效学评价、药代动力学研究、Non-GLP非临床安全性评价等服务项目，全面覆盖药物临床前研究的完整流程。近期，来自美国国立卫生研究院（NIH）国家糖尿病、消化和肾脏疾病研究所的Marc G. Ghany研究团队在期刊《Gastroenterology》上发表了题为“Current Best Practice in Hepatitis B Management and Understanding Long-term Prospects for Cure”的综述，该综述涵盖了当前慢性HBV感染的最佳管理实践和HBV感染的新兴疗法及其治愈前景。 1 HBV介绍 01 HBV生命周期 HBV颗粒（也称Dane particle）由一个外层脂质包膜和一个内部核衣壳组成，核衣壳内含有病毒遗传物质（DNA）和复制所需的酶（聚合酶）。病毒基因组是部分双链DNA，具有四个重叠的开放阅读框，它们编码以下7种病毒蛋白：聚合酶，核心蛋白，乙肝e抗原（HBeAg），大、中、小三种HBsAg以及X蛋白。病毒生命周期如图1所示。复制过程中，会产生双链线性DNA（约占5%～10%），这些DNA可能随机整合到宿主基因组中,进而引发肝细胞癌（HCC）。相当比例的HBsAg可能来源于整合的HBV DNA。图1 HBV生命周期和药物开发靶点（图片来源：Yardeni D et al, Gastroenterology, 2023） 02 HBV感染后的免疫机制免疫反应在HBV清除中起着重要作用。HBV不易激活包括Ⅰ型干扰素（IFN）途径在内的细胞内先天防御机制，但可以通过Ⅰ/Ⅲ型IFN和细胞内抗病毒传感器（如Toll样受体（TLRs）、视黄酸诱导基因Ⅰ（RIG-Ⅰ）样受体）的药理学激活和外源性IFN治疗来抑制其复制。HBV还可以通过HBV前基因组RNA（pgRNA）与RIG-Ⅰ之间的相互作用以及体外肝细胞中的IFN刺激来诱导产生Ⅲ型IFN。此外，在急性HBV感染患者中，自然杀伤（NK）细胞和NKT细胞可在早期被激活。因此，一旦HBV在肝细胞中复制，Ⅲ型IFN以及NK细胞和Kupffer细胞（也称枯否细胞）的激活可能有助于在感染早期调节病毒复制和病毒传播。在动物模型中，T细胞已被证实是HBV清除和肝病发病机制中的关键因素。CD8 T细胞能识别和杀死病毒感染肝细胞，而CD4 T细胞则提供关键的T细胞和协调免疫反应。在急性HBV感染的患者中，广泛的抗病毒T细胞反应和HBsAg特异性中和抗体反应能有效清除病毒，HBV特异性记忆T细胞还能在急性HBV感染临床缓解后持续数十年，这些记忆T细胞由体内微量病毒维持，并可能介导病毒控制；B细胞也参与HBV控制，慢性HBV感染涉及特异性及全身性T细胞和B细胞功能障碍，由于长期暴露于病毒抗原和炎症介质，这将导致免疫衰竭和免疫失调。另外，先天性和适应性免疫细胞的非特异性炎症浸润在HBV感染的肝脏中积聚，并促进肝细胞损伤和纤维化，而无法抑制病毒。因此，免疫介导的HBV治疗需要在病毒免疫控制和肝细胞损伤之间取得平衡以避免不良临床后果。 2 治疗策略 01 HBV感染治疗目标慢性乙肝（CHB）治疗的主要目标是预防肝硬化、HCC发展和降低肝脏相关死亡率。然而，从感染HBV到发生这些终点事件，病情发展通常需要经过几十年。因此，评估慢性HBV感染治疗方法的研究依赖于替代终点，包括HBV DNA水平低于可检测下限、谷丙转氨酶（ALT）正常化、HBeAg清除、HBsAg清除和组织学改善，其中HBsAg清除被认为是最佳的终点，但自发性和治疗相关的HBsAg清除率较低，每年大约只有1%。 02 CHB治疗指征 CHB是一种动态疾病。HBeAg状态、HBV DNA和ALT水平是评估CHB疾病活动的主要指标。美国肝病研究学会（AASLD）、欧洲肝病研究学会（EASL）和亚太肝病研究学会（APASL）这三大肝脏学会已就治疗指征提供了指导（表1）。此外，世界卫生组织针对可能无法进行病毒载量检测的低收入和中等收入国家开发了一种更为简化的治疗方法。所有指南均强烈建议对失代偿性肝病、肝硬化，以及具有活动性疾病指征的患者（HBV DNA和ALT水平升高的患者）进行治疗。其它治疗或预防指征见表2。另有一些专家提出了一种可替代且更简化的“全面治疗”法，即无论患者ALT水平如何，对所有HBsAg阳性且可检出病毒血症的个体进行治疗。但该方法在部分患者中存在争议，研究人员建议“逐例分析”，来考虑疾病进展和肝癌的风险因素以及患者接受治疗的意愿，从而处理指南治疗标准之外的情况。表1 关于CHB肝病学会指南和世界卫生组织的治疗指征（图片来源：Yardeni D et al, Gastroenterology, 2023）表2 关于HBV感染的其他治疗及预防指征（图片来源：Yardeni D et al, Gastroenterology, 2023） 03 CHB治疗药物美国已获批7种用于治疗慢性HBV感染的药物，包括标准干扰素α-2b（美国和欧洲已不再使用）、聚乙二醇干扰素α-2a、拉米夫定（lamivudine）、阿德福韦（adefovir）、替比夫定（telbivudine）、恩替卡韦（entecavir, ETV）、富马酸替诺福韦二吡呋酯（tenofovir disoproxil fumarate, TDF）和替诺福韦艾拉酚胺（tenofovir alafenamide, TAF）。由于聚乙二醇干扰素具有更优越的药代动力学和给药方案（每周一次与每周三次相比），因此它优于标准干扰素。在核苷（酸）类似物中，由于恩替卡韦、富马酸替诺福韦二吡呋酯和替诺福韦艾拉酚胺具有更强的药效和更低的抗病毒耐药性，因此它们被推荐用于替代拉米夫定、阿德福韦和替比夫定。肝病学会指南推荐了两种治疗策略（表3）。一种是使用聚乙二醇干扰素α-2a进行为期48周疗程治疗，另一种是使用推荐的核苷（酸）类似物之一进行长期治疗。表3 目前获批上市的治疗CHB药物及其疗效（图片来源：Yardeni D et al, Gastroenterology, 2023） ▎聚乙二醇干扰素α-2a 作用机制：尚不完全清楚，但具有抗病毒和免疫调节两种特性。推荐剂量和治疗周期：对于HBeAg阳性和HBeAg阴性的患者，推荐剂量均为180mg，每周一次皮下注射，持续48周。优点：HBeAg阳性患者的HBeAg清除率较高（30%），并能在较短时间内清除HBsAg（HBeAg阳性患者为2%-7%，HBeAg阴性患者为4%），特别是在HBV基因型为A、B的患者中。此外，HBeAg和HBsAg能保持持续阴性。缺点：需要皮下注射给药，存在许多严重的不良事件。禁忌症：禁用于失代偿性肝硬化患者、伴有临床上显著门静脉高压的代偿性肝硬化患者和妊娠期女性。 ▎核苷（酸）类似物作用机制：通过被HBV逆转录酶整合到新合成的DNA中，作为DNA链终止剂抑制病毒复制。优点：核苷（酸）类似物的疗效因药物而异（表3），普遍具有良好的安全性和耐受性。缺点：对cccDNA无活性，停药后易复发；存在引起肾病和骨量丢失的风险，尤其是TDF。适用人群：可用于失代偿期肝硬化患者和孕妇，用以治疗或预防母婴传播。 04 治疗终点在HBeAg阳性患者中，聚乙二醇化干扰素相关的HBeAg血清学转换是主要治疗终点之一。大约25%的患者在短期（停药后的6-12个月）内可以持续抑制HBV DNA至2000 IU/mL以下。相比，在HBeAg阴性患者中，只有19%的患者可以在停药后维持HBV DNA ＜400 copies/mL。使用核苷（酸）类似物治疗时的最佳终点是至少2次检测中确认HBsAg已清除，无论是否出现Anti-HBs。对于非肝硬化、HBeAg阳性的患者，如果实现HBeAg血清学转换、HBV DNA检测不出，并接受至少12个月的巩固治疗，则可以停用核苷（酸）类似物。建议进行至少1年的治疗后监测（每3个月一次），以检测疾病是否重新活跃。对于HBeAg阴性患者，AASLD建议进行无限期治疗，直至HBsAg消失。对于无肝硬化的患者，如果实现HBV DNA检测不出且ALT水平正常持续2-3年，APASL和EASL则建议可以停止治疗。实际上，病毒学复发几乎普遍存在，停药后的前3个月内，10-30%的患者观察到病情恶化，近一半的患者可能需要重新开始治疗。因此，停用治疗的决定需要与患者仔细商议，并且患者必须同意在停药后接受密切监测。由于存在肝功能失代偿的风险，肝硬化患者不应停用抗病毒治疗。 05 未治疗患者的监测和筛查由于慢性HBV感染的动态特性，未治疗患者应每3～6个月检测一次HBV DNA和ALT水平，直至出现自发性HBsAg丢失。对于HBeAg阳性患者，应每6～12个月检测一次HBeAg状态。对于HBeAg阴性、HBV DNA水平较低（<2000 IU/mL）且ALT水平正常（非活跃性携带者/HBeAg阴性慢性感染）的患者，应在1年内每3个月检测一次HBV DNA和ALT水平，以确认疾病处于非活跃状态，之后可每6～12个月监测一次，还应每年检测一次HBsAg丢失情况，以及每2～3年进行一次无创性肝纤维化评估。针对肝硬化患者，应每6个月进行一次超声筛查，可结合甲胎蛋白（AFP）检测。HBsAg阳性且无肝硬化的成年人，但如果属于HCC高风险人群（40岁以上的亚洲或黑人男性以及50岁以上的亚洲女性、一级亲属有HCC病史者、或丁型肝炎病毒感染者）也应每6个月进行一次筛查。HBsAg清除后，对于肝硬化患者、一级亲属患HCC或有长期感染史（男性>40岁，女性>50岁）的患者，应继续进行HCC监测。 3 创新疗法由于上述疗法对cccDNA和整合HBV DNA的影响有限，且无法恢复慢性HBV感染的免疫功能紊乱。因此，迫切需要能够实现高HBsAg清除率的治疗方案。目前在研的创新疗法包括阻断病毒产生（表4，图1）和恢复耗竭的免疫反应（表4，图2）。表4 目前在研的抗病毒药物（图片来源：Yardeni D et al, Gastroenterology, 2023）图2 HBV发病机理中的免疫亚群及免疫调节治疗策略（图片来源：Yardeni D et al, Gastroenterology, 2023） 01 直接抗病毒药物靶向病毒入侵的前提是阻断新一轮的肝细胞感染，从而防止cccDNA的形成并减少cccDNA库。 Bulevirtide：能不可逆地阻断牛磺胆酸钠共转运蛋白受体，从而阻止病毒入侵，现已被欧洲药品管理局（EMA）批准用于治疗慢性丁型肝炎病毒感染。研究结果显示，在HBeAg阴性的CHB患者中，以不同剂量给予Bulevirtide 12周后，少数患者的HBsAg水平下降了≥0.5log IU/mL，但无人实现HBsAg清除，还观察到无症状的胆汁酸升高。 Hepalatide：另一种牛磺胆酸钠共转运蛋白受体阻断剂，目前正在进行一项双盲、安慰剂对照的Ⅱ期临床研究，用以评估其联合pegylated IFN与单独使用pegylated IFN治疗CHB的效果。单/多克隆抗体制剂：除阻断病毒入侵外，单克隆抗体还可以降低病毒血症和亚病毒颗粒水平，并通过呈递病毒抗原刺激T细胞，使得HBsAg清除。GC1102是一项正处于Ⅱ期临床试验中的重组乙型肝炎免疫球蛋白。VIR-3434是一种新型单克隆抗体，正在病毒抑制患者中进行Ⅰ期临床研究（NCT04423393），初步结果表明，HBsAg水平呈剂量依赖性快速下降，且未发生显著不良事件。 ▎靶向HBV转录物的药物抑制病毒产生的另一种方法是通过RNA干扰（RNAi）和反义寡核苷酸（ASOs）靶向编码信使RNA（mRNAs）的蛋白质。这种方法的治疗优势是单个小干扰RNA（siRNA）/ASO可以沉默多个病毒转录物。 siRNA：能与病毒mRNA结合，并引起细胞内RNA诱导的沉默复合体（RISC）降解病毒RNA。然而，由于该种疗法存在递送载体毒性和长期作用效果差，因此研究人员建议可以作为诱导疗法在短期疗程内给药以降低HBsAg水平。在部分患者中，研究人员发现AB-729可抑制HBsAg水平，从而增强HBV特异性免疫反应，这可能是该药物的另一个益处。 ASOs：能与病毒mRNA结合，并通过RNAseH1或空间位阻效应诱导其降解，从而阻止翻译。目前有两种反义分子，bepirovirsen和IONIS-HBVLRx，正在接受核苷（酸）类似物治疗的患者中进行Ⅱa期临床试验，最近的研究进展显示其均有积极的治疗效果。 ▎靶向HBV核心蛋白的药物 HBV核心蛋白作为病毒核衣壳的结构蛋白，是基因组进行逆转录和复制的场所。核心蛋白还调节HBV基因组的亚细胞转运和释放、RNA代谢、cccDNA转录，并抑制宿主先天性免疫反应。因此，HBV核心蛋白是乙肝药物开发的一个重要靶点。核心蛋白变构调节剂（CpAMs）通过形成异常组装的核衣壳或缺乏pgRNA的形态正常但空的核衣壳（或两者兼有），来抑制HBV复制。目前至少有12种CpAMs处于药物开发的不同阶段（表4）。CpAMs在抑制所有HBV基因型的HBV复制方面非常有效，不过该类药物必须与一种或多种不同类型的抗病毒药物联合应用。CpAMs与核苷（酸）类似物联合应用时，会带来更快和更显著的病毒抑制作用。 ▎靶向HBV聚合酶的药物靶向HBV聚合酶逆转录酶功能的药物是治疗慢性HBV感染广泛使用的药物。ATI-2173是一种乙肝病毒聚合酶抑制剂。在Ⅰ期临床研究中，28天给药后导致HBV DNA平均减少2.8 log10 IU/mL，且无任何严重不良事件。预计在短暂的给药间隔内，HBsAg水平没有变化，该药的Ⅱ期临床研究正在进行中。其他靶向HBV聚合酶如pradefovir、HS-10234，分别源自阿德福韦和替诺福韦，旨在提高抗病毒效力并降低代谢物毒性。初步数据表明，其有效性与TDF相似。靶向HBV聚合酶RNase H功能的药物也正在临床前开发中。 ▎靶向HBsAg释放的药物由于HBsAg的清除被定义为功能性治愈，因此开发能够降低HBsAg水平和限制病毒产生的药物引起了研究人员的极大兴趣。此外，HBsAg在慢性HBV感染中以亚病毒颗粒的形式大量循环，因此有望通过降低HBsAg来恢复免疫反应。核酸聚合物（NAP）是一种短的合成寡核苷酸，能够与HBV亚病毒颗粒相互作用并阻断其分泌。一项只有40例病患的临床研究中，研究人员评估了REP2139或REP2165这两种NAPs与替诺福韦和pegylated IFN联用，并与替诺福韦和pegylated IFN单用进行了为期48周的比较。