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Eiger doses first patient in phase 2 LIMT HDV study

Eiger BioPharmaceuticals has dosed the first patient in the Phase 2 LIMT HDV (Lambda Interferon MonoTherapy in HDV) study, a monotherapy trial of pegylated interferon lambda 1a (Lambda) as a potential treatment for chronic hepatitis D virus (HDV) infection.

LIMT HDV is a 30-patient study designed to evaluate the safety, tolerability and efficacy of two dose levels of Lambda after 48 weeks of treatment. 

LIMT HDV is an international study currently enrolling at University of Auckland in New Zealand with additional sites planned in Israel and Pakistan.

Eiger senior vice president of liver and infectious diseases drug development Eduardo Martins said: “We are excited to begin dosing HDV-infected patients with Lambda in the LIMT HDV study. 

“We plan to explore Lambda alone and in combination with lonafarnib, our lead compound in Phase 2 development to treat HDV.  Eiger now has multiple active anti-HDV agents in development, including an oral therapy and a subcutaneous injectable therapy to study alone and in combination toward the suppression or cure of HDV.”

“Over recent years, patients with chronic hepatitis B and hepatitis C have benefited from huge advances in antiviral therapy for both diseases.  Unfortunately HDV remains a huge unmet medical need because of the lack of any effective therapy for this most aggressive form of viral hepatitis.  In many countries, HDV presents a real public health challenge,” said Edward Gane, MD, Principal Investigator and Professor of Medicine at University of Auckland, New Zealand, and Chief Hepatologist, Transplant Physician and Deputy Director of the New Zealand Liver Transplant Unit, Auckland City Hospital.  

“We are delighted to have enrolled the first patient in LIMT HDV, a study that may lay the groundwork for development of Lambda in HDV infection.”

About the LIMT HDV Phase 2 Study

LIMT HDV is a 1:1 randomized, open-label study of Lambda 120 or 180 microgram subcutaneous injections administered weekly for 48 weeks in approximately 30 patients with chronic HDV.  End of treatment will be followed by a treatment-free 24-week observation period.  

The primary objective of the phase 2 study is to evaluate the safety, tolerability, and efficacy of treatment with two dose levels of Lambda monotherapy in patients with chronic HDV infection.  All patients will also be administered an anti-hepatitis B virus nucleos(t)ide analog throughout the study.  The trial will be conducted at the University of Auckland in New Zealand with additional clinical trial sites planned in Israel and Pakistan.

About Pegylated Interferon Lambda 1a

Pegylated interferon lambda 1a (“Lambda”) is a well-characterized, late-stage, first in class, type III interferon (IFN) that stimulates immune responses that are critical for the development of host protection during viral infections.  Lambda targets type III IFN receptors which are distinct from the type I IFN receptors targeted by IFN alfa.  These type III receptors are highly expressed on hepatocytes with limited expression on hematopoietic and central nervous system cells, which may reduce the off-target effects associated with other IFNs and improve the tolerability of Lambda. 

Although Lambda does not use the IFN alfa receptor, signaling through either the IFN lambda or IFN alfa receptor complexes results in the activation of the same Jak-STAT signal transduction cascade.

Eiger licensed worldwide rights to Lambda from Bristol-Myers Squibb in April 2016.  Lambda has been administered in clinical trials involving over 3,000 subjects.  Lambda has not been approved for any indication.

About Hepatitis Delta Virus (HDV)

Hepatitis Delta (or Hepatitis D) is caused by infection with HDV and is considered to be one of the most severe forms of viral hepatitis in humans.  Hepatitis delta occurs only as a co-infection in individuals harboring Hepatitis B Virus (HBV).  Hepatitis delta leads to more severe liver disease than HBV alone and is associated with accelerated liver fibrosis, liver cancer, and liver failure.

Hepatitis delta is a disease with a significant impact on global health, which may affect up to approximately 15-20 million people worldwide. 

The prevalence of HDV varies among different parts of the world.  Globally, HDV infection is reported to be present in approximately 4.3% to 5.7% of chronic Hepatitis B carriers. 

The prevalence of HDV in patients infected with chronic HBV is even higher in certain regions, including certain parts of Mongolia, China, Russia, Central Asia, Pakistan, Turkey, Africa, and South America, with an HDV prevalence as high as 60% being reported in HBV-infected patients in Mongolia and Pakistan.