allotment, page-96

Thanks for this post Chuck. It is a relief to actually hear someone give a reasoned argument here, rather than hurl abuse, which seems to characterise the regular level of discourse here when someone expresses an alternate view to the general hype and back-slapping.
I don't for a moment think that the phase 2a trial that has been carried out was not worth doing. It is part of a drug's development to have small trials initially to prove the concept before moving on to more commercially meaningful trials. A trial that contains only 24 patients was most likely to produce statistically insignificant results (my constant references to insignificance are my trying to get the concept of statistical significance across to a few who don't seem to understand it), particularly when performed in Asian subjects who do well on SOC anyway. And I agree that the results would in general warrant moving to the next stage, a properly-powered phase 2b trial.
The problem I see, however, is that such a trial is likely to take 2 years to perform. In the meantime, the HCV world has changed dramatically. When Biotron's phase 2a trial was devised, it was almost universally thought that protease and polymerase inhibitors would inevitably develop resistance, and multiple drugs or interferon would be required to overcome this. In such a world, a viroporin inhibitor is a potentially attractive drug because it provides a third direct means of attacking the virus. But the Pharmasset trial presented at AASLD in Nov showed that in geno 2 and 3 at lease, a polymerase inhibitor in combination with ribavirin (which has a modest effect on viral load) could produce both RVR and SVR, and resistance did not develop. Hence the polymerase inhibitor is extraordinarily potent (at least 1000x more than BIT225) and has a high barrier to resistance. Now nobody thinks that that drug alone, with or without ribavirin, is going to cure all patients with HCV, but if you add that drug to another very potent drug i.e. a protease inhibitor, then the combination very likely will.
BIT225's potency, or lack of, is I think it's major flaw in HCV. It will likely need to be combined with 2 other drugs. Not only does this increase potential side effects, but it dramatically increases the complexity (and duration) of any potential drug trials, and the expense of any resultant regimens. Remember that telaprevir ALONE is $50,000 for a course. Therefore, my guess is that the companies wanting to remain players in the HCV market will go for polymerase and protease inhibitors first, as the moment that combination is shown to work across all genotypes, all other HCV drug candidates are probably dead in the water.