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An integrated analysis of elbasvir/grazoprevir in Korean patients with hepatitis C virus genotype 1b infection

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Background/Aims: In the Republic of Korea, an estimated 231,000 individuals have chronic hepatitis C virus (HCV) infection. The aim of the present analysis was to evaluate the safety and efficacy of elbasvir/grazoprevir (EBR/GZR) administered for 12 weeks in Korean patients who were enrolled in international clinical trial phase 3 studies. Methods: This was a retrospective, integrated analysis of data from patients with HCV genotype (GT) 1b infection enrolled at Korean study sites in four EBR/GZR phase 3 clinical trials. Patients were treatment-naive or had previously failed interferon-based HCV therapy, and included those with human immunodeficiency virus coinfection or Child- Pugh class A cirrhosis. All patients received EBR 50 mg/GZR 100 mg once daily for 12 weeks. The primary endpoint was sustained virologic response at 12 weeks after completion of therapy (SVR12, HCV RNA <15 IU/mL). Results: SVR12 was achieved by 73 of 74 (98.6%) patients. No patients had virologic failure and one discontinued from the study after withdrawing consent. SVR12 rates were uniformly high across all patient subgroups. A total of 16 patients had nonstructural protein 5A resistance-associated substitutions at baseline (16/73, 22%), all of whom achieved SVR12. Adverse events (AEs) reported in >5% of patients were fatigue (6.8%), upper respiratory tract infection (5.4%), headache (5.4%), and nausea (5.4%). Thirteen patients (17.6%) reported drug-related AEs, two serious AEs occurred, and two patients discontinued treatment owing to an AEs. Conclusions: In this retrospective analysis, EBR/GZR administered for 12 weeks was well-tolerated and highly effective in Korean patients with HCV GT1b infection.

Abstract

Background/Aims: In the Republic of Korea, an estimated 231,000 individuals have chronic hepatitis C virus (HCV) infection. The aim of the present analysis was to evaluate the safety and efficacy of elbasvir/grazoprevir (EBR/GZR) administered for 12 weeks in Korean patients who were enrolled in international clinical trial phase 3 studies. Methods: This was a retrospective, integrated analysis of data from patients with HCV genotype (GT) 1b infection enrolled at Korean study sites in four EBR/GZR phase 3 clinical trials. Patients were treatment-naive or had previously failed interferon-based HCV therapy, and included those with human immunodeficiency virus coinfection or Child- Pugh class A cirrhosis. All patients received EBR 50 mg/GZR 100 mg once daily for 12 weeks. The primary endpoint was sustained virologic response at 12 weeks after completion of therapy (SVR12, HCV RNA <15 IU/mL). Results: SVR12 was achieved by 73 of 74 (98.6%) patients. No patients had virologic failure and one discontinued from the study after withdrawing consent. SVR12 rates were uniformly high across all patient subgroups. A total of 16 patients had nonstructural protein 5A resistance-associated substitutions at baseline (16/73, 22%), all of whom achieved SVR12. Adverse events (AEs) reported in >5% of patients were fatigue (6.8%), upper respiratory tract infection (5.4%), headache (5.4%), and nausea (5.4%). Thirteen patients (17.6%) reported drug-related AEs, two serious AEs occurred, and two patients discontinued treatment owing to an AEs. Conclusions: In this retrospective analysis, EBR/GZR administered for 12 weeks was well-tolerated and highly effective in Korean patients with HCV GT1b infection.

참고문헌 (29)