结果显示，在治疗方案中加入NAPs的情况下，44%的患者HBsAg持续降低至检测水平以下，且全部产生了Anti-HBs，大多数接受NAPs治疗的患者（90%）观察到3-4级ALT升高，而在未接受NAP治疗的患者中为20%。未来还需要更大数量患者组的对照研究来进一步评估NAP的有效性和安全性。另一种类似方法是使用S-抗原转运抑制寡核苷酸聚合物（STOPS）。STOPS也是一种单链寡核苷酸，可以隔离HBsAg产生所需的细胞蛋白。体外研究表明，STOPS比NAP具有更大的效力。然而，该药物的Ⅰ期临床研究结果显示，HBsAg未显著降低，因此试验已被终止。 ▎靶向HBV cccDNA的药物消除肝细胞核内的cccDNA是治愈慢性HBV感染的关键。目前，有几种消除或沉默cccDNA的方法正在临床前开发阶段。然而，脱靶效应的潜在风险可能会限制这一方法的应用。基因编辑技术如锌指核酸酶、转录激活因子样效应核酸酶和CRISPR/Cas-9蛋白，通过在DNA中引入靶向双链断裂，然后通过同源修复在裂解位点产生突变使cccDNA失活。一项使用来自嗜热链球菌的CRISPR/Cas9系统对HBV感染细胞系的研究中，成功清除了90%的HBV cccDNA。但在靶标特异性、安全高效以及提高编辑效率以消除所有cccDNA等方面还需进一步的研究。此外，靶向HBV X蛋白（HBX）可能是沉默cccDNA的可行方法。Pevonedistat和dicoumarol显示可降低HBX表达，恢复Smc5/6水平，并在培养的肝细胞和人源化小鼠模型中抑制病毒转录。另外，通过上调APOBEC3A/B表达也可导致cccDNA降解。 02 间接抗病毒药物当前与治疗相关的一个问题是，是否可以通过纯抗病毒方法实现治愈，或者是否有必要添加免疫调节剂。目前的免疫学方法均针对先天性和适应性免疫系统，以广泛增强细胞防御并促进HBV适应性免疫应答（图2）。 ▎靶向先天性免疫系统先天性免疫系统对HBV的识别能力很差，因此HBV被视为一种隐匿性病毒。然而，观察到肝非实质细胞产生的某些细胞因子（如IFN-α、IFN-γ、肿瘤坏死因子-β和白细胞介素[IL]-1α）以及LTbR介导的APOBEC（载脂蛋白BmRNA编辑酶，催化多肽样）激活或RIG-I激活，可以通过非细胞溶解机制抑制甚至清除HBV，这为开发先天性免疫反应的外源性激活剂提供了理论依据。几种病原体识别传感器的激动剂，例如TLRs、RIG-I和干扰素基因刺激物（STING），已被证明能诱导产生IFN刺激基因和促炎细胞因子，从而清除病毒。先天免疫激动剂 TLRs在许多细胞亚群（包括免疫细胞）中表达，作为病毒和细菌病原体相关分子模式的传感器，在宿主防御中发挥着重要作用。在土拨鼠模型中，CpG寡脱氧核苷酸与ETV联合治疗被证明可以抑制土拨鼠肝炎病毒的病毒载量。几种口服TLR-7/8激动剂正在进行临床试验，包括GS-9620、RO7020531（RG7854）、RG7795（ANA773）、JNJ-4964（AL-034/TQ-A3334）和GS-9688。刺激和恢复适应性免疫因子目前临床上已经探索了几种策略来重新激活对HBV的弱适应性免疫应答，其中一个关键考虑因素是安全诱导治疗应答，而不会引起严重的肝细胞损伤和临床失代偿。免疫检查点抑制剂：在一项小型试验研究中，评估了在核苷（酸）类似物治疗的患者中使用PD-1抑制剂（nivolumab）的效果，观察到HBsAg有轻微下降。一名患者在3级ALT升高之前实现了HBsAg血清学转换，且未观察到严重不良事件。最近的一项Ⅱ期临床研究评估了在有核苷（酸）类似物治疗经验的患者中使用PD-1单克隆抗体恩沃利单抗（envafolimab, ASC22）的效果。观察到HBsAg最大降低1.2log10 IU/mL，且未出现显著的ALT升高，患者对治疗耐受性良好。另一种靶向PD-1途径的方法是通过核糖核酸酶H（RNAseH）途径降解PD-1配体mRNA。尽管免疫检查点抑制具有潜在作用，但对其安全性和不可预测反应还需进行更大规模的研究。基因编辑T细胞：免疫疗法在癌症治疗中的成功，为乙肝治疗提供了新思路，如使用CAR-T细胞、TCR-T细胞激活T细胞受体，从而更新替代体内耗竭的T细胞并产生新的功能性T细胞。动物模型的初步证据表明，这种方法可以降低HBsAg和HBV DNA的水平，而不会引起显著的肝脏损伤。未来还需要在非肝细胞癌患者中进行进一步的临床研究以验证其安全性和有效性。新型治疗性疫苗：目前的疫苗方法采用独特的策略来提高疫苗效力，包括纳入多种抗原以扩大T细胞应答（GS-4774，一种包含HBsAg、HB核心抗原和HBX的酵母载体）；改进递送系统（电穿孔，例如编码HBsAg和HB核心抗原的INO-1800疫苗，编码HBV核心和聚合酶蛋白的JNJ-64300535疫苗）；采用新型佐剂（INO-1800疫苗加INO-9112）；与检查点抑制剂联合使用；使用病毒载体（非复制型人腺病毒、黑猩猩腺病毒、改良后的安卡拉痘苗病毒和沙粒病毒）等。 — 总结 — 慢性HBV感染会导致慢性肝炎，患者一生都有发展为肝硬化和肝细胞癌的风险。因此，有必要进行终身监测以检测疾病进展。尽管当前治疗能改善临床结局，但由于药物对共价闭合环状DNA（cccDNA）和整合HBV DNA效果甚微，因此无法完全实现长期治愈。鉴于全球疾病负担，迫切需要更有效的治疗方法，对HBV生命周期和持续性感染的免疫发病机制有更深入的了解，以及开发创新药物和给药方式。要实现功能性治愈可能需要多种药物联合治疗，包括抗病毒药物、降低病毒抗原负荷的药物以及增强免疫反应的免疫调节剂。另外，还需要进一步完善基因编辑疗法。疾病负担在低收入和中等收入国家最为严重，因此，就需要开发出更安全、有效、疗程有限且负担得起的治疗方法。扫码获取全文劲帆医药已开发rAAV-HBV1.3-mer WT replicon、AAV-HBV-1.04（与武汉大学合作开发）和rAAV-1.2×HDV系列造模病毒产品，具备成模率高、稳定性好、适用范围广等优势，加速推进了乙肝/丁肝病毒复制机制的研究及抗乙肝/丁肝药物的研发进程。 01 乙肝造模AAV病毒产品 ▎产品信息可根据客户不同需求定制HBV基因组点突变株。应用场景：慢性乙肝模型、HBV持续复制模型，可用于研究乙肝病毒复制机制及抗乙肝药物的开发。可提供的现货产品见下表，另相关AAV-HBV-1.04系列造模病毒产品可致电客服17720514121详询。 ▎产品列表 02 丁肝造模AAV病毒产品 ▎产品信息可根据客户不同需求定制不同肝脏特异性启动子启动的HDV基因组及其点突变株。应用场景：慢性乙肝/丁肝合并感染模型，可用于研究丁肝病毒复制机制及抗丁肝药物的开发。可提供的现货产品见下表。 ▎产品列表 END 劲帆医药自主研发的昆虫杆状病毒One-Bac 4.0系统，能克服传统Bac/Sf9系统感染效率低、空壳率高、种毒传代不稳定等问题，在大规模量产定制化AAV过程中，可实现高产率、高感染活性、高实心率，单批次产能可达1E+18vg，为您的基因治疗药物研发保驾护航！业务合作欢迎致电17720514121详询！关于劲帆医药劲帆生物医药科技（武汉）有限公司简称“劲帆医药”，创立于2022年，提供一站式基因治疗药物CRO/CDMO服务。拥有全球领先的AAV规模化制备专利技术平台及cGMP级病毒载体生产车间，致力于推进基因治疗更有效，更安全，更经济，更可及，赋能客户，造福患者。联系我们电话：17720522078 官网：www.genevoyager.com 邮箱：marketing@genevoyager.com 地址：中国武汉东湖高新区光谷七路128号微信：Genevoyager2022 关于同写意同写意论坛是中国新药研发行业权威的多元化交流平台，二十年来共举办会议论坛百余期。“同写意新药英才俱乐部”基于同写意论坛而成立，早已成为众多新药英才的精神家园和中国新药思想的重要发源地之一。同写意在北京、苏州、深圳、成都设立多个管理中心负责同写意活动的运营。尊享多重企业/机构会员特权 ● 分享庞大新药生态圈资源库； ● 同写意活动优享折扣； ● 会员专属坐席及专家交流机会； ● 同写意活动优先赞助权； ● 机构品牌活动策划与全方位推广； ● 秘书处一对一贴心服务。入会请联系同写意秘书处同写意创新链盟机构（上下滑动查看更多）国通新药 | 通瑞生物 | 科济药业丨立迪生物 | 森西赛智 | 汇芯生物 | 申科生物 | 方拓生物 | 东抗生物 | 科盛达 | 依利特 | 翊曼生物丨锐拓生物丨复百澳生物丨圆因生物丨普洛斯丨华润三九丨皓阳生物丨人福医药丨广生堂药业丨澳宗生物丨妙顺生物 | 荣捷生物丨行诚生物 | 宜联生物 | 生命资本 | 恒诺康丨益诺思 | 深圳细胞谷丨佰诺达生物 | 沃臻生物 | 金仪盛世 | 朗信生物 | 亦笙科技 | 中健云康 | 九州通 | 劲帆医药 | 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临床研究疫苗

2024-11-06

·GlobeNewswire-Health Care

Barinthus Bio Reports Third Quarter 2024 Update on Corporate Developments and Financial Results

OXFORD, United Kingdom, Nov. 06, 2024 (GLOBE NEWSWIRE) -- Barinthus Biotherapeutics plc (NASDAQ: BRNS), a clinical-stage biopharmaceutical company developing novel immunotherapeutic candidates that guide T cells to control disease, provided an overview of business updates and announced financial results for the third quarter of 2024. “We continue our strong execution on our clinical trials, completing enrollment in the HBV003 trial of VTP-300 in chronic hepatitis B, and advancing VTP-1000 in celiac disease into the clinic with the first in human study of the novel SNAP-TI platform,” said Dr. Leon Hooftman, Chief Medical Officer of Barinthus Bio. “We expect a data rich fourth quarter from the VTP-300 chronic hepatitis B program, with updated interim readouts from both the HBV003 and IM-PROVE II trials accepted as late-breaking abstracts at the American Association for the Study of Liver Diseases (AASLD) – The Liver Meeting® 2024. These updates will provide more mature data than previously disclosed as participants progress and move towards a potential functional cure.” Third Quarter 2024 and Recent Corporate Developments VTP-300 (Chronic hepatitis B) In September 2024, enrollment was completed in the HBV003 trial of VTP-300 in 121 adult participants with chronic hepatitis B. The Phase 2b trial is designed to obtain critical dosing information for a potential functional cure regimen for chronic hepatitis B, with participants receiving VTP-300 and low-dose (LD) nivolumab. Earlier this year, interim data from the HBV003 trial was presented at the European Association for the Study of the Liver (EASL) Congress and demonstrated that treatment with VTP-300 and LD nivolumab was generally well-tolerated and led to a sustained decline in Hepatitis B surface antigen (HBsAg) levels. Seventy-six percent of participants (n=16/21) assessed for nucleos(t)ide analogue (NUC) therapy discontinuation met the criteria. Sixty-seven percent of participants (n=14/21) assessed for NUC discontinuation had HBsAg <10 IU/mL at Week 24 or later. Nineteen percent