Development of d-d4FC (dexelvucitabine, Reverset) discontinued

On 3 April, Incyte announced that it was discontinuing development of the nucleoside analogue d-d4FC (formerly Reverset). This is due to 40% incidence of grade 4 hyperlipasemia (a marker of pancreatic inflammation) including one case of pancreatitis, in patients receiving 200 mg d-d4FC without 3TC or FTC in their combination.

Although hyperlipasemia was only reported in 2% in people using 3TC or FTC, early virological results showed that d-d4FC was significantly less potent if used in regimens that included either of these drugs – in itself a significant limitation for any nucleoside. The toxicity reported without 3TC or FTC makes it impossible to see any context in which to use d-d4FC.

The increased incidence of grade 4 hyperlipasemia was observed in Study 901, the long-term extension of Incytes first Phase IIb trial (Study 203).