不是第一家实现(功能性治愈),vir, arbutus 都有2⃣️期的组合疗法。vir 进展迅速,siRNA+中和单抗方案(VIR-2218+VIR-3434)进入2期临床:快速显著持久降低HBsAg水平。但是歌礼的PD-L1 加NA类组合,三个患者HBsAg 清零后,直至24 周仍没有病毒复活,这可能是第一次发现。另外好处是pd_L1 可以每月注射一次。估计年底有2B 期的完整数据。只能说曙光初现,用药安全有效,停药不复发才算真正意义的乙肝治愈。All three patients maintained HBsAg negative after last dosing of ASC22. ALT flares were observed in 4/7 (57%) and 2/3 (67%) patients with HBsAg reduction ≥ 0.5 log10 IU/mL and HBsAg loss, respectively. Patients treated with ASC22+NAs had a similar AE
profile with those treated with PBO+NAs. Any AEs or Grade ≥ 3 AEs were reported in 79% (26/33) and 82% (9/11), or 6% (2/33) and 9% (1/11), of patients treated with ASC22+NAs and PBO+NAs. No SAE occurred during treatment. PK data showed that Cmin value of ASC22 at steady state was predicted to be > 3 μg/mL one month after dosing,
indicating > 90% receptor occupancy and ASC22 has the potential to be given once monthly.
Conclusion: Subcutaneous administration of ASC22 Q2W for 24 weeks is shown to be safe and well-tolerated, and can induce HBsAg decline, even HBsAg loss, in CHB patients, especially in those with baseline HBsAg ≤ 500 IU/mL. Further analyses will be performed when all 149 patients complete treatment and follow-up.