of the eligible participants (n=4/21) reached undetectable levels of HBsAg, with 2 of these patients maintaining undetectable levels for over 16 weeks. VTP-1000 (Celiac Disease) In September 2024, we initiated the first-in-human Phase 1 AVALON trial of VTP-1000 in adults with celiac disease. The randomized, placebo-controlled clinical trial, which includes a controlled gluten challenge, will evaluate the safety, tolerability, pharmacokinetics and pharmacodynamics of VTP-1000. VTP-850 (Prostate Cancer) In October 2024, we announced that the PCA001 trial of VTP-850 in men with rising prostate-specific antigen (PSA) after definitive local therapy for prostate cancer (i.e., biochemical recurrence) had completed patient enrollment of 22 participants. The Phase 1 trial is designed to evaluate safety and efficacy, as measured by PSA and T cell response. We expect to have data from the Phase 1 trial in the first half of 2025. Financial Update In October 2024, we were informed that an additional $15.0 million of revenue was due to the Company from Oxford University Innovation (OUI) in relation to the Company's share of royalties received by OUI, as a result of prior commercial sales of Vaxzevria® by AstraZeneca. We expect that this additional cash, when received, will enable us to fund our research and development plans further into the second quarter of 2026. Upcoming Milestones VTP-300 (Chronic hepatitis B) In the fourth quarter of 2024, we expect to announce updated data from the VTP-300 program in ongoing clinical trials in chronic hepatitis B at AASLD – The Liver Meeting® 2024 scheduled from November 15-19, 2024 in San Diego, CA: Updated interim data from HBV003, the Phase 2b trial evaluating additional dosing of VTP-300 and timing of PD-1 inhibition, accepted as a late-breaking oral presentation.Updated interim data from the Phase 2a IM-PROVE II clinical trial evaluating the combination of VTP-300 and Arbutus Biopharma’s imdusiran, accepted as a late-breaking poster. VTP-1000 (Celiac Disease) In the first half of 2025, we expect to announce data from the single ascending dose part of the Phase 1 AVALON trial of VTP-1000 in adults with celiac disease. VTP-850 (Prostate Cancer) In the first half of 2025, we expect to announce results of the Phase 1 PCA001 trial of VTP-850 in men with rising PSA after definitive local therapy for prostate cancer (i.e., biochemical recurrence). Third Quarter 2024 Financial Highlights Cash position: As of September 30, 2024, cash, cash equivalents and restricted cash were $106.1 million, compared to $117.8 million as of June 30, 2024. The net cash used in operating activities was $18.2 million in the third quarter of 2024, primarily resulting from the development of our pipeline and ongoing clinical trials, offset by $6.2 million due to the effect of foreign exchange rates on cash balances. Based on our current operating plans, we expect our available resources to fund operating expenses and capital expenditure requirements into the second quarter of 2026.Revenue: Revenue consisted of $15.0 million in the third quarter of 2024 compared to nil in the second quarter of 2024. Revenue was comprised of the Company’s share of royalties received by OUI as a result of prior commercial sales of Vaxzevria® by AstraZeneca.There is no expectation of additional payments or that we will be notified of such payments in a timely manner.Research and development expenses: Research and development expenses were $11.1 million in the third quarter of 2024 compared to $11.7 million in the second quarter of 2024, with the decrease mainly attributable to a reduction in personnel-related costs as a result of the pipeline prioritization earlier in the year. The quarter-on-quarter R&D expense per program is outlined in the following table. Period ended Three monthsendedSeptember 30,2024 Three monthsended June30, 2024 Change $000 $000 $000 Direct research and development expenses by program: VTP-200 HPV $246 $383 $(137)VTP-300 HBV 2,748 3,034 (286)VTP-500 MERS1 40 304 (264)VTP-600 NSCLC/ESCC2 108 24 84 VTP-850 Prostate cancer 914 414 500 VTP-1000 Celiac 1,751 1,371 380 Other and earlier stage programs 707 908 (201)Total direct research and development expenses $6,514 $6,438 $76 Indirect research and development expenses: Personnel-related (including share-based compensation)3 3,871 4,763 (892)Facility related 214 342 (128)Other indirect costs 540 119 421 Total indirect research and development expenses 4,625 5,224 (599)Total research and development expense $11,139 $11,662 $(523) 1 The development of VTP-500 is funded pursuant to an agreement with the Coalition for Epidemic Preparedness Innovations (CEPI). 2 The VTP-600 NSCLC/Esophageal Squamous-Cell Carcinoma (ESCC) Phase 1/2a trial is sponsored by Cancer Research UK. 3 This includes $0.6 million of personnel-related indirect expenses relating to time spent progressing the VTP-500 MERS program funded by CEPI. General and administrative expenses: General and administrative expenses were $13.4 million in the third quarter of 2024, compared to $7.2 million in the second quarter of 2024. The increase of $6.2 million relates primarily to a loss of $7.7 million on foreign exchange in the third quarter of 2024, compared to a loss of $0.1 million in the second quarter of 2024.Net loss: For the third quarter of 2024, we generated a net loss attributable to shareholders of $8.1 million, or $(0.21) per share on both basic and fully diluted bases, compared to a net loss attributable to shareholders of $16.9 million, or $(0.43) per share on both basic and fully diluted bases in the second quarter of 2024. About Barinthus Bio Barinthus Bio is a clinical-stage biopharmaceutical company developing novel immunotherapeutic candidates designed to guide the immune system to overcome chronic infectious diseases and autoimmunity. Helping people living with serious diseases and their families is the guiding principle at the heart of Barinthus Bio. With a focused pipeline