Design Single arm Open label W12 ≥ 18 years, HCV genotype 1 to 6

Slides:



Advertisements
Similar presentations
Roth D. EASL 2015, Abs. LP02 C-SURFER Study: grazoprevir + elbasvir in genotype 1 with chronic kidney disease N = 111 GZR + EBR Placebo GZR + EBR (Intensive.
Advertisements

UNITY-1 DCV/ASV/BCB No randomisation Open-label UNITY-1 Study: daclatasvir/asunaprevir/beclabuvir in genotype 1 without cirrhosis  Design W12 ≥ 18 years.
OBV/PTV/r Placebo Randomisation** 2 : years Chronic HCV Genotype 1b HCV RNA ≥ 10,000 IU/ml Naïve or pre-treated, no prior failure with DAA Without.
No randomization N = 59 W12W24 Arm B : compensated cirrhosis N = 31 N = 29 Arm C : compensated cirrhosis Arm A : No cirrhosis AGATE-II Study: OBV/PTV/r.
SMV + DCV + SOF Open label Chronic HCV infection Genotype 1 or 4 Treatment-naïve or pre-treated with PEG-IFN ± RBV Portal hypertension or liver decompensation.
ALLY-3  Design  Objective –SVR 12 (HCV RNA < 25 IU/ml), with 95% CI DCV 60 mg qd + SOF 400 mg qd Not randomised Open-label ALLY-3 Study: DCV + SOF for.
> 18 years Chronic HCV infection Genotype 1 Failure (relapse) to 4, 6 or 8 weeks of GZR/EBR + SOF in C-SWIFT Part A Compensated cirrhosis assessed by liver.
OBV/PTV/r + DSV Open label Chronic HCV infection Genotype 1 Treatment-naïve HCV RNA > 1,000 IU/ml Chronic kidney disease with eGFR < 30 ml/min/1.73m 2.
No randomisation Open-label years HCV genotype 1 Naïve or null-response to PEG-IFN + RBV HCV RNA > 10,000 IU/ml No cirrhosis No HBV or HIV co-infection.
Roth D. Lancet 2015; Oct 6; 386: C-SURFER Study: grazoprevir + elbasvir in genotype 1 with chronic kidney disease N = 111 GZR + EBR Placebo GZR.
 Objective –SVR 12 (HCV RNA < 25 IU/ml), with 95% CI, next observation carried backward DCV + SOF + RBV Randomised* 1:1 Open-label ALLY-3+ study: DCV.
SOF/VEL 400/100 mg qd N = 120 W12 SOF + RBV > 18 years Chronic HCV infection Genotype 2 Naïve or pre-treatment with IFN-based regimen Compensated cirrhosis.
 Objective –SVR 12 (HCV RNA < 25 IU/ml), by ITT OBV/PTV/r + DSV + SOF +RBV Open-label W24 ≥ 18 years Chronic HCV Genotype 1 Prior failure on DAA-regimen.
 Objective –SVR 12 (HCV RNA < 25 IU/ml), by ITT OBV/PTV/r + SOF + RBV OBV/PTV/r + SOF Not randomised Open-label QUARTZ-II Study: OBV/PTV/r + SOF for HCV.
No cirrhosis or compensated cirrhosis * No HBV or HIV coinfection
Design Randomisation* 1 : 1 Open-label W8 W12
ARV-trial.com RUBY-II Study: ombitasvir/paritaprevir/ritonavir + dasabuvir for HCV genotype 1a or 4 with severe renal impairment Design Open label W12.
eGFR (MDRD) > 50 mL/min
Glecaprevir-Pibrentasvir in GT 1-6 with Renal Disease EXPEDITION-4
Design Randomisation * 1 : 1 Open-label W16 W24 > 18 years
Design Randomisation 1 : 1 Double-blind W8 W12
No HBV or HIV co-infection
Phase 3 Treatment-Naïve and Treatment-Experienced
TOPAZ-II Study: OBV/PTV/r + DSV + RBV for genotype 1
ARV-trial.com SURVEYOR-II study – Part 3: glecaprevir/pibrentasvir + RBV in genotype 3 with treatment experience and/or cirrhosis Design Randomisation.
C-ISLE study: EBR/GZR + SOF + RBV in genotype 3 and cirrhosis
