These authors contributed equally.
HCV796: A selective nonstructural protein 5B polymerase inhibitor with potent anti-hepatitis C virus activity In Vitro, in mice with chimeric human livers, and in humans infected with hepatitis C virus†
Article first published online: 5 NOV 2008
Copyright © 2008 American Association for the Study of Liver Diseases
Volume 49, Issue 3, pages 745–752, March 2009
How to Cite
Kneteman, N. M., Howe, A. Y. M., Gao, T., Lewis, J., Pevear, D., Lund, G., Douglas, D., Mercer, D. F., Tyrrell, D. L. J., Immermann, F., Chaudhary, I., Speth, J., Villano, S. A., O'Connell, J. and Collett, M. (2009), HCV796: A selective nonstructural protein 5B polymerase inhibitor with potent anti-hepatitis C virus activity In Vitro, in mice with chimeric human livers, and in humans infected with hepatitis C virus. Hepatology, 49: 745–752. doi: 10.1002/hep.22717
Potential conflict of interest: Drs. Kneteman, Mercer, and Lund own stock in KMT Hepatech, Inc. Dr. Immermann owns stock in Wyeth Research. Dr. Villano owns stock in Viropharma, Inc. Dr. Collett owns stock in Wyeth Research and Viropharma.
- Issue published online: 24 FEB 2009
- Article first published online: 5 NOV 2008
- Accepted manuscript online: 5 NOV 2008 12:00AM EST
- Manuscript Accepted: 16 OCT 2008
- Manuscript Received: 22 FEB 2008
- Canadian Institutes for Health Research/Wyeth Canada Chair in Transplantation Research and was a Senior Scholar of the Alberta Heritage Foundation for Medical Research
Anti-hepatitis C virus (HCV) drug development has been challenged by a lack of experience with inhibitors inclusive of in vitro, animal model, and clinical study. This manuscript outlines activity and correlation across such a spectrum of models and into clinical trials with a novel selective nonstructural protein 5B (NS5B) polymerase inhibitor, HCV796. Enzyme assays yielded median inhibitory concentration (IC50) values of 0.01 to 0.14 μM for genotype 1, with half maximal effective concentration (EC50s) of 5 nM and 9 nM against genotype 1a and 1b replicons. In the chimeric mouse model, a 2.02 ± 0.55 log reduction in HCV titer was seen with monotherapy, whereas a suboptimal dose of 30 mg/kg three times per day in combination with interferon demonstrated a 2.44 log reduction (P = 0.001 versus interferon alone) Clinical outcomes in combination with pegylated interferon and ribavirin have revealed additive efficacy in treatment naïve patients. Abnormal liver function test results were observed in 8% of HCV-796 patients treated for over 8 weeks, resulting in suspension of further trial activity. Conclusion: The RNA-dependent RNA polymerase inhibitor HCV796 demonstrated potent anti-HCV activity consistently through enzyme inhibition assays, subgenomic replicon, and chimeric mouse studies. Strong correlations of outcomes in the mouse model were seen with subsequent clinical trials, including a plateau in dose-related antiviral activity and additive impact from combination therapy with interferon. These outcomes demonstrate the utility of the range of in vitro and in vivo models now available for anti-HCV drug development and support the potential utility of polymerase inhibitors in future combination therapies for HCV treatment. (HEPATOLOGY 2009.)