built around our proprietary platform technologies, Barinthus Bio is advancing immunotherapeutic product candidates in infectious diseases and autoimmunity, including: VTP-300, that utilizing our ChAdOx/MVA platform designed as a potential component of a functional cure for chronic HBV infection and VTP-1000, utilizing our SNAP-Tolerance Immunotherapy (SNAP-TI) platform and is designed to treat people with celiac disease. Barinthus Bio is also conducting a Phase 1 clinical trial for VTP-850, a second-generation immunotherapeutic candidate designed to treat recurrent prostate cancer. Barinthus Bio’s differentiated technology platforms and therapeutic approach, coupled with deep scientific expertise and focus on clinical development, uniquely positions the company to navigate towards delivering treatments that improve the lives of people with chronic infectious diseases and autoimmunity. For more information, visit www.barinthusbio.com. Barinthus Bio intends to use the Investors section of its website, its X (formerly known as Twitter) account at @Barinthusbio and its LinkedIn account at linkedin.com/company/barinthus-bio as a means of disclosing material nonpublic information and for complying with its disclosure obligations under Regulation FD. Accordingly, investors should monitor Barinthus Bio’s website, its X account and its LinkedIn account in addition to following Barinthus Bio’s press releases, SEC filings, public conference calls, presentations, and webcasts. Forward Looking Statements This press release contains forward-looking statements regarding Barinthus Bio within the meaning of the Private Securities Litigation Reform Act of 1995, as amended, which can generally be identified as such by use of the words “may,” “will,” “plan,” “forward,” “encouraging,” “believe,” “potential,” “expect,” and similar expressions, although not all forward-looking statements contain these identifying words. These forward-looking statements include, without limitation, express or implied statements regarding our future expectations, plans and prospects, including our product development activities and clinical trials, including timing for readouts of any preliminary, interim or final data for any of our programs, our anticipated regulatory filings and approvals, our cash runway, the potential benefits of our product candidates, and our ability to develop and advance our current and future product candidates and programs. Any forward-looking statements in this press release are based on our management’s current expectations and beliefs and are subject to numerous risks, uncertainties and important factors that may cause actual events or results to differ materially from those expressed or implied by any forward-looking statements contained in this press release, including, without limitation, risks and uncertainties related to the success, cost and timing of our pipeline development activities and planned and ongoing clinical trials, including the risk that the timing for preliminary, interim or final data or initiation of our clinical trials may be delayed, the risk that interim or topline data may not reflect final data or results, our ability to execute on our strategy, regulatory developments, the risk that we may not achieve the anticipated benefits of our pipeline prioritization and corporate restructuring, our ability to fund our operations and access capital, our cash runway, including the risk that our estimate of our cash runway may be incorrect, global economic uncertainty, including disruptions in the banking industry, the conflicts in Ukraine, Israel and Gaza, and other risks identified in our filings with the Securities and Exchange Commission, including our Annual Report on Form 10-K for the year ended December 31, 2023, our Quarterly Reports on Form 10-Q and Current Reports on Form 8-K. We caution you not to place undue reliance on any forward-looking statements, which speak only as of the date they are made. We expressly disclaim any obligation to publicly update or revise any such statements to reflect any change in expectations or in events, conditions or circumstances on which any such statements may be based, or that may affect the likelihood that actual results will differ from those set forth in the forward-looking statements. BARINTHUS BIOTHERAPEUTICS PLC CONSOLIDATED BALANCE SHEETS (IN THOUSANDS, EXCEPT NUMBER OF SHARES AND PER SHARE AMOUNTS) (UNAUDITED) September 30,2024 December 31,2023ASSETS Cash, cash equivalents and restricted cash$106,102 $142,090 Contract asset - related parties 14,969 — Research and development incentives receivable 5,403 4,908 Prepaid expenses and other current assets 8,180 9,907 Total current assets 134,654 156,905 Goodwill 12,209 12,209 Property and equipment, net 10,719 11,821 Intangible assets, net 22,737 25,108 Right of use assets, net 7,444 7,581 Other assets 926 882 Total assets$188,689 $214,506 LIABILITIES AND STOCKHOLDERS’ EQUITY Current liabilities: Accounts payable 3,076 1,601 Accrued expenses and other current liabilities 7,966 9,212 Deferred income 2,044 — Operating lease liability - current 1,986 1,785 Total current liabilities 15,072 12,598 Non-current liabilities: Operating lease liability - non-current 10,683 11,191 Contingent consideration 1,610 1,823 Other non-current liabilities 1,406 1,325 Deferred tax liability, net 457 574 Total liabilities$29,228 $27,511 Commitments and contingencies (Note 15) Stockholders’ equity: Ordinary shares, £0.000025 nominal value; 39,542,518 shares authorized, issued and outstanding (December 31, 2023: authorized, issued and outstanding: 38,643,540) 1 1 Deferred A shares, £1 nominal value; 63,443 shares authorized, issued and outstanding (December 31, 2023: authorized, issued and outstanding: 63,443) 86 86 Additional paid-in capital 391,882 386,602 Accumulated deficit (217,124) (176,590)Accumulated other comprehensive loss – foreign currency translation adjustments (15,551) (23,315)Total stockholders’ equity