机构:[1]Peking Univ, Hosp 1, Beijing, Peoples R China[2]Capital Med Univ, Beijing Ditan Hosp, Beijing, Peoples R China[3]Xiamen Hosp Tradit Chinese Med, Xiamen, Peoples R China[4]Shanghai Jiao Tong Univ, Ruijin Hosp, Med Coll, Shanghai, Peoples R China[5]Sixth Peoples Hosp Shenyang, Shenyang, Peoples R China[6]Capital Med Univ, Beijing YouAn Hosp, Beijing, Peoples R China[7]Peking Univ, Shenzhen Hosp, Shenzhen, Peoples R China[8]Nanjing Second Hosp, Nanjing, Peoples R China[9]Sichuan Univ, West China Hosp, Chngdu, Peoples R China四川大学华西医院[10]Anhui Med Univ, Affiliated Hosp 2, Hefei, Peoples R China[11]Shanghai Tongren Hosp, Shanghai, Peoples R China[12]Cent South Univ, Xiangya Hosp, Changsha, Peoples R China[13]Wenzhou Med Univ, Affiliated Hosp 1, Wenzhou, Peoples R China[14]First Hosp Jilin Univ, Changchun, Peoples R China[15]Southern Med Univ, Nanfang Hosp, London, England[16]Ascletis Biosci Co Ltd, Hangzhou, Peoples R China
Background & Aims: Studies have shown that blocking the PD-1/PD-L1 pathway may lead to a potential cure for HBV infections. ASC22 (Envafolimab) is a humanized, single-domain PD-L1 antibody administered subcutaneously. This study aimed to evaluate the efficacy and safety of ASC22 in virally suppressed chronic hepatitis B (CHB) patients on nucleos(t)ide analogs (NAs). Approach and Results: This randomized, single-blind, phase IIb trial enrolled CHB patients in two cohorts for a 24-week treatment with ASC22 or placebo (PBO) once every 2 weeks and 24-week follow-up. In total, 60, 59, and 30 patients were treated with 1.0, 2.5 mg/kg ASC22 and PBO, respectively. The mean HBsAg changes from baseline at week 24 and 24 week follow-up periods were -0.309 (p<0.001) and -0.272 (p<0.023) log10 IU/mL in the 1.0 mg/kg ASC22 group, -0.231 (p=0.007) and -0.205 (p=0.12) log10 IU/mL in the 2.5 mg/kg ASC22 group, and-0.003 and -0.063 log(10) IU/mL in the PBO group, respectively (ITT population). Three out of ten patients with baseline HBsAg levels <= 100 IU/mL in the 1.0 mg/kg group obtained on-treatment HBsAg loss. Most AEs were mild (97.9%). There were no study drug-related serious AEs in the 1.0 mg/kg ASC22 group. Conclusions: Subcutaneous administration of 1.0 mg/kg ASC22 Q2W for 24 weeks was shown to be safe and well tolerated in virally suppressed CHB patients on NAs and can induce HBsAg decline, especially in patients with HBsAg <= 100 IU/mL.