Hepatitis C Virus (HCV)
Conditions
Keywords
chronic hepatitis C virus (HCV), Hepatitis, HCV genotype, aspartate aminotransferase, platelet, Aspartate aminotransferase to Platelet Ratio Index (APRI), glecaprevir, pibrentasvir, Sustained Virologic Response 12 weeks post dosing (SVR12)
Brief summary
A study to evaluate the efficacy and safety of glecaprevir(GLE)/pibrentasvir(PIB) in treatment-naïve participants with chronic hepatitis C virus (HCV) genotypes 1-6 infection and with an aspartate aminotransferase to platelet ratio index (APRI) of less than or equal to 1.
Interventions
Glecaprevir/pibrentasvir 100 mg/40 mg co-formulated tablets taken orally as 3 tablets once a day.
Sponsors
Study design
Eligibility
Inclusion criteria
* Hepatitis C virus (HCV) genotype (GT) 1, 2, 3, 4, 5, or 6 infection. Mixed GT and indeterminate GT may be acceptable. * Aspartate aminotransferase (AST) to platelet ratio index (APRI) score of less than or equal to 1, at time of screening. * Does not have current active hepatitis B virus infection defined as: * positive hepatitis B surface antigen (HBsAg), OR * hepatitis B virus (HBV) deoxyribonucleic acid (DNA) \> lower limit of quantification (LLOQ) in subjects with isolated positive anti-hepatitis B core (HBc) (i.e., negative HBsAg and anti-hepatitis B surface\[HBs\]) * Platelets ≥ 150,000 cells/mm³ * Albumin ≥ lower limit of normal (LLN) * Positive anti-HCV antibody (Ab) AND plasma HCV ribonucleic acid (RNA) viral load ≥ 1,000 IU/mL at Screening and for at least 6 months before Screening. * No past history/evidence of cirrhosis. * No history of hepatocellular carcinoma. * Hepatitis C virus treatment-naïve (had not received a single dose of any approved or investigational anti-HCV medication). * If female, the subject must not be pregnant, breastfeeding, or considering becoming pregnant during the study and for 30 days after the last dose of study drug.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants in the Modified Intention-to-Treat Population With Sustained Virologic Response 12 Weeks Post-treatment (SVR12) | 12 weeks after the last actual dose of study drug, Week 20 | SVR12 was defined as plasma hepatitis C virus ribonucleic acid (HCV RNA) level less than the lower limit of quantification (LLOQ; 15 IU/mL) 12 weeks after the last dose of study drug. The 95% confidence interval (95%CI) was calculated using the Wilson's score method. Efficacy was to be established if the lower bound of the 95%CI was greater than the threshold of 92.4%, based on the historical rate observed in glecaprevir/pibrentasvir registrational studies in treatment-naïve, non-cirrhotic patients (98.4%) minus a margin of 6%. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants in the Intention-to-Treat Population With SVR12 | 12 weeks after the last actual dose of study drug, Week 20 | SVR12 was defined as plasma hepatitis C virus ribonucleic acid (HCV RNA) level less than the LLOQ (15 IU/mL) 12 weeks after the last dose of study drug. The 95% confidence interval was calculated using the normal approximation to the binomial distribution. Efficacy was to be established if the lower bound of the 95%CI was greater than the threshold of 91.4%, based on the mITT threshold minus an expected 1% rate of non-virological SVR failures. |
| Percentage of Participants With On-treatment Virologic Failure | Up to 8 weeks | On-treatment virologic failure was defined as one of the following conditions: * confirmed HCV RNA ≥ 100 IU/mL after HCV RNA \< 15 IU/mL during the Treatment Period; or * confirmed increase from nadir in HCV RNA (two consecutive HCV RNA measurements \> 1 log₁₀ IU/mL above nadir) at any time point during the Treatment Period; or * HCV RNA ≥ 15 IU/mL at end of treatment with at least 6 weeks of treatment, where the HCV RNA value must be collected on or after Study Drug Day 36 and study drug duration ≥ 36 days. |
| Percentage of Participants With Post-treatment Relapse | From the end of treatment (Week 8) through 12 weeks after the last dose of study drug (Week 20) | Post-treatment relapse was defined as confirmed HCV RNA ≥ LLOQ between the end of treatment and 12 weeks after the last dose of study drug among participants who completed treatment with HCV RNA levels \< LLOQ at the end of treatment. |
Countries
Bulgaria, Canada, France, Germany, Poland, Puerto Rico, Russia, Spain, United Kingdom, United States
Participant flow
Recruitment details
Participants were enrolled at 40 sites in Bulgaria, Canada, France, Germany, Poland, Russian Federation, Spain, United Kingdom, and the United States (including Puerto Rico).
