Chronic Hepatitis C, Genotype 1 or 4
Conditions
Keywords
Effectiveness, Influence of adherence, Patient reported outcomes, Ombitasvir/paritaprevir/ritonavir ± dasabuvir, Chronic Hepatitis C genotype 1, Chronic Hepatitis C genotype 4
Brief summary
The interferon-free combination regimen of ombitasvir/paritaprevir/ritonavir/ with or without dasabuvir (ABBVIE REGIMEN) ± ribavirin (RBV) for the treatment of chronic hepatitis C (CHC) has been shown to be safe and effective in randomized controlled clinical trials with strict inclusion and exclusion criteria under well-controlled conditions. This observational study was the first effectiveness research examining the ABBVIE REGIMEN ± RBV, used according to local label, under real world conditions in Belgium in a clinical practice patient population.
Detailed description
This was a prospective, multi-center observational study in participants receiving the interferon-free ABBVIE REGIMEN ± RBV in Belgium. The prescription of a treatment regimen was at the discretion of the physician in accordance with local clinical practice and label, was made independently from this observational study and preceded the decision to offer the participant the opportunity to participate in this study. Adults chronically infected with hepatitis C virus (HCV), receiving the interferon-free ABBVIE REGIMEN, were offered the opportunity to participate in this study during a routine clinical visit at the participating sites.Follow-up visits, treatment, procedures, and diagnostic methods followed physicians' routine clinical practice. Data were collected at the following time windows: baseline, early on-treatment visit, mid-treatment visit (for participants with a treatment duration of 24 weeks), end of treatment (EoT), early post-treatment, and 12 and 24 weeks after the end of treatment (representing sustained virologic response 12 weeks after the end of treatment \[SVR12\] and sustained virologic response 24 weeks after the end of treatment \[SVR24\]).
Interventions
Sponsors
Study design
Eligibility
Inclusion criteria
* Treatment-naïve or -experienced adult male or female participants with confirmed chronic hepatitis C (CHC), genotype 1 or 4, receiving combination therapy with the interferon-free ABBVIE REGIMEN ± ribavirin (RBV) according to standard of care and in line with the current local label * If RBV was co-administered with the ABBVIE REGIMEN, it had to be prescribed in line with the current local label (with special attention to contraception requirements and contraindication during pregnancy) * Participants had to voluntarily sign and date an informed consent form prior to inclusion into the study * Participants must not have participated or intended to participate in a concurrent interventional therapeutic trial
Exclusion criteria
• None
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants Achieving Sustained Virologic Response 12 Weeks Post-treatment (SVR12) | 12 weeks after the last actual dose of study drug | SVR12 was defined as hepatitis C virus ribonucleic acid (HCV RNA) level less than 50 IU/mL 12 weeks after the last actual dose of study drug. The core population (CP) consisted of participants who met all inclusion criteria and were adequately treated according to the standard of care and within local label recommendations for their specific disease characteristics (cirrhotic status, genotype). The core population with sufficient follow-up data 12 weeks after the last actual dose of study drug (CPSFU12) was defined as all CP participants who fulfilled one of the following criteria: * evaluable HCV RNA data ≥70 days after the last actual dose of the ABBVIE REGIMEN * an HCV RNA value ≥50 IU/mL at the last measurement post-baseline * HCV RNA \<50 IU/mL at the last measurement post-baseline, but no HCV RNA measurement ≥70 days after the last actual dose of the ABBVIE REGIMEN due to reasons related to safety (e.g. dropped out due to AE) or virologic failure |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants With Relapse | Up to 48 weeks after the last actual dose of study drug | Relapse was defined as hepatitis C virus ribonucleic acid (HCV RNA) level less than 50 IU/mL at the end of treatment followed by HCV RNA level greater than or equal to 50 IU/mL. |
| Percentage of Participants With Viral Breakthrough | Up to 24 weeks | Viral breakthrough was defined as at least 1 documented hepatitis C virus ribonucleic acid (HCV RNA) level less than 50 IU/mL followed by HCV RNA level greater than or equal to 50 IU/mL during treatment. |
| Percentage of Participants With On-treatment Virologic Failure | 12 weeks after the last actual dose of study drug | On-treatment virologic failure was defined as breakthrough (at least 1 documented hepatitis C virus ribonucleic acid (HCV RNA) less than 50 IU/mL followed by HCV RNA greater than or equal to 50 IU/mL during treatment) or failure to suppress (each measured on-treatment HCV RNA value greater than or equal to 50 IU/mL). |
| Percentage of Participants With Virologic Response at End of Treatment (EoT) | Up to 24 weeks | Virologic response was defined as hepatitis C virus ribonucleic acid (HCV RNA) level less than 50 IU/mL at the end of treatment. |
| Percentage of Participants Meeting Premature Study Drug Discontinuation Criteria | 12 weeks after the last actual dose of study drug | Premature study drug discontinuation was defined as participants who prematurely discontinued study drug with no on-treatment virologic failure. |
| Percentage of Participants With Missing Sustained Virologic Response 12 Weeks Post-Treatment (SVR12) Data and/or Nonresponders Who Did Not Meet Specific SVR12 Nonresponder Criteria | 12 weeks after the last actual dose of study drug | The number of participants with missing SVR12 data or SVR12 nonresponder participants who did not meet criteria for on-treatment virologic failure, relapse, premature treatment discontinuation, and who did not have an Insufficient virological response reported was documented. |
| Percentage of Participants Meeting Relapse Criteria | 12 weeks after the last actual dose of study drug | Relapse was defined as hepatitis C virus ribonucleic acid (HCV RNA) less than 50 IU/mL at end of treatment or at the last on-treatment HCV RNA measurement followed by HCV RNA greater than or equal to 50 IU/mL post-treatment. |
Participant flow
Pre-assignment details
Safety population: all enrolled participants receiving at least 1 dose of the ABBVIE REGIMEN. The prescribed ABBVIE REGIMEN needed to be known. 314 participants enrolled; treatment start date was missing in 2 participants; 1 withdrew consent and no start of treatment was recorded.
