OBV/PTV/r + DSV + RBV OBV/PTV/r + DSV Randomisation* 1 : 1 Open label 18-70 years Chronic HCV infection Genotype 1b Prior failure to PEG-IFN + RBV HCV.

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Design Randomisation* 1 : 1 Open-label W12
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LEAGUE-1 study: daclatasvir + SMV + RBV for genotype 1
No HBV or HIV co-infection
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No HBV or HIV co-infection
Presentation transcript:

OBV/PTV/r + DSV + RBV OBV/PTV/r + DSV Randomisation* 1 : 1 Open label years Chronic HCV infection Genotype 1b Prior failure to PEG-IFN + RBV HCV RNA > 10,000 IU/ml No cirrhosis** No HBV or HIV co-infection * Randomisation stratified on response to prior PEG-IFN + RBV (null responders, partial responders or relapsers) W12 SVR 12 ** Metavir ≤ F3 or Ishak ≤ 4 or fibroscan < 9.6 kPa or FibroTest ≤ APRI ≤ 2 N = 91 N = 95 PEARL II Andreone P. Gastroenterology 2014;147: PEARL II Study: ombitasvir/paritaprevir/ritonavir + dasabuvir + ribavirin for HCV genotype 1b  Design  Objective –SVR 12 (HCV RNA upper limit of the CI for the historical rate minus a 10.5% noninferiority margin (64%)) –Co-formulated ombitasvir (OBV)/paritaprevir (PTV)/rironavir (r) : 25/150/100 mg qd = 2 tablets –Dasabuvir (DSV) : 250 mg bid –RBV : 1000 or 1200 mg/day (bid dosing) according to body weight (< or ≥ 75 kg)

PEARL II Study: ombitasvir/paritaprevir/ritonavir + dasabuvir + ribavirin for HCV genotype 1b OBV/PTV/r + DSV + RBV N = 91 OBV/PTV/r + DSV N = 95 Mean age, years54 Female51%40% Body mass index, mean Metavir fibrosis score : F0-F1 / F2 / F370% / 14% / 15%64% / 22% / 14% IL28B CC genotype11%7% HCV RNA log 10 IU/ml, mean Previous PEG-IFN + RBV failure Relapse / Partial response / Null response 36% / 29 % 35%37% / 28% / 35% Not included in the ITT population, N (non coformulated OBV/PTV/r and/or genotype non-1b) 34 Early discontinuation, N For adverse event Completed evaluation 85/88 1 lost to follow-up 91/91 Baseline characteristics and patient disposition PEARL II Andreone P. Gastroenterology 2014;147:359-65

SVR 12 (HCV RNA < 25 IU/ml), % (95% CI) ( ) 100 ( ) % OBV/PTV/r + DSV + RBV OBV/PTV/r + DSV N8891 No viral breakthrough, no relapse Adjusted difference : 3.4% (95% CI: to 7.2) Both groups were noninferior and superior to the historical SVR 12 with TVR + PEG-IFN + RBV SVR 12 Previous non response Relapse Partial response Null response 100% 96.0% 93.5% IL28B CC CT TT 100% 96.4% 95.8% Sex Male Female 95.3% 97.8% SVR 12 with OBV/PTV/r + DSV + RBV in the different sub-populations PEARL II Andreone P. Gastroenterology 2014;147: PEARL II Study: ombitasvir/paritaprevir/ritonavir + dasabuvir + ribavirin for HCV genotype 1b 0

OBV/PTV/r + DSV + RBV N = 91 OBV/PTV/r + DSV N = 95 p Serious adverse event22 Adverse event leading to discontinuation 20 Adverse event in > 10% in any group Fatigue32%16%0.015 Headache24%23% Nausea21%6%0.005 Insomnia14%3%0.008 Pruritus14%8% Diarrhea13% Asthenia12%7% Anemia11%0< Bilirubin increase > 3 x ULN9% Rash9%1%0.017 PEARL II Andreone P. Gastroenterology 2014;147: Adverse events, n (%)

PEARL II Study: ombitasvir/paritaprevir/ritonavir + dasabuvir + ribavirin for HCV genotype 1b  Summary –The ITT SVR 12 rates in genotype 1b HCV infected patients receiving the 12-week regimen of OBV/PTV/r + DSV with or without RBV (96.6%–100%, respectively) were superior to the historical rate of telaprevir + PEG-IFN + RBV No benefit of addition of RBV, with significantly more adverse events, bilirubin increase and anemia –Adverse events in both groups of 12-week regimens were generally mild and manageable. –Overall, only 2 (1.1%) patients discontinued treatment because of adverse events, and the 5 serious adverse events reported in 4 patients were considered to be unrelated to study drug – Limitations open-label study design exclusion of patients with cirrhosis, HBV or HIV co-infection PEARL II Andreone P. Gastroenterology 2014;147:359-65