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A Study to Evaluate the Efficacy and Safety of Glecaprevir/Pibrentasvir in Adults With Chronic Hepatitis C Virus Genotype 1 - 6 Infection and Renal Impairment

Phase 3
Completed
Conditions
Hepatitis C Virus (HCV)
Interventions
Drug: Glecaprevir/pibrentasvir
Registration Number
NCT03069365
Lead Sponsor
AbbVie
Brief Summary

This was a Phase 3b, open-label, non-randomized, multicenter study to evaluate the efficacy and safety of glecaprevir/pibrentasvir (GLE/PIB) in participants with chronic hepatitis C virus (HCV) genotype (GT) 1 - 6 infection without liver cirrhosis or with compensated liver cirrhosis and with chronic renal impairment in participants who were either HCV treatment-naïve (TN) or prior treatment-experienced (TE) with interferon (IFN) or pegylated interferon (PegIFN) with or without ribavirin (RBV), or sofosbuvir (SOF) plus RBV with or without pegIFN.

Detailed Description

The study included a 42-day screening period, a treatment period of either 8, 12, or 16 weeks, and a 24-week post-treatment period. The duration of treatment was determined by product labeling. Participants received glecaprevir/pibrentasvir (GLE/PIB) 300 mg/120 mg once daily. Participants who completed or prematurely discontinued the treatment period were followed for 24 weeks after their last dose of study drug to monitor safety, hepatitis C virus ribonucleic acid (HCV RNA), and the emergence and persistence of viral substitutions.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
101
Inclusion Criteria
  • Male or female (of non-childbearing potential or using allowed contraceptive methods) at least 18 years of age time of Screening
  • Participant had a positive anti-hepatitis C virus (HCV) antibody (Ab) and plasma HCV ribonucleic acid (RNA) greater than or equal to 1000 IU/mL at the Screening Visit.
  • Participant had an estimated glomerular filtration rate (eGFR) less than 45 mL/min/1.73 m^2 as estimated by the Modification of Diet in Renal Disease (MDRD) method at Screening according to the following formula: eGFR (mL/min/1.73 m^2 ) = 175 × (Serum Creatinine) ^-1.154 × Age^-0.203 × (0.742 if female) × (1.212 if black), or were dialysis dependent. Subjects requiring dialysis had to have been receiving dialysis for at least 1 month prior to enrollment, and may have been on hemodialysis or peritoneal dialysis.
  • Cirrhotic participants only: absence of hepatocellular carcinoma (HCC) as indicated by a negative ultrasound, computed tomography (CT) scan, or magnetic resonance imaging (MRI) within 3 months prior to Screening or a negative ultrasound at Screening. Participants who had an ultrasound with results suspicious of HCC followed by a subsequent negative CT or MRI of the liver were eligible for the study.
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Exclusion Criteria
  • Female participants who were pregnant, breastfeeding, or were considering becoming pregnant during the study or for approximately 30 days after the last dose of study drug
  • Current hepatitis B virus (HBV) or human immunodeficiency virus (HIV) infection on screening tests, defined as:
  • Positive test result at Screening for hepatitis B surface antigen (HBsAg), or;
  • HBV deoxyribonucleic acid (DNA) greater than lower limit of quantification (LLOQ) in participants with isolated positive hepatitis B core antibody (HBcAb), (i.e., negative HBsAg and Anti-HBsAg), or;
  • Positive anti-HIV antibody (Ab).
  • Any current or historical clinical evidence of decompensated cirrhosis, including any current or past evidence of Child-Pugh B or C classification, hepatic encephalopathy or variceal bleeding; radiographic evidence of small ascites; or prior or current empiric use of lactulose/rifaximin for neurologic indications. Prophylactic use of beta blockers was not exclusionary.
  • Clinical history of acute renal failure in the 3 months prior to Screening
  • History of severe, life-threatening, or other significant sensitivity to any excipients of the study drugs
  • Clinically significant abnormalities or co-morbidities, or recent (within 6 months prior to study drug administration) alcohol or drug abuse that could preclude adherence to the protocol in the opinion of the investigator
  • Receipt of any investigational or commercially available direct acting anti-HCV agents other than sofosbuvir
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Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
GLE/PIB for 12 weeksGlecaprevir/pibrentasvirHCV genotype 1,2,4-6 compensated cirrhosis, treatment-naive or treatment-experienced; genotype 3 compensated cirrhosis, treatment- naïve participants treated with glecaprevir/pibrentasvir (GLE/PIB): three 100 mg/40 mg co-formulated tablets once daily with food for 12 weeks
GLE/PIB for 16 weeksGlecaprevir/pibrentasvirHCV genotype 3 non-cirrhotic or with compensated cirrhosis, treatment-experienced participants treated with glecaprevir/pibrentasvir (GLE/PIB): three 100 mg/40 mg co-formulated tablets once daily with food for 16 weeks
GLE/PIB for 8 weeksGlecaprevir/pibrentasvirHCV genotype 1,2,4-6 non-cirrhotic, treatment-naive or treatment-experienced; genotype 3 non-cirrhotic, treatment-naïve participants treated with glecaprevir/pibrentasvir (GLE/PIB): three 100 mg/40 mg co-formulated tablets once daily with food for 8 weeks
Primary Outcome Measures
NameTimeMethod
Percentage of Participants Achieving Sustained Virologic Response 12 Weeks Post Dosing (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 the lower limit of quantification (LLOQ) 12 weeks after the last actual dose of study drug.