Participants by arm
| Arm | Count |
|---|---|
| Participants With HCV Genotype 1 or 4 Ombitasvir/paritaprevir/ritonavir (two 12.5 mg/75 mg/50 mg co-formulated tablets once daily); ± dasabuvir (tablet; 250 mg twice daily); ± weight-based ribavirin (tablet; 1000 or 1200 mg divided twice a day) up to 24 weeks | 311 |
| Total | 311 |
Withdrawals & dropouts
| Period | Reason | FG000 |
|---|---|---|
| Overall Study | Death | 1 |
| Overall Study | Failure to return | 15 |
| Overall Study | Insufficient virological response | 3 |
| Overall Study | Other, not specified | 9 |
| Overall Study | Withdrew consent | 1 |
Baseline characteristics
| Characteristic | Participants With HCV Genotype 1 or 4 |
|---|---|
| Age, Continuous | 61 years STANDARD_DEVIATION 12 |
| Hepatitis C genotype Genotype 1a | 23 Participants |
| Hepatitis C genotype Genotype 1b | 225 Participants |
| Hepatitis C genotype Genotype 1, unknown subtype | 1 Participants |
| Hepatitis C genotype Genotype 4 | 62 Participants |
| Race/Ethnicity, Customized Arab, African | 1 Participants |
| Race/Ethnicity, Customized Arab North Africa | 1 Participants |
| Race/Ethnicity, Customized Asian/Oriental | 7 Participants |
| Race/Ethnicity, Customized Black | 47 Participants |
| Race/Ethnicity, Customized Egyptian | 1 Participants |
| Race/Ethnicity, Customized Moroccan | 1 Participants |
| Race/Ethnicity, Customized Native American/American Indian | 1 Participants |
| Race/Ethnicity, Customized North Africa Maghreb | 1 Participants |
| Race/Ethnicity, Customized North Africa, Maghreb | 1 Participants |
| Race/Ethnicity, Customized North African | 4 Participants |
| Race/Ethnicity, Customized Persian | 1 Participants |
| Race/Ethnicity, Customized White/Caucasian | 245 Participants |
| Sex: Female, Male Female | 147 Participants |
| Sex: Female, Male Male | 164 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk |
|---|---|---|---|---|
| deaths Total, all-cause mortality | 1 / 59 | 2 / 195 | 0 / 3 | 0 / 54 |
| other Total, other adverse events | 30 / 59 | 56 / 195 | 1 / 3 | 24 / 54 |
| serious Total, serious adverse events | 6 / 59 | 6 / 195 | 0 / 3 | 3 / 54 |
Outcome results
Percentage of Participants Achieving Sustained Virologic Response 12 Weeks Post-treatment (SVR12)
SVR12 was defined as hepatitis C virus ribonucleic acid (HCV RNA) level less than 50 IU/mL 12 weeks after the last actual dose of study drug. The core population (CP) consisted of participants who met all inclusion criteria and were adequately treated according to the standard of care and within local label recommendations for their specific disease characteristics (cirrhotic status, genotype). The core population with sufficient follow-up data 12 weeks after the last actual dose of study drug (CPSFU12) was defined as all CP participants who fulfilled one of the following criteria: * evaluable HCV RNA data ≥70 days after the last actual dose of the ABBVIE REGIMEN * an HCV RNA value ≥50 IU/mL at the last measurement post-baseline * HCV RNA \<50 IU/mL at the last measurement post-baseline, but no HCV RNA measurement ≥70 days after the last actual dose of the ABBVIE REGIMEN due to reasons related to safety (e.g. dropped out due to AE) or virologic failure
Time frame: 12 weeks after the last actual dose of study drug
Population: Core population (CP) and core population with sufficient follow-up data 12 weeks after the last actual dose of study drug (CPSFU12) are defined in the outcome measure description.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Participants With HCV Genotype 1 or 4 | Percentage of Participants Achieving Sustained Virologic Response 12 Weeks Post-treatment (SVR12) | Core population (CP) | 87.7 percentage of participants |
| Participants With HCV Genotype 1 or 4 | Percentage of Participants Achieving Sustained Virologic Response 12 Weeks Post-treatment (SVR12) | CPSFU12 | 93.8 percentage of participants |
Percentage of Participants Meeting Premature Study Drug Discontinuation Criteria
Premature study drug discontinuation was defined as participants who prematurely discontinued study drug with no on-treatment virologic failure.
