New BARACLUDE(R)
(entecavir) data presented demonstrated a continued low incidence of
resistance in nucleoside-naive patients through five years of treatment. In
the nucleoside-naive chronic hepatitis B patients analyzed, no additional
patient developed resistance in the fifth year (n=108). Through five years
of treatment, the cumulative probability of developing mutations in the
virus that confer resistance to BARACLUDE (also called genotypic
resistance) was 1.2 percent. Bristol-Myers Squibb Company (NYSE: BMY)
announced the results at the 18th Conference of the Asia-Pacific
Association for the Study of the Liver (APASL) in Seoul, Korea.
In lamivudine-refractory patients who received BARACLUDE after
treatment with lamivudine failed, the cumulative probability of genotypic
BARACLUDE resistance was 51 percent through the fifth year. This finding is
consistent with prior observations that the pre-existence of
lamivudine-resistant mutations results in an increase in the rate of
BARACLUDE resistance.
"Many chronic hepatitis B patients require long-term treatment.
Unfortunately, the initial benefits of therapy can be lost after the
development of resistance. These five-year BARACLUDE data that demonstrate
long-term minimal resistance at 1.2 percent in nucleoside-naive patients
can be of great importance for patients," said Professor Ching-Lung Lai,
Chief, Division of Gastroenterology and Hepatology, University of Hong
Kong.
Drug resistance occurs when the hepatitis B virus (HBV) mutates,
thereby avoiding the effects of the medication. This can decrease the
efficacy of the current medication and may compromise future treatment
options. To date, studies have shown that multiple mutations are required
to develop BARACLUDE(R) (entecavir) resistance.
"These long-term BARACLUDE data continue to support the observations
seen in the first years of treatment and are reflective of BARACLUDE's high
genetic barrier to resistance," said Helena Brett-Smith, M.D., Group
Director of Clinical Research at Bristol-Myers Squibb. "More importantly,
we believe the data support BARACLUDE as an important initial treatment
choice for chronic hepatitis B, which is a disease that results in a large
global health burden."
About the Analysis
More than 700 patients across six studies initiated therapy on
BARACLUDE and were monitored for treatment response and resistance.
The year five analysis expands upon previous analyses, adding in
information on patients who received treatment with BARACLUDE during the
fifth year of follow-up (n=108 for patients in nucleoside-naive studies and
n=33 for patients in lamivudine-refractory studies).
In this comprehensive analysis, all patients enrolled in Bristol-Myers
Squibb clinical trials ETV-014, -015, -022, -027, -026 and -901 who
experienced a virologic breakthrough(1) or whose virus had not yet reached
undetectable levels(2) at weeks 48, 96, 144, 192, 240 or end of dosing,
were sequenced to determine if any changes occurred in the genetic code of
the virus that would result in resistance or loss of effectiveness of
BARACLUDE.
Nucleoside-naive patients in this analysis were initially treated with
BARACLUDE 0.5 mg in studies ETV-022 and -027 and continued treatment with
BARACLUDE 1 mg by enrolling in study ETV-901 with a treatment gap of less
than or equal to 35 days. Lamivudine-refractory patients in this analysis
initiated therapy on BARACLUDE 1 mg in studies ETV-014, -015, and -026 and
continued treatment in study ETV-901 with a treatment gap of less than or
equal to 35 days.
Viral load reduction in chronic hepatitis B patients treated with
BARACLUDE(R) (entecavir) in nucleoside-naive and lamivudine-refractory
studies was also evaluated.
Data Results
Results from these studies prior to this year five analysis were
previously announced on April 14, 2007.
Nucleoside-naive data
-- The incidence of BARACLUDE resistance in patients in
nucleoside-naive studies over time is low, with a cumulative
probability of genotypic BARACLUDE resistance of 1.2 percent
through five years.
-- No nucleoside-naive patient developed resistance (n=108) in year
five.
-- 93 percent of the nucleoside-naive patients taking BARACLUDE were
able to achieve and maintain an undetectable viral load
(HBV DNA