ACH -3422 700 mg is highly comparable to sofosbuvir 400 mg + PSI-352938 (more potent guanosine nucleoside) 300 mg when given for 14 days. Both have a ~5 Log 10 kill for GT 1 naïve. Gilead was trying to get an improved nucleoside combo with these two agents combined, sofosbuvir plus PSI-352938. Though the Phase 1 trial was successful (results in link), in the Phase 2 trial all arms containing PSI-352938 gave liver enzyme elevations and Gilead reluctantly dropped PSI-352938, an agent more potent than sofosbuvir. This means that the combo of ACH 3422 700 mg + ACH 3102 50 mg is fully viable and competitive. ACHN may lower the dose of ACH 3422 to 500 mg. Two cohorts may be run in the trial planned in 2015.
The link for the 14 day viral kill data for sofosbuvir + PSI-352938 is www.medscape.com/viewarticle/811157
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