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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 (EXPEDITION-5)

Primary Purpose

Hepatitis C Virus (HCV)

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Glecaprevir/pibrentasvir
Sponsored by
AbbVie
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hepatitis C Virus (HCV) focused on measuring Chronic Hepatitis C Virus, Chronic Kidney Disease, Glecaprevir, Pibrentasvir, Hepatitis C Virus Genotype, Compensated cirrhosis, Non-cirrhotic, Interferon (IFN), Treatment naïve, Sofosbuvir (SOF), Pegylated interferon (pegIFN), Ribavirin (RBV)

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

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.

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

Sites / Locations

  • Scripps Clinic /ID# 159116
  • Huntington Medical Foundation /ID# 160653
  • Tampa General Medical Group /ID# 159115
  • Northwest Louisiana Nephrology /ID# 160652
  • Massachusetts General Hospital /ID# 159114
  • North Shore University Hospital /ID# 159108
  • Columbia Univ Medical Center /ID# 159112
  • Carolinas Medical Center /ID# 159113
  • University of Pennsylvania /ID# 159117
  • Thomas Jefferson University /ID# 159754
  • TX Liver Inst, Americ Res Corp /ID# 159111
  • Zeidler Ledcor Centre /ID# 160600
  • Vancouver ID Research and Care /ID# 160598
  • GIRI Gastrointestinal Research Institute /ID# 160599
  • Toronto General Hospital /ID# 160601
  • Universitatsklinikum Mannheim /ID# 160829
  • Universitätsklinikum Frankfurt /ID# 160826
  • Med Hochschule Hanover /ID# 160827
  • Univ Johannes Gutenberg /ID# 160828
  • General Hospital of Athens Laiko /ID# 160725
  • Gen Univ Hosp Alexandroupolis /ID# 160724
  • General Hospital of Athens Evaggelismos and Ophthalmiatrio of Athens Polyclinic /ID# 160726
  • Bioclinic Thessaloniki /ID# 160723
  • A.O.U. Policlinico S.Orsola-Malpighi /ID# 163349
  • Policlinico A. Gemelli /ID# 160719
  • Policlinico Paolo Giaccone /Id# 160718
  • A.O. Uni Giovanni e Ruggi /ID# 160720
  • Hanyang University Seoul Hospi /ID# 160259
  • Severance Hospital /ID# 160261
  • Asan Medical Center /ID# 160260
  • HepID - Diagnostyka I Terapia /ID# 161083
  • Uniwersytecki Szpital Kliniczn /ID# 161081
  • VA Caribbean Healthcare System /ID# 160754
  • School of Medicine University of Puerto Rico-Medical Sciences Campus /ID# 160755
  • Hospital Regional de Malaga /ID# 159976
  • Hospital Parc de Salut del Mar /ID# 159975
  • Hospital Universitario Doce de /ID# 159974
  • Karolinska Uni /ID# 159523

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

GLE/PIB for 8 weeks

GLE/PIB for 12 weeks

GLE/PIB for 16 weeks

Arm Description

HCV 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

HCV 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

HCV 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

Outcomes

Primary Outcome Measures

Percentage of Participants Achieving Sustained Virologic Response 12 Weeks Post Dosing (SVR12)
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

Percentage of Participants With On-treatment Virologic Failure
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 Relapse
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. .

Full Information

First Posted
February 28, 2017
Last Updated
February 6, 2019
Sponsor
AbbVie
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1. Study Identification

Unique Protocol Identification Number
NCT03069365
Brief Title
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
Acronym
EXPEDITION-5
Official Title
A Multicenter, Open-Label Study to Evaluate the Efficacy and Safety of Glecaprevir/Pibrentasvir in Renally-Impaired Adults With Chronic Hepatitis C Virus Genotype 1 - 6 Infection (EXPEDITION-5)
Study Type
Interventional

2. Study Status

Record Verification Date
January 2019
Overall Recruitment Status
Completed
Study Start Date
March 28, 2017 (Actual)
Primary Completion Date
February 20, 2018 (Actual)
Study Completion Date
June 5, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
AbbVie