Design No randomisation Open-label W12 W years HCV genotype 1
Design Randomisation 1 : 1 Open-label W16 W24 > 18 years
PHOTON-2 Study: SOF + RBV in HCV-HIV co-infection
> 18 years Chronic HCV infection Compensated cirrhosis **
ARV-trial.com C-CREST study, Part B: uprifosbuvir (MK-3682)/GZR/ruzasvir (MK-8408) fixed-dose combination + RBV for genotypes 1, 2 and 3 - Phase II Randomisation.
Compensated cirrhosis No HBV or HIV co-infection
Design Randomisation 2 : 1 Double-blind W12 ≥ 18 years, HCV genotype 3
GEODE-II Study: OBV/PTV/r + DSV + low dose RBV in genotype 1a
GARNET Study: OBV/PTV/r + DSV 8 weeks in genotype 1b
Phase 3 Treatment-Naïve and Treatment-Experienced
Retreatment study: SOF/VEL + RBV in prior NS5A failure - Phase II
No cirrhosis or compensated cirrhosis** No HBV or HIV co-infection
AL study: AL ODV + SMV in naïve patients, phase II
Creatinine clearance ≥ 50 ml/min No HBV or HIV co-infection
Design Randomisation* 1 : 1 Open-label W12
Failure to achieve SVR on No HBV or HIV co-infection
ARV-trial.com RUBY-I Study, cohort 2: ombitasvir/paritaprevir/ritonavir + dasabuvir + RBV for HCV genotype 1 with renal impairment Design Open label W12.
QUARTZ II-III : OBV/PTV/r + SOF RBV in genotype 2 or 3
Glecaprevir-Pibrentasvir in Non-Cirrhotic Genotype 2 ENDURANCE-2
LDV/SOF in kidney transplant recipients
Design W12 W16 Randomisation Open-label ≥ 18 years HCV genotype 1 or 4
SOF/VEL + GS-9857 in genotypes 1-6 Phase II
LEAGUE-1 study: daclatasvir + SMV + RBV for genotype 1
ARV-trial.com SURVEYOR-II study – Part 3: glecaprevir/pibrentasvir ± RBV in genotype 3 with treatment experience and/or cirrhosis Design Randomisation.
Phase 3 Treatment-Naïve and Treatment-Experienced
Phase 3 Treatment Naïve HIV Coinfection
Phase 3 Treatment-Naïve and Treatment-Experienced
Design W12 Randomisation * Open-label
ARV-trial.com IMPACT Study: SMV + DCV + SOF in HCV genotype 1 with decompensated liver disease Design Open label ≥ 18 years Chronic HCV infection Genotype.
GS-US Study: SOF/VEL + GS-9857 in genotype 1 - Phase II
GS-US Study: SOF/VEL + GS in genotype 2, 3, 4 or 6 - Phase II
LEPTON Study: SOF/VEL + GS-9857 genotype 1 or 3 Phase II
EXPEDITION-V Study: GLE/PIB in patients with renal impairment
MAGELLAN-3 Study: GLE/PIB + SOF + RBV in patients who failed GLE/PIB
LDV/SOF ± RBV in genotype 3 or 6 – Phase 2
ARV-trial.com C-CREST study, Part B: uprifosbuvir (MK-3682)/GZR/ruzasvir (MK-8408) fixed-dose combination + RBV for genotypes 1, 2 and 3 - Phase II Randomisation.
No HBV or HIV co-infection
Design W12 W16 Randomisation Open-label ≥ 18 years HCV genotype 1 or 4
Phase 3 Treatment-Naïve and Treatment-Experienced
SOF/VEL ± RBV in genotype 3 with compensated cirrhosis
ENDURANCE-4 Study: glecaprevir/pibrentasvir in genotype 4, 5 or 6
ARV-trial.com CORAL-I study cohorts 3 to 6: OBV/PTV/r + DSV + RBV in transplant recipients and genotype 1 or 4 Design W12 W24 No randomisation Open-label.
Sequencing cohorts Open-label Design W8 W12 ≥ 18 years
Glecaprevir-Pibrentasvir in Non-Cirrhotic Genotype 2 ENDURANCE-2
Presentation transcript:

