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A Study to Evaluate Chronic Hepatitis C Infection in Adults With Genotype 1b Infection

A Randomized, Double-blind, Controlled Study to Evaluate the Efficacy and Safety of the Combination of ABT-450/Ritonavir/ABT-267 (ABT-450/r/ABT-267) and ABT-333 With and Without Ribavirin (RBV) in Treatment-Naive Adults With Genotype 1b Chronic Hepatitis C Virus (HCV) Infection (PEARL-III)

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01767116
Acronym
PEARL-III
Enrollment
419
Registered
2013-01-14
Start date
2012-12-31
Completion date
2014-08-31
Last updated
2021-07-12

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Chronic Hepatitis C Infection

Keywords

Interferon-Free, Hepatitis C Genotype 1b, Chronic Hepatitis C, Hepatitis C Virus, Hepatitis C, Treatment-Naive, Paritaprevir, Ombitasvir, Dasabuvir, Viekira PAK, Ribavirin

Brief summary

The purpose of this study is to evaluate the safety and antiviral activity of ABT-450/ritonavir/ABT-267 (ABT-450/r/ABT-267; ABT-450 also known as paritaprevir; ABT-267 also known as ombitasvir) and ABT-333 (also known as dasabuvir) with and without ribavirin (RBV) in patients with chronic hepatitis C virus genotype 1b (HCV GT1b) infection without cirrhosis.

Detailed description

A randomized, double-blind, multicenter study to evaluate the safety and antiviral activity of the combination of ABT-450/ritonavir/ABT-267 (ABT-450/r/ABT-267) and ABT-333 with and without ribavirin (RBV) in treatment-naïve, noncirrhotic participants with chronic hepatitis C virus genotype 1b (HCV GT1b) infection.

Interventions

Tablet; ABT-450 coformulated with ritonavir and ABT-267, ABT-333 tablet

DRUGRibavirin

Capsule

Sponsors

AbbVie (prior sponsor, Abbott)
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)

Eligibility

Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No

Inclusion criteria

* Females must be practicing specific forms of birth control on study treatment, or be post-menopausal for more than 2 years or surgically sterile * Chronic hepatitis C, genotype 1b-infection (HCV RNA level greater than or equal to 10,000 IU/mL at screening) * Subject has never received antiviral treatment for hepatitis C infection * No evidence of liver cirrhosis

Exclusion criteria

* Significant liver disease with any cause other than HCV as the primary cause * Positive hepatitis B surface antigen or anti-human immunodeficiency virus antibody * Positive screen for drugs or alcohol * Significant sensitivity to any drug * Use of contraindicated medications within 2 weeks of dosing * Abnormal laboratory tests

Design outcomes

Primary

MeasureTime frameDescription
Percentage of Participants With Sustained Virologic Response 12 Weeks After Treatment; Noninferiority Analyses of Each Treatment Arm Compared to Historical Rate12 weeks after last dose of study drugThe percentage of participants with sustained virologic response (plasma Hepatitis C virus ribonucleic acid \[HCV RNA\] level less than the lower limit of quantitation \[\< LLOQ\]) 12 weeks after the last dose of study drug. The LLOQ for the assay was 25 IU/mL. The primary efficacy endpoints were noninferiority of the percentage of participants who achieved sustained virologic response 12 weeks after treatment in each treatment arm (ABT-450/r/ABT-267 and ABT-333, plus either placebo RBV or RBV) compared with the historical control rate for noncirrhotic, treatment-naïve participants with HCV GT1b infection treated with telaprevir and peginterferon/RBV (pegIFN).