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
No

5. Study Description

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.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hepatitis C Virus (HCV)
Keywords
Chronic Hepatitis C Virus, Chronic Kidney Disease, Glecaprevir, Pibrentasvir, Hepatitis C Virus Genotype, Compensated cirrhosis, Non-cirrhotic, Interferon (IFN), Treatment naïve, Sofosbuvir (SOF), Pegylated interferon (pegIFN), Ribavirin (RBV)

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
101 (Actual)

8. Arms, Groups, and Interventions

Arm Title
GLE/PIB for 8 weeks
Arm Type
Experimental
Arm Description
HCV 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
Arm Title
GLE/PIB for 12 weeks
Arm Type
Experimental
Arm Description
HCV 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
Arm Title
GLE/PIB for 16 weeks
Arm Type
Experimental
Arm Description
HCV 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
Intervention Type
Drug
Intervention Name(s)
Glecaprevir/pibrentasvir
Other Intervention Name(s)
ABT-493/ABT-530, MAVYRET
Intervention Description
Film-coated tablet
Primary Outcome Measure Information:
Title
Percentage of Participants Achieving Sustained Virologic Response 12 Weeks Post Dosing (SVR12)
Description
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.
Time Frame
12 weeks after the last actual dose of study drug
Secondary Outcome Measure Information:
Title
Percentage of Participants With On-treatment Virologic Failure
Description
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
Time Frame
Up to 16 weeks
Title
Percentage of Participants With Post-treatment Relapse
Description
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. .
Time Frame
Up to 12 weeks after the last dose of study drug