attributable to Barinthus Biotherapeutics plc shareholders 159,294 186,784 Noncontrolling interest 167 211 Total stockholders’ equity$159,461 $186,995 Total liabilities and stockholders’ equity$188,689 $214,506 BARINTHUS BIOTHERAPEUTICS PLC CONSOLIDATED STATEMENTS OF OPERATIONS AND COMPREHENSIVE INCOME (IN THOUSANDS, EXCEPT NUMBER OF SHARES AND PER SHARE AMOUNTS) (UNAUDITED) Three months ended Nine months ended September 30,2024 September 30,2023 September 30,2024 September 30,2023License revenue 1$14,969 $— $14,969 $802 Total revenue 14,969 — 14,969 802 Operating expenses Research and development 11,139 15,144 33,926 38,501 General and administrative 13,420 961 26,615 26,227 Total operating expenses 24,559 16,105 60,541 64,728 Other operating income 210 — 992 — Loss from operations (9,380) (16,105) (44,580) (63,926)Other income/(expense): Interest income 631 196 2,041 2,306 Interest expense (17) (7) (41) (21)Research and development incentives 608 1,205 1,895 2,921 Other income/(expense) 26 (2) 46 308 Total other income, net 1,248 1,392 3,941 5,514 Loss before income tax (8,132) (14,713) (40,639) (58,412)Tax benefit 3 603 47 2,255 Net loss (8,129) (14,110) (40,592) (56,157)Net loss attributable to noncontrolling interest 15 38 58 103 Net loss attributable to Barinthus Biotherapeutics plc shareholders (8,114) (14,072) (40,534) (56,054) Weighted-average ordinary shares outstanding, basic 39,419,447 38,533,833 39,079,259 38,320,208 Weighted-average ordinary shares outstanding, diluted 39,419,447 38,533,833 39,079,259 38,320,208 Net loss per share attributable to ordinary shareholders, basic$(0.21) $(0.37) $(1.04) $(1.46)Net loss per share attributable to ordinary shareholders, diluted$(0.21) $(0.37) $(1.04) $(1.46) Net loss$(8,129) $(14,110) $(40,592) $(56,157)Other comprehensive gain/(loss) – foreign currency translation adjustments 9,191 (7,820) 7,778 2,364 Comprehensive income/(loss) 1,062 (21,930) (32,814) (53,793)Comprehensive loss attributable to noncontrolling interest 5 48 44 100 Comprehensive income/(loss) attributable to Barinthus Biotherapeutics plc shareholders$1,067 $(21,882) $(32,770) $(53,693) 1 Includes license revenue from related parties for the three and nine months ended September 30, 2024 of $15.0 million (three and nine months ended September 30, 2023: nil and $0.8 million, respectively). IR contacts:Christopher M. Calabrese Managing Director LifeSci Advisors+1 917-680-5608ccalabrese@lifesciadvisors.com Kevin GardnerManaging DirectorLifeSci Advisors+1 617-283-2856kgardner@lifesciadvisors.com Media contact:Audra FriisSam Brown, Inc.+1 917-519-9577audrafriis@sambrown.com Company contact:Jonothan BlackbournIR & PR ManagerBarinthus Bioir@barinthusbio.com

临床2期临床结果临床1期财报

2024-11-06

·GlobeNewswire-Health Care

Arbutus Reports Third Quarter 2024 Financial Results and Provides Corporate Update

Imdusiran data from IM-PROVE I and IM-PROVE II Phase 2a clinical trials to be presented at upcoming AASLD - The Liver Meeting 2024 Multiple-ascending doses of AB-101 in healthy subjects in the Phase 1a/1b clinical trial were generally safe and well-tolerated with evidence of receptor occupancy Now dosing cHBV patients with AB-101 in Part 3 of the Phase 1a/1b clinical trial Cash runway into the fourth quarter of 2026Conference Call and Webcast Today at 8:45 AM ET WARMINSTER, Pa., Nov. 06, 2024 (GLOBE NEWSWIRE) -- Arbutus Biopharma Corporation (Nasdaq: ABUS) (“Arbutus” or the “Company”), a clinical-stage biopharmaceutical company leveraging its extensive virology expertise to develop a functional cure for people with chronic hepatitis B virus (cHBV) infection, today reports third quarter 2024 financial results and provides a corporate update. “We are making significant progress in advancing the development of imdusiran to bring hope to millions of cHBV patients globally,” said Michael J. McElhaugh, Interim President and Chief Executive Officer of Arbutus Biopharma. “In June, we shared promising data from our IM-PROVE I Phase 2a clinical trial, showing that some patients treated with imdusiran and interferon were trending towards a functional cure. We look forward to presenting follow-up data from this trial, as well as end-of-treatment data from patients that received nivolumab in addition to imdusiran and VTP-300 in our IM-PROVE II Phase 2a trial, at the upcoming AASLD meeting. Assuming continued positive data, and with a projected cash runway extending into the fourth quarter of 2026, we are well-positioned to advance imdusiran into a Phase 2b clinical trial as a cornerstone in a treatment regimen aimed at functionally curing cHBV.” Mr. McElhaugh continued, “Our proprietary oral PD-L1 checkpoint inhibitor, AB-101, is progressing well, as we continue to see dose-dependent receptor occupancy and have now advanced into dosing cHBV patients in our Phase 1a/1b clinical trial. We look forward to providing updates as this trial progresses.” Clinical Development Update Imdusiran (AB-729, RNAi Therapeutic) End-of-treatment data from the IM-PROVE I Phase 2a clinical trial evaluating the safety, tolerability and antiviral activity of the combination of imdusiran (4 or 6 doses over 24 or 48 weeks, respectively), nucleos(t)ide analogue (NA) therapy and a short course of pegylated interferon alfa-2a (IFN, 12 or 24 weeks) in patients with cHBV was presented at the EASL Congress in June. The data showed that 33.3% (n=4/12) of patients in Cohort A1 receiving 48 weeks (6 doses) of imdusiran combined with 24 weeks of IFN and NA therapy achieved HBsAg loss at the end-of-treatment that was maintained in 100% of these patients 24 weeks after completing imdusiran and IFN treatment. HBsAg loss was achieved and maintained in 67% of those patients with HBsAg less than 1000 IU/mL at baseline. A total of six patients from Cohort A1 (n=4) and Cohort A2 (n=2) seroconverted with HBsAg loss. At the time the data was reported, all six of those patients had stopped all therapy, with two of those patients reaching 12 weeks off