Eiger BioPharmaceuticals announced results of an investigator sponsored study of Peginterferon Lambda-1a (Lambda) in outpatients with mild and uncomplicated COVID-19.
The primary endpoint was duration of viral shedding, determined by time to first of two consecutive negative tests for SARS-CoV-2 by qRT-PCR. The secondary endpoint was reducing duration of symptoms and hospitalization in patients with mild COVID-19. A total of 120 patients were randomized 1:1 to a single subcutaneous dose of Lambda or normal saline placebo. Patients were followed for 28 days.
No difference was demonstrated in duration of SARS-CoV-2 viral shedding and time to symptom resolution when compared with placebo. Median time to cessation of viral shedding in both groups was 7 days. Lambda was well-tolerated with few adverse events, which included elevated transaminases which self-resolved.
The study was co-led by Stanford University School of Medicine researchers Upinder Singh, MD, Professor of Medicine and Infectious Diseases and Geographic Medicine and Microbiology and Immunology, and Prasanna Jagannathan, MD, Assistant Professor of Medicine and Infectious Diseases.
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"We now know that untreated patients with mild COVID-19 clear virus quickly. Published reports have demonstrated evidence of a therapeutic benefit of interferons in hospitalized patients with more advanced COVID-19 disease," said Colin Hislop, MD, Senior Vice President of Clinical and Development Operations at Eiger. "We look forward to the results of the four on-going peginterferon lambda investigator sponsored studies in hospitalized patients with more advanced COVID-19, as well as the prophylaxis study of exposed or at-risk patients."
"Lambda is in late stage development for the treatment of Hepatitis Delta Virus (HDV), the most severe form of human viral hepatitis, and HDV is our lead clinical program," said David Cory, President and CEO of Eiger. "We have previously generated positive results in two Phase 2 studies in HDV-infected patients and have concurrence with FDA and EMA on a single, Phase 3 study of Lambda monotherapy in patients infected with chronic HDV. We look forward to initiating this study."
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. Binding leads to activation of JAK-STAT signaling pathway and upregulation of numerous IFN-stimulated genes (ISGs). IFN lambda receptors are largely restricted to cells and tissues of epithelial origin, including respiratory epithelial cells.
IFN lambdas are critical for maintaining a balanced antiviral response in the respiratory tract. They are induced at lower viral burden before type I IFNs to limit the initial infection by inducing viral resistance to cells and helping them deal with the virus load. IFN lambda lacks the strong pro-inflammatory effects of type I IFNs and are tissue-protective and anti-inflammatory. Administration of IFN lambda has been shown to suppress viral replication while stopping the 'cytokine storm' from developing.
This study is one of six international, investigator sponsored studies evaluating Lambda in COVID-19. Other sites include patients with more advanced COVID-19 at University of Toronto (Toronto), Soroka University (Israel), Mount Sinai Hospital (New York), Massachusetts General Hospital (Boston), and Johns Hopkins University (Baltimore). Collectively, up to 520 patients are expected be enrolled and dosed across international sites.