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
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. 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
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
AbbVie Inc.
Organizational Affiliation
AbbVie
Official's Role
Study Director
Facility Information:
Facility Name
Scripps Clinic /ID# 159116
City
La Jolla
State/Province
California
ZIP/Postal Code
92037
Country
United States
Facility Name
Huntington Medical Foundation /ID# 160653
City
Pasadena
State/Province
California
ZIP/Postal Code
91105
Country
United States
Facility Name
Tampa General Medical Group /ID# 159115
City
Tampa
State/Province
Florida
ZIP/Postal Code
33606
Country
United States
Facility Name
Northwest Louisiana Nephrology /ID# 160652
City
Shreveport
State/Province
Louisiana
ZIP/Postal Code
71101
Country
United States
Facility Name
Massachusetts General Hospital /ID# 159114
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States
Facility Name
North Shore University Hospital /ID# 159108
City
New Hyde Park
State/Province
New York
ZIP/Postal Code
11040
Country
United States
Facility Name
Columbia Univ Medical Center /ID# 159112
City
New York
State/Province
New York
ZIP/Postal Code
10032-3725
Country
United States
Facility Name
Carolinas Medical Center /ID# 159113
City
Charlotte
State/Province
North Carolina
ZIP/Postal Code
28203
Country
United States
Facility Name
University of Pennsylvania /ID# 159117
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104-5502
Country
United States
Facility Name
Thomas Jefferson University /ID# 159754
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19107-4414
Country
United States
Facility Name
TX Liver Inst, Americ Res Corp /ID# 159111
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78215
Country
United States
Facility Name
Zeidler Ledcor Centre /ID# 160600
City
Edmonton
State/Province
Alberta
ZIP/Postal Code
T6G 2X8
Country
Canada
Facility Name
Vancouver ID Research and Care /ID# 160598
City
Vancouver
State/Province
British Columbia
ZIP/Postal Code
V6Z 2C7
Country
Canada
Facility Name
GIRI Gastrointestinal Research Institute /ID# 160599
City
Vancouver
State/Province
British Columbia
ZIP/Postal Code
V6Z 2K5
Country
Canada
Facility Name
Toronto General Hospital /ID# 160601
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5G 2C4
Country
Canada
Facility Name
Universitatsklinikum Mannheim /ID# 160829
City
Mannheim
State/Province
Baden-Wuerttemberg
ZIP/Postal Code
68167
Country
Germany
Facility Name
Universitätsklinikum Frankfurt /ID# 160826
City
Frankfurt am Main
State/Province
Hessen
ZIP/Postal Code
60590
Country
Germany
Facility Name
Med Hochschule Hanover /ID# 160827
City
Hannover
ZIP/Postal Code
30625
Country
Germany
Facility Name
Univ Johannes Gutenberg /ID# 160828
City
Mainz
ZIP/Postal Code
55131
Country
Germany
Facility Name
General Hospital of Athens Laiko /ID# 160725
City
Athens
State/Province
Attiki
ZIP/Postal Code
115 27
Country
Greece
Facility Name
Gen Univ Hosp Alexandroupolis /ID# 160724
City
Alexandroupolis
ZIP/Postal Code
68100
Country
Greece
Facility Name
General Hospital of Athens Evaggelismos and Ophthalmiatrio of Athens Polyclinic /ID# 160726
City
Athens
ZIP/Postal Code
10676
Country
Greece
Facility Name
Bioclinic Thessaloniki /ID# 160723
City
Thessaloniki
ZIP/Postal Code
54622
Country
Greece
Facility Name
A.O.U. Policlinico S.Orsola-Malpighi /ID# 163349
City
Bologna
State/Province
Emilia-Romagna
ZIP/Postal Code
40138
Country
Italy
Facility Name
Policlinico A. Gemelli /ID# 160719
City
Roma
State/Province
Lazio
ZIP/Postal Code
00168
Country
Italy
Facility Name
Policlinico Paolo Giaccone /Id# 160718
City
Palermo
State/Province
Sicilia
ZIP/Postal Code
90127
Country
Italy
Facility Name
A.O. Uni Giovanni e Ruggi /ID# 160720
City
Salerno
ZIP/Postal Code
84100
Country
Italy
Facility Name
Hanyang University Seoul Hospi /ID# 160259
City
Seongdong
State/Province
Seoul Teugbyeolsi
ZIP/Postal Code
04763
Country
Korea, Republic of
Facility Name
Severance Hospital /ID# 160261
City
Seoul
State/Province
Seoul Teugbyeolsi
ZIP/Postal Code
03722
Country
Korea, Republic of
Facility Name
Asan Medical Center /ID# 160260
City
Seoul
ZIP/Postal Code
05505
Country
Korea, Republic of
Facility Name
HepID - Diagnostyka I Terapia /ID# 161083
City
Lublin
State/Province
Lubelskie
ZIP/Postal Code
20-884
Country
Poland
Facility Name
Uniwersytecki Szpital Kliniczn /ID# 161081
City
Bialystok
ZIP/Postal Code
15-276
Country
Poland
Facility Name
VA Caribbean Healthcare System /ID# 160754
City
San Juan
ZIP/Postal Code
00921-3201
Country
Puerto Rico
Facility Name
School of Medicine University of Puerto Rico-Medical Sciences Campus /ID# 160755
City
San Juan
ZIP/Postal Code
00935
Country
Puerto Rico
Facility Name
Hospital Regional de Malaga /ID# 159976
City
Málaga
State/Province
Malaga
ZIP/Postal Code
29009
Country
Spain
Facility Name
Hospital Parc de Salut del Mar /ID# 159975
City
Barcelona
ZIP/Postal Code
08003
Country
Spain
Facility Name
Hospital Universitario Doce de /ID# 159974
City
Madrid
ZIP/Postal Code
28041
Country
Spain
Facility Name
Karolinska Uni /ID# 159523
City
Stockholm
ZIP/Postal Code
SE-141 86
Country
Sweden

12. IPD Sharing Statement

Plan to Share IPD
Undecided
Citations:
PubMed Identifier
35174470
Citation
Brown RS Jr, Collins MA, Strasser SI, Emmett A, Topp AS, Burroughs M, Ferreira R, Feld JJ. Efficacy and Safety of 8- or 12 Weeks of Glecaprevir/Pibrentasvir in Patients with Evidence of Portal Hypertension. Infect Dis Ther. 2022 Apr;11(2):913-924. doi: 10.1007/s40121-022-00599-8. Epub 2022 Feb 17.
Results Reference
derived
PubMed Identifier
31821716
Citation
Lawitz E, Flisiak R, Abunimeh M, Sise ME, Park JY, Kaskas M, Bruchfeld A, Worns MA, Aglitti A, Zamor PJ, Xue Z, Schnell G, Jalundhwala YJ, Porcalla A, Mensa FJ, Persico M. Efficacy and safety of glecaprevir/pibrentasvir in renally impaired patients with chronic HCV infection. Liver Int. 2020 May;40(5):1032-1041. doi: 10.1111/liv.14320. Epub 2019 Dec 26.
Results Reference
derived

Learn more about this trial

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

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