Secondary

MeasureTime frameDescription
Percentage of Participants With Sustained Virologic Response 12 Weeks After Treatment; Noninferiority Analysis of ABT-450/r/ABT-267 and ABT-333, Plus Placebo RBV Compared With ABT-450/r/ABT-267 and ABT-333, Plus RBV12 weeks after last dose of study drugThe percentage of participants with sustained virologic response (plasma Hepatitis C virus ribonucleic acid \[HCV RNA\] level less than the lower limit of quantitation \[\< LLOQ\]) 12 weeks after the last dose of study drug. The secondary endpoint was the noninferiority of the percentage of participants who achieved sustained virologic response 12 weeks after treatment who received ABT-450/r/ABT-267 and ABT-333, plus placebo RBV compared with those who received ABT-450/r/ABT-267 and ABT-333, plus RBV.
Percentage of Participants With Hemoglobin Decrease to Below the Lower Limit of Normal (LLN) At End of TreatmentBaseline (Day 1) and Week 12 (End of Treatment)The percentage of participants with a decrease in hemoglobin from greater than or equal to the lower limit of normal (≥ LLN) at baseline to \< LLN at the end of treatment.
Percentage of Participants With Sustained Virologic Response 12 Weeks After Treatment; Superiority Analyses of Each Treatment Arm Compared to Historical Rate12 weeks after last dose of study drugThe percentage of participants with sustained virologic response (plasma HCV RNA less than the lower limit of quantitation \[\< LLOQ\]) 12 weeks after the last dose of study drug. The secondary efficacy endpoints were superiority of the percentage of participants who achieved sustained virologic response 12 weeks after treatment in each treatment arm (ABT-450/r/ABT-267 and ABT-333, plus either placebo RBV or RBV) compared with the historical control rate for noncirrhotic, treatment-naïve participants with HCV GT1b treated with telaprevir and pegIFN/RBV.
Percentage of Participants With Virologic Failure During TreatmentBaseline (Day 1), and Treatment Weeks 1, 2, 4, 6, 8, 10, and 12Virologic failure during treatment was defined as rebound (confirmed HCV RNA greater than or equal to the lower limit of quantitation \[≥ LLOQ\] after HCV RNA \< LLOQ during treatment, or confirmed increase from the lowest value post baseline in HCV RNA \[2 consecutive HCV RNA measurements \> 1 log10 IU/mL above the lowest value post baseline\] at any time point during treatment), or failure to suppress (HCV RNA ≥ LLOQ persistently during treatment with at least 6 weeks \[≥ 36 days\] of treatment).
Percentage of Participants With Virologic Relapse After TreatmentBetween End of Treatment (Week 12) and Post-treatment (up to Week 12 Post-treatment)Participants who completed treatment with plasma HCV RNA less than the lower limit of quantification (\<LLOQ) at the end of treatment were considered to have virologic relapse if they had confirmed HCV RNA ≥ LLOQ during the post-treatment period.

Participant flow

Participants by arm

ArmCount
ABT-450/r/ABT-267 and ABT-333, Plus RBV
ABT-450/r/ABT-267 (150 mg/ 100 mg/ 25 mg once daily) and ABT-333 (250 mg twice daily), plus weight-based RBV (dosed 1,000 or 1,200 mg daily divided twice a day) for 12 weeks
210
ABT-450/r/ABT-267 and ABT-333, Plus Placebo RBV
ABT-450/r/ABT-267 (150 mg/ 100 mg/ 25 mg once daily) and ABT-333 (250 mg twice daily) for 12 weeks plus placebo RBV (twice daily) for 12 weeks
209
Total419

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyLost to Follow-up22

Baseline characteristics

CharacteristicABT-450/r/ABT-267 and ABT-333, Plus RBVABT-450/r/ABT-267 and ABT-333, Plus Placebo RBVTotal
Age, Continuous48.4 years
STANDARD_DEVIATION 11.94
49.2 years
STANDARD_DEVIATION 12.03
48.8 years
STANDARD_DEVIATION 11.98
Sex: Female, Male
Female
104 Participants123 Participants227 Participants
Sex: Female, Male
Male
106 Participants86 Participants192 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
— / —— / —
other
Total, other adverse events
133 / 21097 / 209
serious
Total, serious adverse events
4 / 2104 / 209

Outcome results

Primary

Percentage of Participants With Sustained Virologic Response 12 Weeks After Treatment; Noninferiority Analyses of Each Treatment Arm Compared to Historical Rate

The percentage of participants with sustained virologic response (plasma Hepatitis C virus ribonucleic acid \[HCV RNA\] level less than the lower limit of quantitation \[\< LLOQ\]) 12 weeks after the last dose of study drug. The LLOQ for the assay was 25 IU/mL. The primary efficacy endpoints were noninferiority of the percentage of participants who achieved sustained virologic response 12 weeks after treatment in each treatment arm (ABT-450/r/ABT-267 and ABT-333, plus either placebo RBV or RBV) compared with the historical control rate for noncirrhotic, treatment-naïve participants with HCV GT1b infection treated with telaprevir and peginterferon/RBV (pegIFN).

Time frame: 12 weeks after last dose of study drug

Population: All randomized participants who received at least 1 dose of study drug (intent-to-treat \[ITT\] population); participants with missing data were counted as non-responders.