EXPEDITION-IV Study: glecaprevir/pibrentasvir in patients with renal impairment Design Single arm Open label W12 ≥ 18 years, HCV genotype 1 to 6 HCV RNA ≥ 1000 IU/mL eGFR (MDRD) < 30 mL/min Treatment-naïve or treatment-experienced with IFN/PEG-IFN ± RBV or SOF + RBV ± PEG-IFN Compensated cirrhosis allowed No HBV or HIV co-infection Acute renal failure excluded N = 104 GLE/PIB SVR12 GLE/PIB : 100/40 mg 3 tablets QD Objective SVR12 (HCV RNA < 15 IU/mL) EXPEDITION-IV Gane E. AASLD 2016, Abs. LB-11 1

EXPEDITION-IV Study: glecaprevir/pibrentasvir in patients with renal impairment Baseline characteristics and SVR12 GLE/PIB , N = 104 Median age, years 57 Female, % 24 Race : Black, % 25 Median BMI, kg/m2 26 Genotype 1a / 1b / 1 other / 2 / 3 / 4 / 5 / 6, % 22 / 28 / 2 / 16 / 11 / 19 / 1 / 1 Median HCV RNA, log10 IU/mL 5.9 Compensated cirrhosis, % 19 IL28B CC, % 23 Treatment-experienced, % IFN-based SOF-based 42 95 5 PPI use, % 41 Chronic kidney disease stage, % eGFR 15-29 ml/min/1.73 m2 eGFR < 15 ml/min/1.73 m2 (hemodialysis) 12 88 (82) SVR12, by ITT, n/N (%) 102/104 (98%) [1 discontinuation, 1 LTFU] EXPEDITION-IV Gane E. AASLD 2016, Abs. LB-11 2

Adverse events and laboratory abnormalities, % EXPEDITION-IV Study: glecaprevir/pibrentasvir in patients with renal impairment Adverse events and laboratory abnormalities, % GLE/PIB , N = 104 Any adverse event 71 Serious adverse event related to study drug 24 Adverse event leading to discontinuation 4 * Death 1 ** Adverse events in > 10% of patients, % Pruritus Fatigue Nausea 20 14 12 Laboratory abnormalities, % Hemoglobin grade ≥ 3 (6.5-8 g/dL) AST grade ≥ 2 (> 3 x ULN) ALT grade≥ 2 (> 3 x ULN) Total bilirubin grade ≥ 3 ( > 3 x ULN) 5 0 0 1 * 1) diarrhea, 2) pruritus, 3) pulmonary edema, hypertensive cardiomyopathy with congestive failure, and 4) hypertensive crisis ** Serious adverse event of cerebral hemorrhage, not related to study drug, at post-treatment W2 EXPEDITION-IV Gane E. AASLD 2016, Abs. LB-11 3

EXPEDITION-IV Study: glecaprevir/pibrentasvir in patients with renal impairment Summary GLE/PIB (300 mg/120 mg QD) achieved high efficacy in patients with stage 4 or 5 chronic kidney disease and HCV infection 98% ITT SVR12 rate across all major HCV genotypes No virologic failures GLE/PIB was well tolerated with a favorable safety profile in this difficult-to-treat population: No drug-related serious adverse event No grade ≥ 2 laboratory abnormalities in ALT or AST EXPEDITION-IV Gane E. AASLD 2016, Abs. LB-11 4