all therapy with sustained HBsAg and HBV DNA loss. The combination of imdusiran and IFN in this clinical trial was generally safe and well-tolerated. The Company will present a late-breaker poster with additional follow-up data at the upcoming AASLD-The Liver Meeting 2024 later this month. End-of treatment data from the IM-PROVE II Phase 2a clinical trial evaluating the safety and immunogenicity of imdusiran, NA therapy and Barinthus Bio’s VTP-300, an HBV antigen-specific immunotherapy was presented at the EASL Congress in June. The data showed that the combination of imdusiran and VTP-300 was generally safe and well-tolerated. At 24-weeks post-end of treatment, statistical significance (p<0.05) was achieved in HBsAg levels between the VTP-300 arm (n=5) and placebo (n=6). IM-PROVE II includes an additional cohort of patients who received 4 doses of imdusiran plus NA therapy for 24 weeks followed by VTP-300 plus up to two low doses of nivolumab, an approved anti-PD-1 monoclonal antibody. The Company will present a late-breaker poster with preliminary end-of-treatment data from this additional cohort at the upcoming AASLD - The Liver Meeting 2024 in November. AB-101 (Oral PD-L1 Inhibitor) AB-101-001 is a Phase 1a/1b double-blind, randomized, placebo-controlled clinical trial designed to investigate the safety, tolerability, pharmacokinetics (PK), and pharmacodynamics (PD) of single- and multiple-ascending oral doses of AB-101 in healthy subjects and patients with cHBV.Part 2 of this clinical trial has enrolled to date two sequential cohorts of ten healthy subjects each receiving 10 mg or 25 mg of AB-101 (n=8) or placebo (n=2) daily for 7 days. AB-101 was generally well-tolerated with evidence of dose-dependent receptor occupancy. In the 25 mg cohort, all subjects showed evidence of receptor occupancy, with seven of the eight subjects demonstrating receptor occupancy greater than 70% during the 7-day dosing period.Arbutus has moved into Part 3 of this clinical trial which evaluates repeat dosing of AB-101 for 28 days in patients with cHBV and expects to report preliminary data in the first half of next year. LNP Litigation Update Expert reports and expert depositions continue in the Moderna lawsuit. A trial date has been set for September 24, 2025, and is subject to the Court’s availability.The lawsuit against Pfizer/BioNTech is ongoing and a date for the claim construction hearing has been set for December 18, 2024.  Arbutus continues to protect and defend its intellectual property, which is the subject of the on-going lawsuits against Moderna and Pfizer/BioNTech. The Company is seeking fair compensation for Moderna’s and Pfizer/BioNTech’s use of its patented LNP technology that was developed with great effort and at a great expense, without which Moderna’s and Pfizer/BioNTech’s COVID-19 vaccines would not have been successful. Financial Results Cash, Cash Equivalents and Investments As of September 30, 2024, the Company had cash, cash equivalents and investments in marketable securities of $130.8 million compared to $132.3 million as of December 31, 2023. During the nine months ended September 30, 2024, the Company used $54.5 million in operating activities, which was partially offset by $44.1 million of net proceeds from the issuance of common shares under its “at-the-market” offering program (ATM Program) and $6.1 million of proceeds from the exercise of stock options. The Company did not issue any common shares under its ATM program in the third quarter of 2024. The Company expects its 2024 cash burn to range from $63 million to $67 million. With the organizational changes in the third quarter, the Company believes its cash, cash equivalents and investments in marketable securities will be sufficient to fund its operations into the fourth quarter of 2026. Revenue Total revenue was $1.3 million for the three months ended September 30, 2024 compared to $4.7 million for the same period in 2023. The decrease of $3.4 million was due primarily to: i) a decrease in license revenue recognized under the Company’s licensing agreement with Qilu Pharmaceutical; and ii) a decrease in license royalty revenue from Alnylam due to lower sales of ONPATTRO in 2024 compared to 2023. Operating Expenses Research and development expenses were $14.3 million for the three months ended September 30, 2024 compared to $20.2 million for the same period in 2023. The decrease of $5.9 million was due primarily to the discontinuation of the Company’s coronavirus and AB-161 programs in September 2023, along with related headcount reductions. General and administrative expenses were $4.5 million for the three months ended September 30, 2024 compared to $5.8 million for the same period in 2023. The decrease of $1.3 million was due primarily to decreased employee compensation and non-cash stock-based compensation expenses due to headcount reductions. The Company also incurred a $3.6 million one-time restructuring charge in the third quarter of 2024 related to its decision to cease all discovery efforts, discontinue its IM-PROVE III clinical trial, and reduce headcount to streamline the organization with a focus on advancing the clinical development of imdusiran and AB-101. Net Loss The Company’s net loss was $19.7 million for the three months ended September 30, 2024 and $20.1 million for the same period in 2023, with a loss per basic and diluted common share of $0.10 and $0.12, respectively. Outstanding Shares As of September 30, 2024, the Company had approximately 189.4 million common shares issued and outstanding. In addition, the Company had approximately 18.7 million stock options and unvested restricted stock units outstanding as of September 30, 2024. Roivant Sciences Ltd. owned approximately 21% of the Company’s outstanding common shares as of September 30, 2024. UNAUDITED CONDENSED CONSOLIDATED STATEMENTS OF LOSS(in thousands, except share and per share data) Three Months EndedSeptember 30, Nine Months EndedSeptember 30, 