ArmMeasureValue (NUMBER)
ABT-450/r/ABT-267 and ABT-333, Plus RBVPercentage of Participants With Sustained Virologic Response 12 Weeks After Treatment; Noninferiority Analyses of Each Treatment Arm Compared to Historical Rate99.5 percentage of participants
ABT-450/r/ABT-267 and ABT-333, Plus Placebo RBVPercentage of Participants With Sustained Virologic Response 12 Weeks After Treatment; Noninferiority Analyses of Each Treatment Arm Compared to Historical Rate100.0 percentage of participants
Comparison: For the primary efficacy endpoint of sustained virologic response at 12 weeks after treatment, based on a 2-sided significance level of 0.05 and an underlying rate of 92% or higher in each arm, a sample size of 200 participants per treatment arm provides \>95% power to demonstrate noninferiority of each regimen to the historical rate for telaprevir plus pegIFN and RBV therapy (84%) (based on the normal approximation of a single binomial proportion in a one-sample test for superiority).95% CI: [98.2, 100]
Comparison: For the primary efficacy endpoint of sustained virologic response at 12 weeks after treatment, based on a 2-sided significance level of 0.05 and an underlying rate of 92% or higher in each arm, a sample size of 200 participants per treatment arm provides \>95% power to demonstrate noninferiority of each regimen to the historical rate for telaprevir plus pegIFN and RBV therapy (84%) (based on the normal approximation of a single binomial proportion in a one-sample test for superiority).95% CI: [98.6, 100]
Secondary

Percentage of Participants With Hemoglobin Decrease to Below the Lower Limit of Normal (LLN) At End of Treatment

The percentage of participants with a decrease in hemoglobin from greater than or equal to the lower limit of normal (≥ LLN) at baseline to \< LLN at the end of treatment.

Time frame: Baseline (Day 1) and Week 12 (End of Treatment)

Population: All randomized participants who received at least 1 dose of study drug (ITT population) and had hemoglobin ≥ LLN reference range at baseline.

ArmMeasureValue (NUMBER)
ABT-450/r/ABT-267 and ABT-333, Plus RBVPercentage of Participants With Hemoglobin Decrease to Below the Lower Limit of Normal (LLN) At End of Treatment51.2 percentage of participants
ABT-450/r/ABT-267 and ABT-333, Plus Placebo RBVPercentage of Participants With Hemoglobin Decrease to Below the Lower Limit of Normal (LLN) At End of Treatment3.4 percentage of participants
p-value: <0.001Fisher Exact
Secondary

Percentage of Participants With Sustained Virologic Response 12 Weeks After Treatment; Noninferiority Analysis of ABT-450/r/ABT-267 and ABT-333, Plus Placebo RBV Compared With ABT-450/r/ABT-267 and ABT-333, Plus RBV

The percentage of participants with sustained virologic response (plasma Hepatitis C virus ribonucleic acid \[HCV RNA\] level less than the lower limit of quantitation \[\< LLOQ\]) 12 weeks after the last dose of study drug. The secondary endpoint was the noninferiority of the percentage of participants who achieved sustained virologic response 12 weeks after treatment who received ABT-450/r/ABT-267 and ABT-333, plus placebo RBV compared with those who received ABT-450/r/ABT-267 and ABT-333, plus RBV.

Time frame: 12 weeks after last dose of study drug

Population: All randomized participants who received at least 1 dose of study drug (ITT population); participants with missing data were counted as non-responders.

ArmMeasureValue (NUMBER)
ABT-450/r/ABT-267 and ABT-333, Plus RBVPercentage of Participants With Sustained Virologic Response 12 Weeks After Treatment; Noninferiority Analysis of ABT-450/r/ABT-267 and ABT-333, Plus Placebo RBV Compared With ABT-450/r/ABT-267 and ABT-333, Plus RBV99.5 percentage of participants
ABT-450/r/ABT-267 and ABT-333, Plus Placebo RBVPercentage of Participants With Sustained Virologic Response 12 Weeks After Treatment; Noninferiority Analysis of ABT-450/r/ABT-267 and ABT-333, Plus Placebo RBV Compared With ABT-450/r/ABT-267 and ABT-333, Plus RBV100 percentage of participants
Comparison: For the secondary efficacy endpoint of sustained virologic response at 12 weeks after treatment, based on a -10% margin, a 2-sided significance level of 0.05 and an underlying rate of 92% or higher in each arm, a sample size of 200 participants per arm provides \>95% power to demonstrate noninferiority of ABT-450/r/ABT-267 and ABT-333, plus Placebo RBV compared with ABT-450/r/ABT-267 and ABT-333, plus RBV (normal approximation of a single binomial proportion in a 1-sample test for superiority).95% CI: [-0.5, 1.4]
Secondary

Percentage of Participants With Sustained Virologic Response 12 Weeks After Treatment; Superiority Analyses of Each Treatment Arm Compared to Historical Rate

The percentage of participants with sustained virologic response (plasma HCV RNA less than the lower limit of quantitation \[\< LLOQ\]) 12 weeks after the last dose of study drug. The secondary efficacy endpoints were superiority of the percentage of participants who achieved sustained virologic response 12 weeks after treatment in each treatment arm (ABT-450/r/ABT-267 and ABT-333, plus either placebo RBV or RBV) compared with the historical control rate for noncirrhotic, treatment-naïve participants with HCV GT1b treated with telaprevir and pegIFN/RBV.

