ruzasvir (MK-8408) / Merck (MSD), Atea Pharma - LARVOL DELTA

Drug-drug Interaction Study of Bemnifosbuvir/Ruzasvir (BEM/RZR) and Ethinyl Estradiol/Levonorgestrel (EE/LNG) (clinicaltrials.gov) - P1 | N=24 | Not yet recruiting | Sponsor: Atea Pharmaceuticals, Inc.

New P1 trial

C-BEYOND: Efficacy and Safety of BEM/RZR vs. SOF/VEL in Subjects With Chronic HCV (clinicaltrials.gov) - P3 | N=880 | Active, not recruiting | Sponsor: Atea Pharmaceuticals, Inc. | Recruiting ➔ Active, not recruiting

Enrollment closed • Hepatitis C • Infectious Disease • Inflammation

MULTISCALE MODELING OF RESULTS: FROM A PHASE 2 STUDY OF AN 8-WEEK COMBINATION REGIMEN OF BEMNIFOSBUVIR AND RUZASVIR IN PATIENTS WITH CHRONIC HEPATITIS C VIRUS INFECTION (AASLD 2025) - P2 | "BEM/RZR for 8 weeks was highly effective in blocking both viral replication and viral assembly/secretion in HCV-infected patients independent of genotype and fibrosis score. The time to cure estimates support 8 wk treatment for non-cirrhotic patients and longer treatment duration (e.g., up to 12 wks) for those with compensated cirrhosis."

Clinical • P2 data • Fibrosis • Hepatitis C • Hepatology • Immunology • Infectious Disease • Inflammation • Liver Cirrhosis

BEMNIFOSBUVIR AND RUZASVIR PROVIDED AS A FIXED-DOSE-COMBINATION DEMONSTRATES HIGH RELATIVE BIOAVAILABILITY TO THEIR INDIVIDUAL FORMULATIONS AND CAN BE DOSED WITH NO REGARD TO FOOD (AASLD 2025) - P1 | "The BEM/RZR FDC was safe and well-tolerated when dosed without or with food or with famotidine. BEM/RZR FDC demonstrated a high rBA to the BEM and RZR individual reference formulations. A HFHC meal or simultaneously co-administered famotidine had no meaningful effect on plasma exposure of the FDC."

Clinical

AT-01B-010: Study of Bemnifosbuvir/Ruzasvir as a Fixed-dose Combination in Subjects With Normal or Severely Impaired Renal or Hepatic Function (clinicaltrials.gov) - P1 | N=28 | Recruiting | Sponsor: Atea Pharmaceuticals, Inc. | Trial completion date: Aug 2025 ➔ Nov 2025 | Trial primary completion date: Aug 2025 ➔ Nov 2025

Trial completion date • Trial primary completion date • Hepatology • Renal Disease

NO IMPACT OF RASS ON THE HIGH EFFICACY OF BEM AND RZR IN COMBINATION: RESISTANCE ANALYSIS FROM A PH 2 STUDY IN HCV-INFECTED PATIENTS (AASLD 2025) - P2 | "Background: Bemnifosbuvir (BEM) and ruzasvir (RZR) are potent pan-genotypic inhibitors of HCV NS5B and NS5A, respectively... The combination of BEM/RZR in this phase 2 study showed strong antiviral activity against all tested HCV genotypes (GT 1-4). VK and PK data indicated most VFs were due to poor adherence and resulted from NS5A resistance to RZR. BEM/RZR is currently in phase 3 development."

Clinical • Hepatitis C • Liver Cirrhosis

Drug-drug Interaction Study of Omeprazole and Bemnifosbuvir/Ruzasvir (clinicaltrials.gov) - P1 | N=20 | Completed | Sponsor: Atea Pharmaceuticals, Inc. | Not yet recruiting ➔ Completed

Trial completion

Drug-drug Interaction Study of Bemnifosbuvir/Ruzasvir (BEM/RZR) and Digoxin and Rosuvastatin (clinicaltrials.gov) - P1 | N=38 | Completed | Sponsor: Atea Pharmaceuticals, Inc. | Recruiting ➔ Completed

Trial completion

C-Forward: Efficacy and Safety of BEM/RZR vs SOF/VEL in Subjects With Chronic HCV (clinicaltrials.gov) - P3 | N=880 | Recruiting | Sponsor: Atea Pharmaceuticals, Inc.