2024 2023 2024 2023 Revenue Collaborations and licenses$767 $3,935 $2,861 $13,329 Non-cash royalty revenue572 723 1,736 2,667 Total revenue1,339 4,658 4,597 15,996 Operating expenses Research and development14,273 20,169 45,227 56,136 General and administrative4,537 5,842 17,396 17,374 Change in fair value of contingent consideration344 205 735 (158)Restructuring3,625 - 3,625 - Total operating expenses22,779 26,216 66,983 73,352 Loss from operations(21,440) (21,558) (62,386) (57,356)Other income Interest income1,747 1,494 5,121 4,223 Interest expense(29) (46) (107) (415)Foreign exchange gain / (loss)5 6 (16) 11 Total other income1,723 1,454 4,998 3,819 Net loss$(19,717) $(20,104) $(57,388) $(53,537)Loss per share Basic and diluted$(0.10) $(0.12) $(0.31) $(0.32)Weighted average number of common shares Basic and diluted188,997,194 167,512,708 184,244,819 165,085,243 Comprehensive loss Unrealized gain on available-for-sale securities218 584 331 1,604 Comprehensive loss$(19,499) $(19,520) $(57,057) $(51,933) UNAUDITED CONDENSED CONSOLIDATED BALANCE SHEETS(in thousands) September 30, 2024 December 31, 2023Cash, cash equivalents and marketable securities, current$127,794 $126,003Accounts receivable and other current assets4,983 6,024Total current assets132,777 132,027Property and equipment, net of accumulated depreciation3,556 4,674Investments in marketable securities, non-current2,964 6,284Right of use asset1,144 1,416Total assets$140,441 $144,401Accounts payable and accrued liabilities$7,544 $10,271Deferred license revenue, current 10,911 11,791Lease liability, current468 425Total current liabilities18,923 22,487Liability related to sale of future royalties5,315 6,953Contingent consideration8,335 7,600Lease liability, non-current978 1,343Total stockholders’ equity106,890 106,018Total liabilities and stockholders’ equity$140,441 $144,401 UNAUDITED CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS(in thousands) Nine Months Ended September 30, 2024 2023Net loss$(57,388) $(53,537)Non-cash items5,453 4,613 Change in deferred license revenue(880) (10,349)Other changes in working capital(1,720) (9,371)Net cash used in operating activities(54,535) (68,644)Net cash provided by investing activities9,537 28,548 Issuance of common shares pursuant to the Open Market Sale Agreement44,124 26,000 Cash provided by other financing activities6,451 840 Net cash provided by financing activities50,575 26,840 Effect of foreign exchange rate changes on cash and cash equivalents(16) 11 Increase/(decrease) in cash and cash equivalents5,561 (13,245)Cash and cash equivalents, beginning of period26,285 30,776 Cash and cash equivalents, end of period31,846 17,531 Investments in marketable securities98,912 127,145 Cash, cash equivalents and marketable securities, end of period$130,758 $144,676 Conference Call and Webcast Today Arbutus will hold a conference call and webcast today, Wednesday, November 6, 2024, at 8:45 AM Eastern Time to provide a corporate update. To dial-in for the conference call by phone, please register using the following link: Registration Link. A live webcast of the conference call can be accessed through the Investors section of Arbutus' website at www.arbutusbio.com. An archived webcast will be available on the Arbutus website after the event. About Imdusiran (AB-729) Imdusiran is an RNA interference (RNAi) therapeutic specifically designed to reduce all HBV viral proteins and antigens including hepatitis B surface antigen, which is thought to be a key prerequisite to enable reawakening of a patient’s immune system to respond to the virus. Imdusiran targets hepatocytes using Arbutus’ novel covalently conjugated N-Acetylgalactosamine (GalNAc) delivery technology enabling subcutaneous delivery. Clinical data generated thus far has shown single and multiple doses of imdusiran to be generally safe and well-tolerated, while also providing meaningful reductions in hepatitis B surface antigen and hepatitis B DNA. Imdusiran is currently in multiple Phase 2a clinical trials.   About AB-101 AB-101 is our oral PD-L1 inhibitor candidate that we believe will allow for controlled checkpoint blockade while minimizing the systemic safety issues typically seen with checkpoint antibody therapies. Immune checkpoints such as PD-1/PD-L1 play an important role in the induction and maintenance of immune tolerance and in T-cell activation. Preclinical data generated thus far indicates that AB-101 mediates re-activation of exhausted HBV-specific T-cells from cHBV patients. We believe AB-101, when used in combination with other approved and investigational agents, could potentially lead to a functional cure in patients chronically infected with HBV. AB-101 is currently being evaluated in a Phase 1a/1b clinical trial. About HBV Hepatitis B is a potentially life-threatening liver infection caused by the hepatitis B virus (HBV). HBV can cause chronic infection which leads to a higher risk of death from cirrhosis and liver cancer. Chronic HBV infection represents a significant unmet medical need. The World Health Organization estimates that over 250 million people worldwide suffer from chronic HBV infection, while other estimates indicate that approximately 2.4 million people in the United States suffer from chronic HBV infection. Approximately 820,000 people die every year from complications related to chronic HBV infection despite the availability of effective vaccines and current treatment options. About Arbutus Arbutus Biopharma Corporation (Nasdaq: ABUS) is a clinical-stage biopharmaceutical company leveraging its extensive virology expertise to develop novel therapeutics with distinct mechanisms of action, which can potentially be combined to provide a functional cure for patients with chronic hepatitis B virus (cHBV). We believe the key to success in developing a functional cure involves suppressing HBV DNA, reducing surface antigen, and boosting HBV-specific immune responses. Our pipeline of internally developed, proprietary