Bristol-Myers Squibb posted new Baraclude (entecavir) data which 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. 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 per cent.
In lamivudine-refractory patients who received Baraclude after treatment with lamivudine failed, the cumulative probability of genotypic Baraclude resistance was 51 per cent 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 (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, MD, 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."
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.
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 or whose virus had not yet reached undetectable levels 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 (entecavir) in nucleoside-naive and lamivudine-refractory studies was also evaluated.