Participants by arm
| Arm | Count |
|---|---|
| Glecaprevir/Pibrentasvir Participants received oral glecaprevir/pibrentasvir (300 mg/120 mg) once daily with food for 8 weeks. | 230 |
| Total | 230 |
Withdrawals & dropouts
| Period | Reason | FG000 |
|---|---|---|
| Overall Study | Adverse Event | 1 |
| Overall Study | Lost to Follow-up | 4 |
| Overall Study | Other | 1 |
| Overall Study | Withdrawal by Subject | 1 |
Baseline characteristics
| Characteristic | Glecaprevir/Pibrentasvir |
|---|---|
| Age, Continuous | 48 years |
| Aminotransferase/Platelet Ratio Index (APRI) | 0.41 ratio |
| Ethnicity (NIH/OMB) Hispanic or Latino | 25 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 205 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants |
| HCV Ribonucleic Acid (RNA) Concentration | 6.29 Log₁₀ IU/mL |
| Hepatitis C Virus (HCV) Genotype Genotype 1 | 151 Participants |
| Hepatitis C Virus (HCV) Genotype Genotype 2 | 33 Participants |
| Hepatitis C Virus (HCV) Genotype Genotype 3 | 35 Participants |
| Hepatitis C Virus (HCV) Genotype Genotype 4 | 9 Participants |
| Hepatitis C Virus (HCV) Genotype Genotype 5 | 0 Participants |
| Hepatitis C Virus (HCV) Genotype Genotype 6 | 2 Participants |
| Race/Ethnicity, Customized Asian | 10 Participants |
| Race/Ethnicity, Customized Black or African American | 13 Participants |
| Race/Ethnicity, Customized White | 207 Participants |
| Sex: Female, Male Female | 113 Participants |
| Sex: Female, Male Male | 117 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 0 / 230 |
| other Total, other adverse events | 46 / 230 |
| serious Total, serious adverse events | 4 / 230 |
Outcome results
Percentage of Participants in the Modified Intention-to-Treat Population With Sustained Virologic Response 12 Weeks Post-treatment (SVR12)
SVR12 was defined as plasma hepatitis C virus ribonucleic acid (HCV RNA) level less than the lower limit of quantification (LLOQ; 15 IU/mL) 12 weeks after the last dose of study drug. The 95% confidence interval (95%CI) was calculated using the Wilson's score method. Efficacy was to be established if the lower bound of the 95%CI was greater than the threshold of 92.4%, based on the historical rate observed in glecaprevir/pibrentasvir registrational studies in treatment-naïve, non-cirrhotic patients (98.4%) minus a margin of 6%.
Time frame: 12 weeks after the last actual dose of study drug, Week 20
Population: The modified intention-to-treat (mITT) population includes all enrolled participants who received at least 1 dose of study drug, excluding participants who did not achieve SVR12 for reasons other than virologic failure, such as missing SVR12 data (5 participants) or premature study drug discontinuation (3 participants).
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Glecaprevir/Pibrentasvir | Percentage of Participants in the Modified Intention-to-Treat Population With Sustained Virologic Response 12 Weeks Post-treatment (SVR12) | 100.0 percentage of participants |
Percentage of Participants in the Intention-to-Treat Population With SVR12
SVR12 was defined as plasma hepatitis C virus ribonucleic acid (HCV RNA) level less than the LLOQ (15 IU/mL) 12 weeks after the last dose of study drug. The 95% confidence interval was calculated using the normal approximation to the binomial distribution. Efficacy was to be established if the lower bound of the 95%CI was greater than the threshold of 91.4%, based on the mITT threshold minus an expected 1% rate of non-virological SVR failures.
Time frame: 12 weeks after the last actual dose of study drug, Week 20
Population: The intention-to-treat (ITT) population included all enrolled participants who received at least 1 dose of study drug.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Glecaprevir/Pibrentasvir | Percentage of Participants in the Intention-to-Treat Population With SVR12 | 96.5 percentage of participants |
Percentage of Participants With On-treatment Virologic Failure
On-treatment virologic failure was defined as one of the following conditions: * confirmed HCV RNA ≥ 100 IU/mL after HCV RNA \< 15 IU/mL during the Treatment Period; or * confirmed increase from nadir in HCV RNA (two consecutive HCV RNA measurements \> 1 log₁₀ IU/mL above nadir) at any time point during the Treatment Period; or * HCV RNA ≥ 15 IU/mL at end of treatment with at least 6 weeks of treatment, where the HCV RNA value must be collected on or after Study Drug Day 36 and study drug duration ≥ 36 days.
Time frame: Up to 8 weeks
Population: Intention-to-treat population
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Glecaprevir/Pibrentasvir | Percentage of Participants With On-treatment Virologic Failure | 0.0 percentage of participants |
Percentage of Participants With Post-treatment Relapse
Post-treatment relapse was defined as confirmed HCV RNA ≥ LLOQ between the end of treatment and 12 weeks after the last dose of study drug among participants who completed treatment with HCV RNA levels \< LLOQ at the end of treatment.
Time frame: From the end of treatment (Week 8) through 12 weeks after the last dose of study drug (Week 20)
Population: Intention-to-treat population with HCV RNA \< 15 IU/mL at the end of treatment, at least one post-treatment HCV RNA value, and who completed the assigned treatment.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Glecaprevir/Pibrentasvir | Percentage of Participants With Post-treatment Relapse | 0.0 percentage of participants |