compounds includes an RNAi therapeutic, imdusiran (AB-729), and an oral PD-L1 inhibitor, AB-101. Imdusiran has generated meaningful clinical data demonstrating an impact on both surface antigen reduction and reawakening of the HBV-specific immune response. Imdusiran is currently in two Phase 2a combination clinical trials. AB-101 is currently being evaluated in a Phase 1a/1b clinical trial. For more information, visit www.arbutusbio.com. Forward-Looking Statements and Information This press release contains forward-looking statements within the meaning of the Section 27A of the Securities Act of 1933 and Section 21E of the Securities Exchange Act of 1934, and forward-looking information within the meaning of Canadian securities laws (collectively, forward-looking statements). Forward-looking statements in this press release include statements about our future development plans for our product candidates; the expected cost, timing and results of our clinical development plans and clinical trials with respect to our product candidates; our expectations with respect to the release of data from our clinical trials and the expected timing thereof; our expectations and goals for our collaborations with third parties and any potential benefits related thereto; our expectations regarding our organizational changes; the potential for our product candidates to achieve success in clinical trials; our expectations regarding our pending litigation matters; and our expected financial condition, including our anticipated net cash burn, the anticipated duration of cash runways and timing regarding needs for additional capital. With respect to the forward-looking statements contained in this press release, Arbutus has made numerous assumptions regarding, among other things: the effectiveness and timeliness of preclinical studies and clinical trials, and the usefulness of the data; the timeliness of regulatory approvals; the continued demand for Arbutus’ assets; and the stability of economic and market conditions. While Arbutus considers these assumptions to be reasonable, these assumptions are inherently subject to significant business, economic, competitive, market and social uncertainties and contingencies, including uncertainties and contingencies related to patent litigation matters. Additionally, there are known and unknown risk factors which could cause Arbutus’ actual results, performance or achievements to be materially different from any future results, performance or achievements expressed or implied by the forward-looking statements contained herein. Known risk factors include, among others: anticipated pre-clinical studies and clinical trials may be more costly or take longer to complete than anticipated, and may never be initiated or completed, or may not generate results that warrant future development of the tested product candidate; Arbutus may elect to change its strategy regarding its product candidates and clinical development activities; Arbutus may not receive the necessary regulatory approvals for the clinical development of Arbutus’ products; economic and market conditions may worsen; Arbutus may not realize the anticipated benefits from the organizational changes; Arbutus may incur additional unexpected expenses in connection with the organizational changes; Arbutus may experience additional employee turnover as a result of the organizational changes; uncertainties associated with litigation generally and patent litigation specifically; and Arbutus and its collaborators may never realize the expected benefits of the collaborations; market shifts may require a change in strategic focus. A more complete discussion of the risks and uncertainties facing Arbutus appears in Arbutus’ Annual Report on Form 10-K, Arbutus’ Quarterly Reports on Form 10-Q and Arbutus’ continuous and periodic disclosure filings, which are available at www.sedar.com and at www.sec.gov. All forward-looking statements herein are qualified in their entirety by this cautionary statement, and Arbutus disclaims any obligation to revise or update any such forward-looking statements or to publicly announce the result of any revisions to any of the forward-looking statements contained herein to reflect future results, events or developments, except as required by law. Contact Information Investors and Media Lisa M. CaperelliVice President, Investor RelationsPhone: 215-206-1822Email: lcaperelli@arbutusbio.com

临床2期临床结果疫苗财报

100 项与 Imdusiran 相关的药物交易

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适应症	最高研发状态	国家/地区	公司	日期
慢性乙型肝炎	临床2期	澳大利亚	Assembly Biosciences, Inc.	2021-05-07
慢性乙型肝炎	临床2期	保加利亚	Assembly Biosciences, Inc.	2021-05-07
慢性乙型肝炎	临床2期	加拿大	Assembly Biosciences, Inc.	2021-05-07
慢性乙型肝炎	临床2期	新西兰	Assembly Biosciences, Inc.	2021-05-07
乙型肝炎	临床申请	中国	齐鲁制药有限公司	2022-05-10
乙型肝炎	临床申请	中国	Arbutus Biopharma Corp.	2022-05-10

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研究	分期	人群特征	评价人数	分组	结果	评价	发布日期


NCT04980482 (AB-729-201, EASL2024) 人工标引	临床2期	慢性乙型肝炎	43	imdusiran (A1: 24 wks IFN + 2 imdusiran doses + NA)	鏇鬱選構鑰繭窪願鹽網(獵醖鹽膚蓋積窪簾鹹顧) = 鑰顧遞觸願廠鹹積鏇築製淵窪築構襯積範選壓 (衊憲壓構膚憲製積蓋網 ) 更多	积极	2024-06-01
				imdusiran (A2: 24 wks IFN + NA)	鏇鬱選構鑰繭窪願鹽網(獵醖鹽膚蓋積窪簾鹹顧) = 獵遞蓋製鬱艱膚艱積觸製淵窪築構襯積範選壓 (衊憲壓構膚憲製積蓋網 ) 更多
AB-729-202 (GlobeNewswire) 人工标引	临床2期	乙型肝炎	40	imdusilan+VTP-300	憲範壓觸廠衊簾築製積(齋獵願艱遞簾艱膚蓋廠) = There were no serious adverse events, Grade 3 or 4 adverse events or treatment discontinuations. 餘獵鏇醖鹽遞衊鏇壓淵 (觸衊窪繭築鹹憲願製鏇 ) 更多	积极	2023-11-09
				imdusilan+placebo
Phase 2a (EASL2022)	临床2期	HBV RNA transcripts \| HBV DNA \| hepatitis B surface antigen (HBsAg)	-	AB-729 siRNA	夢鏇繭淵鏇衊範簾鬱範(膚範艱憲壓積憲鑰築製) = 顧艱選築鏇網鑰觸繭鹽襯網壓糧齋獵簾築襯糧 (鹹齋襯構範窪觸餘範廠 )	积极	2022-06-25
				Control GalNAc siRNA	夢鏇繭淵鏇衊範簾鬱範(膚範艱憲壓積憲鑰築製) = 簾網範鬱廠憲膚網糧積襯網壓糧齋獵簾築襯糧 (鹹齋襯構範窪觸餘範廠 )
NCT04820686 (AB-729-001, EASL2022) 人工标引	临床2期	慢性乙型肝炎	27	AB-729	衊顧憲廠醖夢蓋顧鬱範(餘膚壓簾積範簾夢襯艱) = 鏇壓廠廠膚襯夢鏇顧遞簾觸願遞鏇憲鹽顧選範 (繭顧願繭壓憲膚醖衊壓 )	积极	2022-06-22
EASL2021	N/A	慢性乙型肝炎 HBsAg	-	AB-729	願網壓廠壓艱遞獵觸繭(齋壓鹹夢膚襯獵簾蓋鬱) = 鹽蓋積範鬱糧範簾繭壓齋艱繭網構觸網窪憲構 (壓憲範衊壓壓壓製衊窪 ) 更多	-	2021-06-23