Chronic Hepatitis C
Conditions
Keywords
Paritaprevir/r - Ombitasvir, ± Dasabuvir, Sustained Virological Response, Chronic Hepatitis C genotype 4, Observational Study, Chronic Hepatitis C genotype 1, Chronic Hepatitis C
Brief summary
The interferon-free combination regimen of paritaprevir/r - ombitasvir 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 is the first effectiveness research examining the ABBVIE REGIMEN ± RBV, used according to local label, under real world conditions in Kuwait in a clinical practice patient population.
Interventions
None listed
Sponsors
Study design
Eligibility
Inclusion criteria
* Treatment-naïve or -experienced adult male or female participants with confirmed CHC, genotype 1 or 4, receiving combination therapy with the interferon-free ABBVIE REGIMEN ± RBV according to standard of care and in line with the current local label. * If RBV is co-administered with the ABBVIE REGIMEN, it has been prescribed in line with the current local label (with special attention to contraception requirements and contraindication during pregnancy). * Participant must not be participating or intending to participate in a concurrent interventional therapeutic trial.
Exclusion criteria
* Participant must not be participating or attending in a concurrent interventional therapeutic trial.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants Achieving Sustained Virological Response 12 Weeks Post-treatment (SVR12) | 12 weeks (i.e. at least 70 days) after the last dose of study drug | SVR12 defined as the HCV ribonucleic acid (RNA) level less than 50 IU/mL 12 weeks after the last dose of study drug |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants With Relapse at EoT | Up to EoT, maximum of 24 weeks | Relapse defined as HCV RNA less than 50 IU/mL at EoT followed by HCV RNA greater than or equal to 50 IU/mL. |
| Percentage of Participants With Breakthrough. | Up to EoT, maximum of 24 weeks | Breakthrough defined as at least 1 documented HCV RNA less than 50 IU/mL followed by HCV RNA greater than or equal to 50 IU/mL during treatment. |
| Percentage of Participants Meeting the SVR Non-response Categories of On-treatment Virologic Failure or Relapse | 12 weeks (i.e. at least 70 days) after the last dose of study drug | On-treatment virologic failure defined as breakthrough (at least 1 documented 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). Relapse (defined as HCV RNA \<50 IU/mL at EoT or at the last on-treatment HCV RNA measurement followed by HCV RNA ≥50 IU/mL post-treatment). |
| Percentage of Participants Meeting the SVR Non-response Categories of Premature Study Drug Discontinuation or Missing SVR12 Data and/or None of the Above Criteria | 12 weeks (i.e. at least 70 days) after the last dose of study drug | Premature study drug discontinuation category is defined as participants who prematurely discontinued study drug and who experienced no on-treatment virologic failure. The final SVR non-response category was defined as missing SVR12 data and/or none of the above criteria. |
| Percentage of Participants With Virological Response at End of Treatment (EoT) | Up to EoT, maximum of 24 weeks | Virological response defined as HCV RNA level less than 50 IU/mL. |
| Adherence to RBV: Percentage of RBV Dose Taken in Relation to the Target Dose of RBV | Up to 48 weeks | Percentage of the RBV dose taken in relation to the target dose of RBV (cumulative dose taken divided by target dose in percent), presented as the number of participants taking \> 95% to ≤ 105% of the target dose and those taking \> 80% to ≤ 95% of the target dose. |
| Adherence: Percentage of Planned Duration of RBV Taken by Participant | Up to 48 weeks | — |
| Change From Baseline in the PAM-13 Questionnaire | Up to 48 weeks | The PAM-13 item scale is a measure used to assess the patient knowledge, skill, and confidence for self-management. Each of the 13 items can be answered with one of four possible response options, which are disagree strongly (1), disagree (2), agree (3), agree strongly (4). Based on responses to the 13-item measure, the score is calculated by adding up the raw scores (range of the sum: 13 - 52) and mapping up the value onto a scale of 0-100 indicating strength of agreement with the 13 items. A higher score indicates that the patient is likely to participate more actively in health care processes and takes more responsibility for his or her health. |
| Patient Support Program (PSP) Questionnaire: Utilization of PSP Components | Up to EoT, maximum of 24 weeks | Percentage of participants using each component of the PSP, including personal support, educational and information material (printed, online) and additional digital and mobile resources (web-portal, app, and reminders). |
