Presentation is loading. Please wait.

Presentation is loading. Please wait.

Placebo + PR W24 DCV + PR Placebo + PR Yes Dore GJ. Gastroenterology 2015;148:355-66 COMMAND GT2/3 COMMAND GT2/3 Study: daclatasvir + PEG-IFN + RBV for.

Similar presentations


Presentation on theme: "Placebo + PR W24 DCV + PR Placebo + PR Yes Dore GJ. Gastroenterology 2015;148:355-66 COMMAND GT2/3 COMMAND GT2/3 Study: daclatasvir + PEG-IFN + RBV for."— Presentation transcript:

1 Placebo + PR W24 DCV + PR Placebo + PR Yes Dore GJ. Gastroenterology 2015;148:355-66 COMMAND GT2/3 COMMAND GT2/3 Study: daclatasvir + PEG-IFN + RBV for genotype 2 or 3 DCV + PEG-IFN + RBV N = 50 No Yes No Randomisation* 1 : 1 : 1 Double blind  Design 18-70 years Chronic HCV infection Genotype 2 or 3 Treatment naïve HCV RNA ≥ 100,000 IU/ml Compensated cirrhosis allowed No HBV or HIV coinfection Placebo + PEG-IFN + RBV, N = 51 DCV + PEG-IFN + RBV N = 50 PDR (protocol-defined response) = HCV RNA < 25 IU/ml at W4 and undetectable at W10 W12 * Randomisation stratified on genotype (2 or 3) Stop W16 –DCV : 60 mg qd or matching placebo (2 pills) ; PEG-IFN  -2a : 180  g SC once weekly –RBV : 1000 or 1200 mg/day (bid dosing) according to body weight (< or ≥ 75 kg)  Objective –SVR 24 (HCV RNA undetectable) : non-inferiority of DCV regimens (lower limit of the 80% CI : - 20%), 85% power

2 DCV + PEG-IFN + RBV 12W DCV + PEG-IFN + RBV 16W Placebo + PEG-IFN + RBV 24W Genotype 2, N242324 Median age, years52 55 Female46%35%54% HCV RNA log 10 IU/ml, mean6.66.86.6 Cirrhosis004% IL28B CC42%30%25% Genotype 3, N2627 Median age, years464446 Female27%18%41% HCV RNA log 10 IU/ml, mean6.26.46.5 Cirrhosis27%15%26% IL28B CC39%44%41% Discontinued treatment For adverse event / lack of efficacy 5 3 / 0 6 1 / 1 9 2 / 3 Baseline characteristics and patient disposition Dore GJ. Gastroenterology 2015;148:355-66 COMMAND GT2/3 Study: daclatasvir + PEG-IFN + RBV for genotype 2 or 3 COMMAND GT2/3

3 SVR 24 (HCV RNA undetectable), % (95% CI) Virologic breakthrough001001 Relapse102663 SVR 24 As-observed analysis (exclusion of post-treatment missing data) DCV 12W DCV 16W Placebo Genotype 295%100%83% Genotype 372%69%70% 25 50 100 75 83.3 (74-93) % 82.6 (73-93) Genotype 2 62.5 (50-75) 69.2 (58-81) N2423242627 66.7 (55-78) Genotype 3 59.3 (47-71) Modified ITT  DCV 12W or 16W was non inferior to placebo (lower bound of the 80% CIs for the difference (DCV - placebo) : 4.9% and 3.9% for genotype 2, respectively ; - 6.8% and - 9.4% for genotype 3, respectively Dore GJ. Gastroenterology 2015;148:355-66 COMMAND GT2/3 Study: daclatasvir + PEG-IFN + RBV for genotype 2 or 3 COMMAND GT2/3 DCV + PR 16WPlacebo + PR 24WDCV + PR 12W 0

4 Virologic failure in genotype 3 Dore GJ. Gastroenterology 2015;148:355-66 COMMAND GT2/3 COMMAND GT2/3 Study: daclatasvir + PEG-IFN + RBV for genotype 2 or 3  Resistance analysis –All 12 relapses in DCV groups had DCV resistant NS5A variants Y93H or A30K –4/8 patients with baseline Y93H or A30K at baseline relapsed –8/43 patients without these variants at baseline relapsed  Baseline characteristics associated with post-treatment relapse –Cirrhosis : 36% relapse if present vs 21% –BMI > 30 kg/m2 : 56% vs 16% –Baseline HCV RNA > 800,000 IU/ml : 30% vs 0%

5 DCV + PEG-IFN + RBV 12W N = 50 DCV + PEG-IFN + RBV 16W N = 50 Placebo + PEG-IFN + RBV 24W N = 51 Serious adverse event403 Adverse event leading to discontinuation432 Grade 3-4 adverse events7 (14%)4 (8%)6 (12%) Adverse events of interest (grade 1-4) Rash26%24% Pruritus28%26%28% Anemia8%6%10% Grade 3-4 laboratory abnormalities Neutropenia20%24%31% Lymphocytopenia10%14%8% Anemia6%0 Thrombocytopenia2%4%8% ALT elevation2% 0 Bilirubin increase4%00 Adverse events and laboratory abnormalities, n (%) Dore GJ. Gastroenterology 2015;148:355-66 COMMAND GT2/3 COMMAND GT2/3 Study: daclatasvir + PEG-IFN + RBV for genotype 2 or 3

6  Summary – 12 or 16 weeks of treatment with DCV, in combination with PEG-IFN + RBV, is a well tolerated and effective therapy for patients with HCV genotype 2 or 3 infections For the primary end point of SVR 24, the differences between both DCV arms and placebo met statistical criteria for noninferiority in patients with genotype 2 and genotype 3 infection DCV containing regimens could reduce the duration of therapy for these patients, when given with PEG-IFN + RBV – These results suggest that combinations of DCV with other potent oral antiviral agents may offer alternatives to the current standard of care for genotypes 2 and 3 infection Dore GJ. Gastroenterology 2015;148:355-66 COMMAND GT2/3


Download ppt "Placebo + PR W24 DCV + PR Placebo + PR Yes Dore GJ. Gastroenterology 2015;148:355-66 COMMAND GT2/3 COMMAND GT2/3 Study: daclatasvir + PEG-IFN + RBV for."

Similar presentations


Ads by Google