Time frame: 12 weeks after the last actual dose of study drug
Population: Core population: Participants meeting all inclusion criteria and who were adequately treated according to the standard of care and within local label recommendations for their specific disease characteristics (cirrhotic status, genotype)
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Participants With HCV Genotype 1 or 4 | Percentage of Participants Meeting Premature Study Drug Discontinuation Criteria | 1.6 percentage of participants |
Percentage of Participants Meeting Relapse Criteria
Relapse was defined as hepatitis C virus ribonucleic acid (HCV RNA) less than 50 IU/mL at end of treatment or at the last on-treatment HCV RNA measurement followed by HCV RNA greater than or equal to 50 IU/mL post-treatment.
Time frame: 12 weeks after the last actual dose of study drug
Population: Core population: Participants meeting all inclusion criteria and who were adequately treated according to the standard of care and within local label recommendations for their specific disease characteristics (cirrhotic status, genotype)
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Participants With HCV Genotype 1 or 4 | Percentage of Participants Meeting Relapse Criteria | 1.9 percentage of participants |
Percentage of Participants With Missing Sustained Virologic Response 12 Weeks Post-Treatment (SVR12) Data and/or Nonresponders Who Did Not Meet Specific SVR12 Nonresponder Criteria
The number of participants with missing SVR12 data or SVR12 nonresponder participants who did not meet criteria for on-treatment virologic failure, relapse, premature treatment discontinuation, and who did not have an Insufficient virological response reported was documented.
Time frame: 12 weeks after the last actual dose of study drug
Population: Core population: Participants meeting all inclusion criteria and who were adequately treated according to the standard of care and within local label recommendations for their specific disease characteristics (cirrhotic status, genotype)
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Participants With HCV Genotype 1 or 4 | Percentage of Participants With Missing Sustained Virologic Response 12 Weeks Post-Treatment (SVR12) Data and/or Nonresponders Who Did Not Meet Specific SVR12 Nonresponder Criteria | 5.8 percentage of participants |
Percentage of Participants With On-treatment Virologic Failure
On-treatment virologic failure was defined as breakthrough (at least 1 documented hepatitis C virus ribonucleic acid (HCV RNA) less than 50 IU/mL followed by HCV RNA greater than or equal to 50 IU/mL during treatment) or failure to suppress (each measured on-treatment HCV RNA value greater than or equal to 50 IU/mL).
Time frame: 12 weeks after the last actual dose of study drug
Population: Core population: Participants meeting all inclusion criteria and who were adequately treated according to the standard of care and within local label recommendations for their specific disease characteristics (cirrhotic status, genotype)
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Participants With HCV Genotype 1 or 4 | Percentage of Participants With On-treatment Virologic Failure | 1.6 percentage of participants |
Percentage of Participants With Relapse
Relapse was defined as hepatitis C virus ribonucleic acid (HCV RNA) level less than 50 IU/mL at the end of treatment followed by HCV RNA level greater than or equal to 50 IU/mL.
Time frame: Up to 48 weeks after the last actual dose of study drug
Population: Participants meeting inclusion criteria, treated according to standard of care and within local label recommendations for their specific disease characteristics (cirrhotic status, genotype), with virologic response at end of treatment (EOT), completing Tx with ≥ 1 HCV RNA measurement ≥ 70 days post Tx or were a Tx failure between EOT and day 70
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Participants With HCV Genotype 1 or 4 | Percentage of Participants With Relapse | 2.3 percentage of participants |
Percentage of Participants With Viral Breakthrough
Viral breakthrough was defined as at least 1 documented hepatitis C virus ribonucleic acid (HCV RNA) level less than 50 IU/mL followed by HCV RNA level greater than or equal to 50 IU/mL during treatment.
Time frame: Up to 24 weeks
Population: Core population (those meeting inclusion criteria and treated according to the standard of care and w/in local label guidelines for specific disease characteristics \[cirrhotic status, genotype\]) who had at least 1 undetectable or unquantifiable, on-treatment HCV RNA measurement and at least 1 on-treatment or end of treatment measurement thereafter
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Participants With HCV Genotype 1 or 4 | Percentage of Participants With Viral Breakthrough | 0.3 percentage of participants |
Percentage of Participants With Virologic Response at End of Treatment (EoT)
Virologic response was defined as hepatitis C virus ribonucleic acid (HCV RNA) level less than 50 IU/mL at the end of treatment.
Time frame: Up to 24 weeks
Population: Core population: Participants meeting all inclusion criteria and who were adequately treated according to the standard of care and within local label recommendations for their specific disease characteristics (cirrhotic status, genotype)
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Participants With HCV Genotype 1 or 4 | Percentage of Participants With Virologic Response at End of Treatment (EoT) | 92.9 percentage of participants |