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Design Randomisation 2 : 1 Double-blind W12 ≥ 18 years, HCV genotype 3

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Presentation on theme: "Design Randomisation 2 : 1 Double-blind W12 ≥ 18 years, HCV genotype 3"— Presentation transcript:

1 ENDURANCE-3 Study: glecaprevir/pibrentasvir versus sofosbuvir + daclatasvir in genotype 3
Design Randomisation 2 : 1 Double-blind W12 ≥ 18 years, HCV genotype 3 Treatment-naïve HCV RNA > IU/mL No cirrhosis (Metavir ≤ F3) No HBV or HIV co-infection ALT/AST < 10 x ULN, albumin > LLN N = 233 GLE/PIB SVR12 SOF + DCV SVR12 N = 115 W8 Third arm, non randomised, added after the completion of the phase 2 study N = 157 GLE/PIB SVR12 Glecaprevir/pibrentasvir: 100/40 mg 3 tablets QD Sofosbuvir: 400 mg 1 tablet QD + daclatasvir 60 mg 1 tablet QD Objective Non-inferiority of SVR12 of GLE/PIB compared to SOF + DCV (lower bound of 95% CI of the difference: - 6%) ENDURANCE-3 Foster G. EASL 2017, Abs. GS-007 1

2 Baseline characteristics
ENDURANCE-3 Study: glecaprevir/pibrentasvir versus sofosbuvir + daclatasvir in genotype 3 Baseline characteristics GLE/PIB 12W N = 233 SOF + DCV 12W N = 115 GLE/PIB 8W N = 157 Median age, years 48 49 47 Female, % 55 41 Race: White, % 88 90 85 BMI, median kg/m2 25 26 History of injection drug use, % 64 63 66 Median HCV RNA, log10 IU/mL 6.1 6.0 Fibrosis stage: F0-F1 / F2 / F3, % 86 / 5 / 9 84 / 7 / 9 78 / 5 /17 Subtype genotype 3a, % 99 100 ENDURANCE-3 Foster G. EASL 2017, Abs. GS-007 2

3 SVR12 by intention-to-treat analysis, %
ENDURANCE-3 Study: glecaprevir/pibrentasvir versus sofosbuvir + daclatasvir in genotype 3 SVR12 by intention-to-treat analysis, % 233 115 157 Breakthrough/relapse (N) Failure due to other reasons Lost o follow-up/Missing SVR12 1 / 3 0/ 1 1 / 5 Both GLE/PIB treatments met non-inferiority criteria (lower bound of the 95% confidence interval above - 6%) GLE/PIB 12W vs SOF + DCV : -1.2% (95% CI: -5.6 to 3.1) GLE/PIB 8W vs GLE/PIB 12W : -0.4% (95% CI : -5.4 to 4.6) ENDURANCE-3 Foster G. EASL 2017, Abs. GS-007 3

4 SVR12 by baseline polymorphisms *
ENDURANCE-3 Study: glecaprevir/pibrentasvir versus sofosbuvir + daclatasvir in genotype 3 SVR12 by baseline polymorphisms * GLE/PIB 12W N = 233 SOF + DCV 12W N = 115 GLE/PIB 8W N = 157 NS3 RASs only 26/26 (100%) - 14/15 (93%) NS5A RASs only 35/36 (97%) 20/21 (95%) 35/36 (94%) NS3 + NS5A RASs 6/7 (86%) 5/7 (71%) None 151/153 (99%) 89/89 (100%) 94/95 (99%) * Detected by next-generation sequencing using 15% detection threshold 3% of patients (N = 10) had virologic failure Common baseline RASs NS3A: A166S, N = 3 NS5A: A30K, N = 5 RASs at failure A30K + Y93H in 5/10 ENDURANCE-3 Foster G. EASL 2017, Abs. GS-007 4

5 Adverse events and laboratory abnormalities, N (%)
ENDURANCE-3 Study: glecaprevir/pibrentasvir versus sofosbuvir + daclatasvir in genotype 3 Adverse events and laboratory abnormalities, N (%) GLE/PIB 12W N = 233 SOF + DCV 12W N = 115 GLE/PIB 8W N = 157 Any adverse event 177 (76%) 80 (70%) 98 (62%) Serious adverse event * 5 (2%) 2 (2%) 3 (2%) Adverse event leading to discontinuation 3 (1%) 1 (1%) Adverse events in > 10% of patients, % Headache Fatigue Nausea 26 19 14 20 13 12 Laboratory abnormalities, N (%) ALT grade ≥ 3 (5 x ULN) Total bilirubin > 3 x ULN Neutrophil count < 1.0 x 109/L 1 (< 1) 1 (1) * No serious adverse event was assessed as related to study drugs ENDURANCE-3 Foster G. EASL 2017, Abs. GS-007 5

6 ENDURANCE-3 Study: glecaprevir/pibrentasvir versus sofosbuvir + daclatasvir in genotype 3
Summary Glecaprevir/pibrentasvir achieved high efficacy in non-cirrhotic, treatment-naïve patients with genotype 3 12 weeks of GLE/PIB was not inferior to 12 weeks of SOF+DCV 8 weeks of GLE/PIB was not inferior to 12 weeks of GLE/PIB Treatment was well-tolerated Of note, resistance analysis observed that the combination of NS3 + NS5A RAs reduced SVR12 to 86% (GLE/PIB 12 weeks) and 71% (GLE/PIB 8 weeks) ENDURANCE-3 Foster G. EASL 2017, Abs. GS-007 6


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