Time frame: 12 weeks after last dose of study drug

Population: All randomized participants who received at least 1 dose of study drug (ITT population); participants with missing data were counted as non-responders.

ArmMeasureValue (NUMBER)
ABT-450/r/ABT-267 and ABT-333, Plus RBVPercentage of Participants With Sustained Virologic Response 12 Weeks After Treatment; Superiority Analyses of Each Treatment Arm Compared to Historical Rate99.5 percentage of particpants
ABT-450/r/ABT-267 and ABT-333, Plus Placebo RBVPercentage of Participants With Sustained Virologic Response 12 Weeks After Treatment; Superiority Analyses of Each Treatment Arm Compared to Historical Rate100 percentage of particpants
Comparison: For the secondary efficacy endpoint of sustained virologic response at 12 weeks after treatment, based on a 2-sided significance level of 0.05 and an underlying rate of 92% or higher in each arm, a sample size of 200 participants per treatment arm provides \>90% power to demonstrate superiority of each regimen to the historical rate for telaprevir plus pegIFN and RBV therapy (84%) (based on the normal approximation of a single binomial proportion in a one-sample test for superiority).95% CI: [98.2, 100]
Comparison: For the secondary efficacy endpoint of sustained virologic response at 12 weeks after treatment, based on a 2-sided significance level of 0.05 and an underlying rate of 92% or higher in each arm, a sample size of 200 participants per treatment arm provides \>90% power to demonstrate superiority of each regimen to the historical rate for telaprevir plus pegIFN and RBV therapy (84%) (based on the normal approximation of a single binomial proportion in a one-sample test for superiority).95% CI: [98.6, 100]
Secondary

Percentage of Participants With Virologic Failure During Treatment

Virologic failure during treatment was defined as rebound (confirmed HCV RNA greater than or equal to the lower limit of quantitation \[≥ LLOQ\] after HCV RNA \< LLOQ during treatment, or confirmed increase from the lowest value post baseline in HCV RNA \[2 consecutive HCV RNA measurements \> 1 log10 IU/mL above the lowest value post baseline\] at any time point during treatment), or failure to suppress (HCV RNA ≥ LLOQ persistently during treatment with at least 6 weeks \[≥ 36 days\] of treatment).

Time frame: Baseline (Day 1), and Treatment Weeks 1, 2, 4, 6, 8, 10, and 12

Population: All randomized participants who received at least 1 dose of study drug (ITT population).

ArmMeasureGroupValue (NUMBER)
ABT-450/r/ABT-267 and ABT-333, Plus RBVPercentage of Participants With Virologic Failure During TreatmentRebound0.5 percentage of participants
ABT-450/r/ABT-267 and ABT-333, Plus RBVPercentage of Participants With Virologic Failure During TreatmentFailure to suppress0 percentage of participants
ABT-450/r/ABT-267 and ABT-333, Plus Placebo RBVPercentage of Participants With Virologic Failure During TreatmentRebound0 percentage of participants
ABT-450/r/ABT-267 and ABT-333, Plus Placebo RBVPercentage of Participants With Virologic Failure During TreatmentFailure to suppress0 percentage of participants
Secondary

Percentage of Participants With Virologic Relapse After Treatment

Participants who completed treatment with plasma HCV RNA less than the lower limit of quantification (\<LLOQ) at the end of treatment were considered to have virologic relapse if they had confirmed HCV RNA ≥ LLOQ during the post-treatment period.

Time frame: Between End of Treatment (Week 12) and Post-treatment (up to Week 12 Post-treatment)

Population: All randomized participants who received at least 1 dose of study drug (ITT population) with HCV RNA \< LLOQ at the final treatment visit and completed treatment.

ArmMeasureValue (NUMBER)
ABT-450/r/ABT-267 and ABT-333, Plus RBVPercentage of Participants With Virologic Relapse After Treatment0 percentage of participants
ABT-450/r/ABT-267 and ABT-333, Plus Placebo RBVPercentage of Participants With Virologic Relapse After Treatment0 percentage of participants

Source: ClinicalTrials.gov · Data processed: Mar 8, 2026