New P3 trial • Hepatitis C • Infectious Disease • Inflammation

Drug-drug Interaction Study of Omeprazole and Bemnifosbuvir/Ruzasvir (clinicaltrials.gov) - P1 | N=20 | Not yet recruiting | Sponsor: Atea Pharmaceuticals, Inc.

New P1 trial

AT-01B-010: Study of Bemnifosbuvir/Ruzasvir as a Fixed-dose Combination in Subjects With Normal or Severely Impaired Renal or Hepatic Function (clinicaltrials.gov) - P1 | N=28 | Recruiting | Sponsor: Atea Pharmaceuticals, Inc. | Not yet recruiting ➔ Recruiting | Trial completion date: May 2025 ➔ Aug 2025 | Trial primary completion date: May 2025 ➔ Aug 2025

Enrollment open • Trial completion date • Trial primary completion date • Hepatology • Renal Disease

Drug-drug Interaction Study of Bemnifosbuvir/Ruzasvir (BEM/RZR) and Digoxin and Rosuvastatin (clinicaltrials.gov) - P1 | N=36 | Recruiting | Sponsor: Atea Pharmaceuticals, Inc. | Not yet recruiting ➔ Recruiting

Enrollment open

No DDI between Bemnifosbuvir/Ruzasvir and Bictegravir/Emtricitabine/Tenofovir Alafenamide (EASL 2025) - "BEM/RZR and B/FTC/TAF, alone and co-administered, were well tolerated in healthy subjects with no clinically relevant PK DDI. These results support the enrollment of HCV/HIV-co- infected subjects receiving B/FTC/TAF in BEM/RZR clinical trials."

Human Immunodeficiency Virus • Infectious Disease

Pharmacokinetics of bemnifosbuvir in participants with hepatic impairment (EASL 2025) - P1 | "Background and Aims: Bemnifosbuvir (BEM, AT-527) is an oral double prodrug of a guanosine nucleotide analog with potent activity against coronaviruses and flaviviruses including hepatitis C virus (HCV). BEM in combination with ruzasvir (HCV NS5A inhibitor), is under clinical development for the treatment of chronic HCV infection... BEM 550 mg was safe and well-tolerated in participants with impaired or normal hepatic function. Plasma exposures to the parent BEM, but not the metabolite AT-273, surrogate for the active triphosphate, increased as hepatic function worsened. These results provide PK support for dosing BEM 550 mg in HCV-infected participants with compensated or decompensated cirrhosis."

PK/PD data • Fibrosis • Hepatitis C • Hepatology • Immunology • Infectious Disease • Inflammation • Novel Coronavirus Disease

Efficacy and safety of Bemnifosbuvir and Ruzasvir after 8 weeks of treatment in patients with chronic hepatitis C virus (HCV) infection (EASL 2025) - P2 | "In this population with NS5A RAS high prevalence at baseline, high efficacy was observed, regardless of treatment adherence. These data support that non-cirrhotic patients can effectively be treated for 8 weeks with BEM+RZR, while cirrhotic patients will require 12 weeks of dosing to maximize efficacy. The regimen was well tolerated with no drug-related SAEs or treatment discontinuations due to AEs."

Clinical • Fibrosis • Hepatitis C • Hepatology • Infectious Disease • Inflammation • Liver Cirrhosis

Efficacy and safety of Bemnifosbuvir and Ruzasvir after 8 weeks of treatment in patients with chronic hepatitis C virus (HCV) infection (EASL 2025) - No abstract available

Clinical • Hepatitis C • Hepatology • Infectious Disease • Inflammation

Pharmacokinetics of bemnifosbuvir in participants with renal impairment (EASL 2025) - P1 | "BEM in combination with ruzasvir (HCV NS5A inhibitor), is under clinical development for the treatment of HCV... BEM 550 mg was safe and well-tolerated in participants with impaired or normal renal function. Plasma exposure to BEM was not affected by RI but increased with worsening renal function especially for the inactive nucleoside metabolite AT-273. The high renal clearance of AT-273 which exceeded GFR indicated the involvement of active transport in its renal elimination."