| Adherence to ABBVIE Regimen: Percentage of the Direct-acting Antiviral (DAA) Dose Taken in Relation to the Target Dose of DAA | Up to 48 weeks | Percentage of the DAA dose taken in relation to the target dose of DAA (cumulative dose taken divided by target dose in percent), presented as the number of participants taking \> 95% to ≤ 105% of the target dose and those taking \> 80% to ≤ 95% of the target dose. |
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Participants With HCV Genotype 1 or 4 Participants with HCV genotype 1 or 4 receiving paritaprevir/r - ombitasvir with or without dasabuvir (ABBVIE REGIMEN) ± RBV. | 40 |
| Total | 40 |
Withdrawals & dropouts
| Period | Reason | FG000 |
|---|---|---|
| Overall Study | Failure to return | 1 |
Baseline characteristics
| Characteristic | Participants With HCV Genotype 1 or 4 |
|---|---|
| Age, Continuous | 49 years STANDARD_DEVIATION 13.9 |
| Patient Activation Measure 13 (PAM-13) | 55.0 units on a scale |
| Race/Ethnicity, Customized Other (Not Specified) | 40 Participants |
| Sex: Female, Male Female | 20 Participants |
| Sex: Female, Male Male | 20 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 0 / 40 |
| other Total, other adverse events | 4 / 40 |
| serious Total, serious adverse events | 0 / 40 |
Outcome results
Percentage of Participants Achieving Sustained Virological Response 12 Weeks Post-treatment (SVR12)
SVR12 defined as the HCV ribonucleic acid (RNA) level less than 50 IU/mL 12 weeks after the last dose of study drug
Time frame: 12 weeks (i.e. at least 70 days) after the last dose of study drug
Population: Core population: all participants 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 Achieving Sustained Virological Response 12 Weeks Post-treatment (SVR12) | 100 percentage of participants |
Adherence: Percentage of Planned Duration of RBV Taken by Participant
Time frame: Up to 48 weeks
Population: Core population: all participants who were adequately treated according to the standard of care and within local label recommendations for their specific disease characteristics (cirrhotic status, genotype) and were prescribed RBV.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Participants With HCV Genotype 1 or 4 | Adherence: Percentage of Planned Duration of RBV Taken by Participant | 101.0 percentage of planned duration of RBV | Standard Deviation 2 |
Adherence to ABBVIE Regimen: Percentage of the Direct-acting Antiviral (DAA) Dose Taken in Relation to the Target Dose of DAA
Percentage of the DAA dose taken in relation to the target dose of DAA (cumulative dose taken divided by target dose in percent), presented as the number of participants taking \> 95% to ≤ 105% of the target dose and those taking \> 80% to ≤ 95% of the target dose.
Time frame: Up to 48 weeks
Population: Core population: all participants 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 | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Participants With HCV Genotype 1 or 4 | Adherence to ABBVIE Regimen: Percentage of the Direct-acting Antiviral (DAA) Dose Taken in Relation to the Target Dose of DAA | > 95% to ≤ 105% of target dose | 38 Participants |
| Participants With HCV Genotype 1 or 4 | Adherence to ABBVIE Regimen: Percentage of the Direct-acting Antiviral (DAA) Dose Taken in Relation to the Target Dose of DAA | > 80% to ≤ 95% of target dose | 1 Participants |
Adherence to RBV: Percentage of RBV Dose Taken in Relation to the Target Dose of RBV
Percentage of the RBV dose taken in relation to the target dose of RBV (cumulative dose taken divided by target dose in percent), presented as the number of participants taking \> 95% to ≤ 105% of the target dose and those taking \> 80% to ≤ 95% of the target dose.
Time frame: Up to 48 weeks
Population: Core population: all participants who were adequately treated according to the standard of care and within local label recommendations for their specific disease characteristics (cirrhotic status, genotype) and were prescribed RBV.
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Participants With HCV Genotype 1 or 4 | Adherence to RBV: Percentage of RBV Dose Taken in Relation to the Target Dose of RBV | > 95% to ≤ 105% of target dose | 32 Participants |
| Participants With HCV Genotype 1 or 4 | Adherence to RBV: Percentage of RBV Dose Taken in Relation to the Target Dose of RBV | > 80% to ≤ 95% of target dose | 1 Participants |
Change From Baseline in the PAM-13 Questionnaire
The PAM-13 item scale is a measure used to assess the patient knowledge, skill, and confidence for self-management. Each of the 13 items can be answered with one of four possible response options, which are disagree strongly (1), disagree (2), agree (3), agree strongly (4). Based on responses to the 13-item measure, the score is calculated by adding up the raw scores (range of the sum: 13 - 52) and mapping up the value onto a scale of 0-100 indicating strength of agreement with the 13 items. A higher score indicates that the patient is likely to participate more actively in health care processes and takes more responsibility for his or her health.
