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A Study to Evaluate Chronic Hepatitis C Infection in Adults With Genotype 1a 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-Naïve Adults With Genotype 1a Chronic Hepatitis C Virus (HCV) Infection (PEARL-IV)

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01833533
Acronym
PEARL-IV
Enrollment
305
Registered
2013-04-17
Start date
2013-03-31
Completion date
2014-09-30
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

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

DRUGRibavirin

Capsule

Sponsors

AbbVie
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 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

MeasureTime frameDescription
Percentage of Participants With Sustained Virologic Response 12 Weeks After Treatment; Primary Analyses12 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 GT1a infection treated with telaprevir and peginterferon(pegIFN)/RBV.

Secondary

MeasureTime frameDescription
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; Secondary Analyses12 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 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 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. 95% CI calculated using the normal approximation to the binomial distribution.

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
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
Total305

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyAdverse Event01
Overall StudyLost to Follow-up49
Overall StudyOther27
Overall StudyTo Enter an Extension Study04

Baseline characteristics

CharacteristicABT-450/r/ABT-267 and ABT-333, Plus RBVABT-450/r/ABT-267 and ABT-333, Plus Placebo RBVTotal
Age, Continuous51.6 years
STANDARD_DEVIATION 10.99
51.4 years
STANDARD_DEVIATION 10.64
51.5 years
STANDARD_DEVIATION 10.74
Sex: Female, Male
Female
30 Participants76 Participants106 Participants
Sex: Female, Male
Male
70 Participants129 Participants199 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
— / —— / —
other
Total, other adverse events
81 / 100138 / 205
serious
Total, serious adverse events
3 / 1001 / 205

Outcome results

Primary

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.

ArmMeasureValue (NUMBER)
ABT-450/r/ABT-267 and ABT-333, Plus RBVPercentage of Participants With Sustained Virologic Response 12 Weeks After Treatment; Primary Analyses97.0 percentage of participants
ABT-450/r/ABT-267 and ABT-333, Plus Placebo RBVPercentage of Participants With Sustained Virologic Response 12 Weeks After Treatment; Primary Analyses90.2 percentage of participants
Comparison: Based on a 2-sided significance level of 0.05 and an underlying rate of ≥90% in the ABT-450/r/ABT-267 and ABT-333, plus RBV arm (100 participants) and ≥85% in the ABT-450/r/ABT-267 and ABT-333, plus Placebo RBV arm (200 participants) provides \>95% power to demonstrate noninferiority of each regimen to the historical rate for telaprevir plus pegIFN and RBV therapy (75%) (based on the normal approximation of a single binomial proportion in a one-sample test for superiority).95% CI: [86.2, 94.3]
Comparison: Based on a 2-sided significance level of 0.05 and an underlying rate of ≥90% in the ABT-450/r/ABT-267 and ABT-333, plus RBV arm (100 participants) and ≥85% in the ABT-450/r/ABT-267 and ABT-333, plus Placebo RBV arm (200 participants) provides \>95% power to demonstrate noninferiority of each regimen to the historical rate for telaprevir plus pegIFN and RBV therapy (75%) (based on the normal approximation of a single binomial proportion in a one-sample test for superiority).95% CI: [93.7, 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 Treatment42.0 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 Treatment3.9 percentage of participants
p-value: <0.001Fisher Exact
Secondary

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.

ArmMeasureValue (NUMBER)
ABT-450/r/ABT-267 and ABT-333, Plus RBVPercentage of Participants With Sustained Virologic Response 12 Weeks After Treatment; Secondary Analyses97.0 percentage of participants
ABT-450/r/ABT-267 and ABT-333, Plus Placebo RBVPercentage of Participants With Sustained Virologic Response 12 Weeks After Treatment; Secondary Analyses90.2 percentage of participants
Comparison: Based on a 2-sided significance level of 0.05 and an underlying rate of ≥90% in the ABT-450/r/ABT-267 and ABT-333, plus RBV arm (100 participants) and ≥85% in the ABT-450/r/ABT-267 and ABT-333, plus Placebo RBV arm (200 participants) provides \>90% power to demonstrate superiority of each regimen to the historical rate for telaprevir plus pegIFN and RBV therapy (75%) (based on the normal approximation of a single binomial proportion in a one-sample test for superiority).95% CI: [93.7, 100]
Comparison: Based on a 2-sided significance level of 0.05 and an underlying rate of ≥90% in the ABT-450/r/ABT-267 and ABT-333, plus RBV arm (100 participants) and ≥85% in the ABT-450/r/ABT-267 and ABT-333, plus Placebo RBV arm (200 participants) provides \>90% power to demonstrate superiority of each regimen to the historical rate for telaprevir plus pegIFN and RBV therapy (75%) (based on the normal approximation of a single binomial proportion in a one-sample test for superiority).95% CI: [86.2, 94.3]
Comparison: Based on a 2-sided significance level of 0.05 and an underlying rate of ≥90% in the ABT-450/r/ABT-267 and ABT-333, plus RBV arm (100 participants) and ≥85% in the ABT-450/r/ABT-267 and ABT-333, plus Placebo RBV arm (200 participants) provides \>95% power to demonstrate noninferiority of the ABT-450/r/ABT-267 and ABT-333, plus RBV arm compared with the ABT-450/r/ABT-267 and ABT-333, plus Placebo RBV arm (normal approximation of a single binomial proportion in a one-sample test for superiority).95% CI: [-12, -1.5]
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 TreatmentRebound1.0 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 TreatmentRebound2.9 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. 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.

ArmMeasureValue (NUMBER)
ABT-450/r/ABT-267 and ABT-333, Plus RBVPercentage of Participants With Virologic Relapse After Treatment1.0 percentage of participants
ABT-450/r/ABT-267 and ABT-333, Plus Placebo RBVPercentage of Participants With Virologic Relapse After Treatment5.2 percentage of participants

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