Chronic Hepatitis C Infection
Conditions
Keywords
Chronic Hepatitis C, Hepatitis C Virus, Hepatitis C Genotype 1a, Hepatitis C, Treatment-Naïve, Interferon-Free, Paritaprevir, Ombitasvir, Dasabuvir, Ribavirin, Viekira PAK
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 1a (HCV GT1a) infection without cirrhosis.
Detailed description
A randomized, double-blind, placebo-controlled, 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-naive, noncirrhotic participants with chronic hepatitis C virus genotype 1a (HCV GT1a) infection.
Interventions
Tablet; ABT-450 coformulated with ritonavir and ABT-267, ABT-333 tablet
Capsule
Capsule
Sponsors
Study design
Eligibility
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 1a-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
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants With Sustained Virologic Response 12 Weeks After Treatment; Primary Analyses | 12 weeks after last dose of study drug | 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 GT1a infection treated with telaprevir and peginterferon(pegIFN)/RBV. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants With Hemoglobin Decrease to Below the Lower Limit of Normal (LLN) At End of Treatment | Baseline (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; Secondary Analyses | 12 weeks after last dose of study drug | 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 GT1a infection treated with telaprevir and pegIFN/RBV; and 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 Virologic Failure During Treatment | Baseline (Day 1), and Treatment Weeks 1, 2, 4, 6, 8, 10, and 12 | 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). |
| Percentage of Participants With Virologic Relapse After Treatment | Between 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. 95% CI calculated using the normal approximation to the binomial distribution. |
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| 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 | 100 |
| 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 | 205 |
| Total | 305 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Adverse Event | 0 | 1 |
| Overall Study | Lost to Follow-up | 4 | 9 |
| Overall Study | Other | 2 | 7 |
| Overall Study | To Enter an Extension Study | 0 | 4 |
Baseline characteristics
| Characteristic | ABT-450/r/ABT-267 and ABT-333, Plus RBV | ABT-450/r/ABT-267 and ABT-333, Plus Placebo RBV | Total |
|---|---|---|---|
| Age, Continuous | 51.6 years STANDARD_DEVIATION 10.99 | 51.4 years STANDARD_DEVIATION 10.64 | 51.5 years STANDARD_DEVIATION 10.74 |
| Sex: Female, Male Female | 30 Participants | 76 Participants | 106 Participants |
| Sex: Female, Male Male | 70 Participants | 129 Participants | 199 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — |
| other Total, other adverse events | 81 / 100 | 138 / 205 |
| serious Total, serious adverse events | 3 / 100 | 1 / 205 |
Outcome results
Percentage of Participants With Sustained Virologic Response 12 Weeks After Treatment; Primary Analyses
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 GT1a infection treated with telaprevir and peginterferon(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 (intent-to-treat \[ITT\] population); participants with missing data were counted as non-responders.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| ABT-450/r/ABT-267 and ABT-333, Plus RBV | Percentage of Participants With Sustained Virologic Response 12 Weeks After Treatment; Primary Analyses | 97.0 percentage of participants |
| ABT-450/r/ABT-267 and ABT-333, Plus Placebo RBV | Percentage of Participants With Sustained Virologic Response 12 Weeks After Treatment; Primary Analyses | 90.2 percentage of participants |
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.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| 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 Treatment | 42.0 percentage of participants |
| ABT-450/r/ABT-267 and ABT-333, Plus Placebo RBV | Percentage of Participants With Hemoglobin Decrease to Below the Lower Limit of Normal (LLN) At End of Treatment | 3.9 percentage of participants |
Percentage of Participants With Sustained Virologic Response 12 Weeks After Treatment; Secondary Analyses
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 GT1a infection treated with telaprevir and pegIFN/RBV; and 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.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| ABT-450/r/ABT-267 and ABT-333, Plus RBV | Percentage of Participants With Sustained Virologic Response 12 Weeks After Treatment; Secondary Analyses | 97.0 percentage of participants |
| ABT-450/r/ABT-267 and ABT-333, Plus Placebo RBV | Percentage of Participants With Sustained Virologic Response 12 Weeks After Treatment; Secondary Analyses | 90.2 percentage of participants |
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).
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| ABT-450/r/ABT-267 and ABT-333, Plus RBV | Percentage of Participants With Virologic Failure During Treatment | Rebound | 1.0 percentage of participants |
| ABT-450/r/ABT-267 and ABT-333, Plus RBV | Percentage of Participants With Virologic Failure During Treatment | Failure to suppress | 0 percentage of participants |
| ABT-450/r/ABT-267 and ABT-333, Plus Placebo RBV | Percentage of Participants With Virologic Failure During Treatment | Rebound | 2.9 percentage of participants |
| ABT-450/r/ABT-267 and ABT-333, Plus Placebo RBV | Percentage of Participants With Virologic Failure During Treatment | Failure to suppress | 0 percentage of participants |
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. 95% CI calculated using the normal approximation to the binomial distribution.
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.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| ABT-450/r/ABT-267 and ABT-333, Plus RBV | Percentage of Participants With Virologic Relapse After Treatment | 1.0 percentage of participants |
| ABT-450/r/ABT-267 and ABT-333, Plus Placebo RBV | Percentage of Participants With Virologic Relapse After Treatment | 5.2 percentage of participants |