Secondary Outcome Measures
NameTimeMethod
Percentage of Participants With On-treatment Virologic FailureUp to 16 weeks

On-treatment virologic failure was defined as:

* Confirmed increase from nadir in hepatitis C virus ribonucleic acid (HCV RNA) defined as confirmed increase of \> 1 log (subscript)10(subscript) IU/mL above nadir during treatment; or

* Confirmed HCV RNA greater than or equal to 100 IU/mL after HCV RNA less than the lower limit of quantification (LLOQ) during study drug treatment; or

* HCV RNA ≥ LLOQ at the end of treatment with at least 6 weeks of treatment

Percentage of Participants With Post-treatment RelapseUp to 12 weeks after the last dose of study drug

Post-treatment relapse was defined as confirmed hepatitis C virus ribonucleic acid (HCV RNA) ≥ the lower limit of quantification (LLOQ) between the end of treatment and 12 weeks after the last dose of study drug among participants who completed treatment as planned with HCV RNA \< LLOQ at the end of treatment and had post-treatment HCV RNA data; participants who had been shown to be reinfected were not considered to have relapsed.

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Trial Locations

Locations (38)

Northwest Louisiana Nephrology /ID# 160652

🇺🇸

Shreveport, Louisiana, United States

Univ Johannes Gutenberg /ID# 160828

🇩🇪

Mainz, Germany

School of Medicine University of Puerto Rico-Medical Sciences Campus /ID# 160755

🇵🇷

San Juan, Puerto Rico

Hospital Parc de Salut del Mar /ID# 159975

🇪🇸

Barcelona, Spain

Hospital Regional de Malaga /ID# 159976

🇪🇸

Málaga, Malaga, Spain

VA Caribbean Healthcare System /ID# 160754

🇵🇷

San Juan, Puerto Rico

Karolinska Uni /ID# 159523

🇸🇪

Stockholm, Sweden

Uniwersytecki Szpital Kliniczn /ID# 161081

🇵🇱

Bialystok, Poland

Hospital Universitario Doce de /ID# 159974

🇪🇸

Madrid, Spain

Huntington Medical Foundation /ID# 160653

🇺🇸

Pasadena, California, United States

Tampa General Medical Group /ID# 159115

🇺🇸

Tampa, Florida, United States

Scripps Clinic /ID# 159116

🇺🇸

La Jolla, California, United States

Massachusetts General Hospital /ID# 159114

🇺🇸

Boston, Massachusetts, United States

North Shore University Hospital /ID# 159108

🇺🇸

New Hyde Park, New York, United States

Carolinas Medical Center /ID# 159113

🇺🇸

Charlotte, North Carolina, United States

Columbia Univ Medical Center /ID# 159112

🇺🇸

New York, New York, United States

University of Pennsylvania /ID# 159117

🇺🇸

Philadelphia, Pennsylvania, United States

Thomas Jefferson University /ID# 159754

🇺🇸

Philadelphia, Pennsylvania, United States

TX Liver Inst, Americ Res Corp /ID# 159111

🇺🇸

San Antonio, Texas, United States

Zeidler Ledcor Centre /ID# 160600

🇨🇦

Edmonton, Alberta, Canada

GIRI Gastrointestinal Research Institute /ID# 160599

🇨🇦

Vancouver, British Columbia, Canada

Vancouver ID Research and Care /ID# 160598

🇨🇦

Vancouver, British Columbia, Canada

Toronto General Hospital /ID# 160601

🇨🇦

Toronto, Ontario, Canada

Med Hochschule Hanover /ID# 160827

🇩🇪

Hannover, Germany

Universitatsklinikum Mannheim /ID# 160829

🇩🇪

Mannheim, Baden-Wuerttemberg, Germany

Universitätsklinikum Frankfurt /ID# 160826

🇩🇪

Frankfurt am Main, Hessen, Germany

Gen Univ Hosp Alexandroupolis /ID# 160724

🇬🇷

Alexandroupolis, Greece

General Hospital of Athens Laiko /ID# 160725

🇬🇷

Athens, Attiki, Greece

General Hospital of Athens Evaggelismos and Ophthalmiatrio of Athens Polyclinic /ID# 160726

🇬🇷

Athens, Greece

Bioclinic Thessaloniki /ID# 160723

🇬🇷

Thessaloniki, Greece

Policlinico A. Gemelli /ID# 160719

🇮🇹

Roma, Lazio, Italy

Policlinico Paolo Giaccone /Id# 160718

🇮🇹

Palermo, Sicilia, Italy

Hanyang University Seoul Hospi /ID# 160259

🇰🇷

Seongdong, Seoul Teugbyeolsi, Korea, Republic of

A.O. Uni Giovanni e Ruggi /ID# 160720

🇮🇹

Salerno, Italy

Severance Hospital /ID# 160261

🇰🇷

Seoul, Seoul Teugbyeolsi, Korea, Republic of

Asan Medical Center /ID# 160260

🇰🇷

Seoul, Korea, Republic of

HepID - Diagnostyka I Terapia /ID# 161083

🇵🇱

Lublin, Lubelskie, Poland

A.O.U. Policlinico S.Orsola-Malpighi /ID# 163349

🇮🇹

Bologna, Emilia-Romagna, Italy

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