PK/PD data • Chronic Kidney Disease • Hepatitis C • Hepatology • Infectious Disease • Inflammation • Nephrology • Novel Coronavirus Disease • Renal Disease

Clinical Evaluation of Potential Interaction Between Bemnifosbuvir and Ruzasvir With an Assessment of Food Effect: Results of a Phase 1 Study in Healthy Participants. (PubMed, Clin Pharmacol Drug Dev) - "No serious adverse events or premature drug discontinuations were reported. Overall, the study results support further evaluation of bemnifosbuvir and ruzasvir combination therapy for treating chronic HCV."

Journal • P1 data • Hepatitis C • Hepatology • Infectious Disease • Inflammation

Drug-drug Interaction Study of Bemnifosbuvir/Ruzasvir (BEM/RZR) and Digoxin and Rosuvastatin (clinicaltrials.gov) - P1 | N=36 | Not yet recruiting | Sponsor: Atea Pharmaceuticals, Inc.

New P1 trial

Study of Bemnifosbuvir/Ruzasvir as a Fixed-dose Combination in Subjects With Normal or Severely Impaired Renal or Hepatic Function (clinicaltrials.gov) - P1 | N=28 | Not yet recruiting | Sponsor: Atea Pharmaceuticals, Inc.

New P1 trial • Hepatology • Renal Disease

C-BEYOND: Efficacy and Safety of BEM/RZR vs. SOF/VEL in Subjects With Chronic HCV (clinicaltrials.gov) - P3 | N=800 | Recruiting | Sponsor: Atea Pharmaceuticals, Inc. | Not yet recruiting ➔ Recruiting

Enrollment open • Hepatitis C • Hepatology • Infectious Disease • Inflammation

C-BEYOND: Efficacy and Safety of BEM/RZR Vs. SOF/VEL in Subjects with Chronic HCV (clinicaltrials.gov) - P3 | N=800 | Not yet recruiting | Sponsor: Atea Pharmaceuticals, Inc.

New P3 trial • Hepatitis C • Hepatology • Infectious Disease • Inflammation

Bemnifosbuvir and ruzasvir in combination exhibit potent synergistic antiviral activity in vitro while maintaining a favorable nonclinical safety profile in vivo. (PubMed, Antiviral Res) - "All doses were well tolerated with no test article-related adverse effects identified in either the separate or combined dose groups. Moreover, toxicokinetic analyses conducted on dose days 1, 28 and 84 indicated minimal pharmacokinetic interactions between the two drugs in rats, with AUC values for AT-511 (free base form of BEM), its major circulating metabolites, and RZR being similar, regardless of separate or co-administration."

Journal • Preclinical

A Phase 2, Safety and Efficacy of Bemnifosbuvir (BEM) and Ruzasvir (RZR) in Subjects with Chronic HCV (clinicaltrials.gov) - P2 | N=275 | Completed | Sponsor: Atea Pharmaceuticals, Inc. | Active, not recruiting ➔ Completed

Trial completion • Fibrosis • Hepatitis C • Hepatology • Immunology • Infectious Disease • Inflammation • Liver Cirrhosis

MULTISCALE MODELING OF LEAD-IN RESULTS FROM A PHASE 2 STUDY OF AN 8-WEEK COMBINATION REGIMEN OF BEMNIFOSBUVIR AND RUZASVIR IN PATIENTS WITH CHRONIC HEPATITIS C VIRUS INFECTION (AASLD 2024) - P2 | "Previously we developed a multiscale model of HCV infection and treatment to estimate the in vivo effectiveness of daclatasvir in blocking HCV replication and viral assembly/secretion... BEM/ RZR for 8 weeks was highly effective in blocking both viral replication and viral assembly/secretion in HCV-infected patients independent of genotype, age, sex or fibrosis stage. This analysis supports the shortened 8 weeks of treatment with BEM/RZR for CHC."

Clinical • P2 data • Fibrosis • Hepatitis C • Hepatology • Immunology • Infectious Disease • Inflammation