EXPEDITION-V Study: GLE/PIB in patients with renal impairment

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Presentation transcript:

EXPEDITION-V Study: GLE/PIB in patients with renal impairment Design No randomisation Open label W8 W12 W16 ≥ 18 years, HCV genotype 1-6 HCV RNA > 1 000 IU/mL Treatment-naïve (TN) or treatment-experienced (TE) without DAA except SOF With or without cirrhosis Chronic kidney disease stage 3b, 4 or 5 * No HBV or HIV co-infection N = 84 GLE/PIB N = 13 GLE/PIB N = 4 GLE/PIB 8W: no cirrhosis, TN (GT 1 to 6) or TE (GT 1,2, 4,-6 12W: cirrhosis, TN (GT 1 to 6) or TE (GT 1,2, 4,-6) 16W: TE, GT3 * stage 3b: eGFR ≥ 30 to < 45 mL/min/1.73m² ; stage 4: eGFR ≥ 15 to < 30 mL ; stage 5: eGFR<15 mL or dialysis-dependent GLE/PIB: 100/40 mg 3 tablets QD, administered regardless of timing of dialysis (hemo- or peritoneal) Primary endpoint SVR12 (HCV < LLOQ) EXPEDITION-V Persico N. EASL 2018, Abs. THU-363 1

EXPEDITION-V Study: GLE/PIB in patients with renal impairment Baseline characteristics GLE/PIB 8W N = 84 GLE/PIB 12W N = 13 GLE/PIB 16W N = 4 Median age, years (range) 59 (32-84) 58 (49-87) 62 (54-70) Male, N (%) 51 (61%) 7 (54%) 2 (50%) Race: White, N (%) 62 (74%) 8 (62%) 4(100%) Median BMI, kg/m2 (range) 24.9 (16.8-53.5) 28.7 (17.1-41.1) 24.3 (17.7-26.8) Genotype: 1 / 2 / 3 / 4 / 5 / 6, % 54 / 31 / 11 / 4 / 0 / 0 69 / 8 / 15 / 8 / 0 / 0 0 / 0 / 100 / 0 / 0 / 0 Median HCV RNA, log10 IU/mL 5,9 (3.2-7.2) 5.6 (4.8-7.2) 6.6 (5.4-6.9) Fibrosis F0-F1 / F2 / F3 / F4, % 73 / 6 / 19 / 1 0 / 0 / 0 / 100 100 / 0 / 0 / 0 Naïve/experienced, % 82 / 18 92 / 8 0 / 100 CKD stage 3b / 4 / 5, % 5 / 17 / 79 23 / 15 / 62 0 / 25 / 75 On dialysis, N (%) 66 (79%) 3 (75%) EXPEDITION-V Persico N. EASL 2018, Abs. THU-363 2

EXPEDITION-V Study: GLE/PIB in patients with renal impairment Primary Endpoint (SVR12) 13 84 4 101 98 96 * 100 97 100 ** N = % * 1 patient had missing data and 2 patients discontinued treatment ** 1 patient with NS5A Y93H RAS achieved SVR12 EXPEDITION-V Persico N. EASL 2018, Abs. THU-363 3

EXPEDITION-V Study: GLE/PIB in patients with renal impairment Adverse events and laboratory abnormalities, % Overall N = 101 Any adverse event 55 Grade ≥ 3 adverse event / serious adverse event 13 / 12 * Adverse event leading to discontinuation 2 Adverse events in > 5% of patients Pruritus Hypertension Generalized pruritus Bronchitis Diarrhea 22 12 10 Laboratory abnormalities AST grade ≥ 3 (5 x ULN) ALT grade ≥ 3 (5 x ULN) Total bilirubin grade 3 (> 3 x ULN) * No AE related to treatment No death observed EXPEDITION-V Persico N. EASL 2018, Abs. THU-363 4

EXPEDITION-V Study: GLE/PIB in patients with renal impairment Renal function Of the 24 patients with CKD stage 3b or 4 and with available results, eGFR remained unchanged from screening to end of treatment and post-treatment week 4: 27.1 ± 9.2 vs 26.4 ± 9.8 vs 27.4 ± 11.6 mL/min/1.73m² CKD stage remained unchanged in 22/24 patients with end of treatment results and declined in 2/24 from screening to end of treatment EXPEDITION-V Persico N. EASL 2018, Abs. THU-363 5

EXPEDITION-V Study: GLE/PIB in patients with renal impairment Summary GLE/PIB is highly efficacious in patients with chronic kidney disease stage 3b to 5 with the label recommended treatment durations based on genotype, cirrhosis status and prior treatment experience Treatment was well-tolerated Overall, renal function remained unchanged after treatment in pre-dialysis patients assessed EXPEDITION-V Persico N. EASL 2018, Abs. THU-363 6