  1. Polaris Observatory HCV Collaborators, "Global prevalence and genotype distribution of hepatitis C virus infection in 2015 : a modelling study", Lancet Gastroenterol Hepatol, 2, pp.161~176 (2017)
  2. Kim DY, "A nationwide seroepidemiology of hepatitis C virus infection in South Korea", Liver Int, 33, pp.586~594 (2013)
  3. Kim BK, "Current status of and strategies for hepatitis C control in South Korea", Clin Mol Hepatol, 23, pp.212~218 (2017)
  4. Jong Eun Yeon, "Recent update of the 2017 Korean Association for the Study of the Liver (KASL) treatment guidelines of chronic hepatitis C: Comparison of guidelines from other continents, 2017 AASLD", IDSA and 2016 EASL, 2018, pp.24(3), 278~293[DOI]
  5. Summa V, "MK-5172, a selective inhibitor of hepatitis C virus NS3", 4a protease with broad activity across genotypes and resistant variants, 2012, pp.56, 4161~4167
  6. Harper S, "Discovery of MK-5172, a macrocyclic hepatitis C virus NS3", 4a protease inhibitor, 2012, pp.3, 332~336
  7. Coburn CA, "Discovery of MK-8742 : an HCV NS5A inhibitor with broad genotype activity", ChemMedChem, 8, pp.1930~1940 (2013)
  8. Zeuzem S, "Grazoprevir-elbasvir combination therapy for treatment-naive cirrhotic and noncirrhotic patients with chronic hepatitis C virus genotype 1, 4, or 6 infection : a randomized trial", Ann Intern Med, 163, pp.1~13 (2015)
  9. Kwo P, "Effectiveness of elbasvir and grazoprevir combination, with or without ribavirin, for treatment-experienced patients with chronic hepatitis C infection", Gastroenterology, 152, pp.164~175 (2017)[DOI]
  10. Jacobson IM, "Safety and efficacy of elbasvir", grazoprevir in patients with hepatitis C virus infection and compensated cirrhosis : an integrated analysis, 2017, pp.152, 1372~1382
  11. Roth D, "Grazoprevir plus elbasvir in treatment-naive and treatmentexperienced patients with hepatitis C virus genotype 1 infection and stage 4-5 chronic kidney disease(the C-SURFER study) : a combination phase 3 study", Lancet, 386, pp.1537~1545 (2015)
  12. Rockstroh JK, "Efficacy and safety of grazoprevir(MK-5172)and elbasvir(MK-8742)in patients with hepatitis C virus and HIV co-infection(C-EDGE CO-INFECTION) : a non-randomised, open-label trial", Lancet HIV, 2, pp.e319~ (2015)[DOI]
  13. George J, "Elbasvir", grazoprevir in Asia-Pacific, Hepatol Commun, pp.2018, 2[DOI]
  14. Su F, "The association between race", ethnicity and the effectiveness of direct antiviral agents for hepatitis C virus infection, 2017, pp.65, 426~438
  15. Zepatier, "Prescribing information" (2018), Merck & Co. Inc
  16. "Hepatology", 2015, 562~, A.
  17. 남희철, "Efficacy and safety of daclatasvir and asunaprevir for hepatitis C virus genotype 1b infection", Clinical and Molecular Hepatology, 22(2), pp.259~266 (2016), 대한간학회
  18. 조병욱, "Efficacy and safety of daclatasvir plus asunaprevir for Korean patients with HCV genotype Ib infection: a retrospective multi-institutional study", Clinical and Molecular Hepatology, 23(1), pp.51~56 (2017), 대한간학회[DOI]
  19. Lim YS, "A phase IIIb study of ledipasvir", sofosbuvir fixed-dose combination tablet in treatment-naïve and treatment-experienced Korean patients chronically infected with genotype 1 hepatitis C virus, 2016, pp.10, 947~955
  20. Zeuzem S, "The safety and efficacy of elbasvir and grazoprevir in participants with hepatitis C virus genotype 1b infection", J Gastroenterol, 53, pp.679~688 (2018)
  21. Wei L, "Efficacy and safety of elbasvir", grazoprevir in participants with hepatitis C virus genotype 1, 4, or 6 infection from the Asia-Pacific region and Russia : final results from the randomized C-CORAL study, 2019, pp.34, 12~21
  22. Reig M, "Unexpected high rate of early tumor recurrence in patients with HCV-related HCC undergoing interferon-free therapy", J Hepatol, 65, pp.719~726 (2016)
  23. Pearlman BL, "Incidence of hepatocellular carcinoma among patients with hepatitis C virus infection following treatment with a grazoprevir-containing regimen", Hepatology, 68(1Suppl), pp.387A~ (2018)
  24. Nahon P, "Incidence of hepatocellular carcinoma after direct antiviral therapy for HCV in patients with cirrhosis included in surveillance programs", Gastroenterology, 155, pp.1436~1450 (2018)[DOI]
  25. Waziry R, "Hepatocellular carcinoma risk following direct-acting antiviral HCV therapy : a systematic review, meta-analyses, and meta-regression", J Hepatol, 67, pp.1204~1212 (2017)
  26. Calvaruso V, "Incidence of hepatocellular carcinoma in patients with HCVassociated cirrhosis treated with direct-acting antiviral agents", Gastroenterology, 155, pp.411~421 (2018)[DOI]
  27. Llovet JM, "Liver cancer : effect of HCV clearance with direct-acting antiviral agents on HCC", Nat Rev Gastroenterol Hepatol, 13, pp.561~562 (2016)
  28. Conti F, "Early occurrence and recurrence of hepatocellular carcinoma in HCV-related cirrhosis treated with direct-acting antivirals", J Hepatol, 65, pp.727~733 (2016)
  29. Kanwal F, "Risk of hepatocellular cancer in HCV patients treated with directacting antiviral agents", Gastroenterology, 153, pp.996~1005 (2017)[DOI]

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