Time frame: Up to 48 weeks
Population: Core population: all participants who were adequately treated according to the standard of care and within local label recommendations for their specific disease characteristics (cirrhotic status, genotype) and contributed to the PAM-13.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Participants With HCV Genotype 1 or 4 | Change From Baseline in the PAM-13 Questionnaire | 7.60 units on a scale |
Patient Support Program (PSP) Questionnaire: Utilization of PSP Components
Percentage of participants using each component of the PSP, including personal support, educational and information material (printed, online) and additional digital and mobile resources (web-portal, app, and reminders).
Time frame: Up to EoT, maximum of 24 weeks
Population: Core population: all participants who were adequately treated according to the standard of care and within local label recommendations for their specific disease characteristics (cirrhotic status, genotype) and who participated int he PSP.
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Participants With HCV Genotype 1 or 4 | Patient Support Program (PSP) Questionnaire: Utilization of PSP Components | Additional resources - app | 6 Participants |
| Participants With HCV Genotype 1 or 4 | Patient Support Program (PSP) Questionnaire: Utilization of PSP Components | Additional resources - reminders | 2 Participants |
| Participants With HCV Genotype 1 or 4 | Patient Support Program (PSP) Questionnaire: Utilization of PSP Components | Personal support | 28 Participants |
| Participants With HCV Genotype 1 or 4 | Patient Support Program (PSP) Questionnaire: Utilization of PSP Components | Educational/information material - printed | 24 Participants |
| Participants With HCV Genotype 1 or 4 | Patient Support Program (PSP) Questionnaire: Utilization of PSP Components | Educational/information material - online | 6 Participants |
| Participants With HCV Genotype 1 or 4 | Patient Support Program (PSP) Questionnaire: Utilization of PSP Components | Additional resources - web portal | 3 Participants |
Percentage of Participants Meeting the SVR Non-response Categories of On-treatment Virologic Failure or Relapse
On-treatment virologic failure defined as breakthrough (at least 1 documented 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). Relapse (defined as HCV RNA \<50 IU/mL at EoT or at the last on-treatment HCV RNA measurement followed by HCV RNA ≥50 IU/mL post-treatment).
Time frame: 12 weeks (i.e. at least 70 days) after the last dose of study drug
Population: Core population: all participants 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 | Group | Value (NUMBER) |
|---|---|---|---|
| Participants With HCV Genotype 1 or 4 | Percentage of Participants Meeting the SVR Non-response Categories of On-treatment Virologic Failure or Relapse | On-treatment virologic failure | 0 percentage of participants |
| Participants With HCV Genotype 1 or 4 | Percentage of Participants Meeting the SVR Non-response Categories of On-treatment Virologic Failure or Relapse | Relapse | 0 percentage of participants |
Percentage of Participants Meeting the SVR Non-response Categories of Premature Study Drug Discontinuation or Missing SVR12 Data and/or None of the Above Criteria
Premature study drug discontinuation category is defined as participants who prematurely discontinued study drug and who experienced no on-treatment virologic failure. The final SVR non-response category was defined as missing SVR12 data and/or none of the above criteria.
Time frame: 12 weeks (i.e. at least 70 days) after the last dose of study drug
Population: Core population: all participants 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 | Group | Value (NUMBER) |
|---|---|---|---|
| Participants With HCV Genotype 1 or 4 | Percentage of Participants Meeting the SVR Non-response Categories of Premature Study Drug Discontinuation or Missing SVR12 Data and/or None of the Above Criteria | Premature study drug discontinuation | 0 percentage of participants |
| Participants With HCV Genotype 1 or 4 | Percentage of Participants Meeting the SVR Non-response Categories of Premature Study Drug Discontinuation or Missing SVR12 Data and/or None of the Above Criteria | Missing SVR12 data / other | 0 percentage of participants |
Percentage of Participants With Breakthrough.
Breakthrough defined as at least 1 documented HCV RNA less than 50 IU/mL followed by HCV RNA greater than or equal to 50 IU/mL during treatment.
Time frame: Up to EoT, maximum of 24 weeks
Population: Core population: all participants 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 Breakthrough. | 0 percentage of participants |
Percentage of Participants With Relapse at EoT
Relapse defined as HCV RNA less than 50 IU/mL at EoT followed by HCV RNA greater than or equal to 50 IU/mL.
Time frame: Up to EoT, maximum of 24 weeks
Population: Core population: all participants 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 Relapse at EoT | 0 percentage of participants |
Percentage of Participants With Virological Response at End of Treatment (EoT)
Virological response defined as HCV RNA level less than 50 IU/mL.
Time frame: Up to EoT, maximum of 24 weeks
Population: Core population: all participants 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 Virological Response at End of Treatment (EoT) | 100 percentage of participants |