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Advances in Therapy
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Safety and Effectiveness Using 8 Weeks of Glecaprevir/Pibrentasvir in HCV-Infected Treatment-Naïve Patients with Compensated Cirrhosis: The CREST Study

Authors: Cornberg, Markus; Ahumada, Adriana; Aghemo, Alessio; Andreoni, Massimo; Bhagat, Abhi; Butrymowicz, Isabel; Carmiel, Michal; +15 Authors

Safety and Effectiveness Using 8 Weeks of Glecaprevir/Pibrentasvir in HCV-Infected Treatment-Naïve Patients with Compensated Cirrhosis: The CREST Study

Abstract

In clinical trials with hepatitis C virus-infected treatment-naïve (TN) patients with compensated cirrhosis (CC), glecaprevir/pibrentasvir (G/P), a fixed-dose, once-daily, pangenotypic regimen, has demonstrated sustained virologic response at posttreatment Week 12 (SVR12) > 95%. We evaluated the real-world safety and effectiveness of 8-week G/P therapy in TN patients with CC, including certain subgroups of interest.The CREST study is a real-world, noninterventional, multicenter study retrospectively assessing data from Canada, Germany, Israel, Italy, and Spain. The full analysis set (FAS) designated all patients in the study; the modified analysis set (MAS) excluded patients who discontinued G/P for nonvirologic failure or who had missing SVR12 data. The primary endpoint was SVR12; safety endpoints were also assessed.A total of 386 patients were included in the FAS, 375 patients completed the study, and 325 patients were included in the MAS; 51 patients had missing SVR12 data. Overall, in the MAS and FAS, SVR12 was achieved in 99.1% and 84.2% of patients, respectively. In subgroups of interest, the percentage of patients achieving SVR12 in the MAS (and FAS) was: genotype (GT)3: 97.5% (80.6%); FibroScan® ≥ 12.5 kPa: 98.9% (89.3%); platelet count  20 kPa: 100% (88.9%); aspartate aminotransferase-to-platelet ratio index > 1.09: 98.7% (83.1%); fibrosis-4 index > 3.25: 98.6% (84.0%); albumin < 3 g/dl: 100% (91.7%); people who use drugs: 97.7% (84.3%); psychiatric disorders: 96.6% (84.8%); and human immunodeficiency virus coinfection: 100% (95.0%). Overall, 26.9% (104/386) of patients experienced an adverse event, none of which were classed as serious.In this real-world cohort, 8 weeks of G/P therapy was well tolerated in TN patients with CC. SVR12 rates were similar to clinical trials, supporting 8-week treatment in TN patients with CC, including those with signs of advanced liver disease and GT3 infection.

Country
Italy
Keywords

Cyclopropanes, Liver Cirrhosis, Aminoisobutyric Acids, Pyrrolidines, Genotype, Proline, Sustained Virologic Response, Lactams, Macrocyclic, Hepacivirus, Direct-acting antivirals, Antiviral Agents, Leucine, Quinoxalines, Liver Cirrhosis/complications [MeSH] ; Cyclopropanes [MeSH] ; Sustained Virologic Response [MeSH] ; Quinoxalines [MeSH] ; Aminoisobutyric Acids [MeSH] ; Hepacivirus/genetics [MeSH] ; Hepatitis C, Chronic/genetics [MeSH] ; Real world ; Compensated cirrhosis ; Benzimidazoles [MeSH] ; Hepatitis C, Chronic/drug therapy [MeSH] ; Original Research ; Pyrrolidines/therapeutic use [MeSH] ; Sulfonamides [MeSH] ; Lactams, Macrocyclic [MeSH] ; Antiviral Agents/adverse effects [MeSH] ; Humans [MeSH] ; Retrospective Studies [MeSH] ; Treatment-naïve ; Hepatitis C, Chronic/complications [MeSH] ; Leucine/analogs ; Direct-acting antivirals ; Medical and Health Sciences ; Hepatitis C/drug therapy [MeSH] ; Genotype [MeSH] ; Liver Cirrhosis/drug therapy [MeSH] ; Proline/analogs ; Hepatitis C virus, Humans, Original Research, Retrospective Studies, Compensated cirrhosis; Direct-acting antivirals; Hepatitis C virus; Real world; Treatment-naïve, Sulfonamides, Hepatitis C virus, Real world, Treatment-naïve, Hepatitis C, Chronic, Hepatitis C, Compensated cirrhosis, Benzimidazoles

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
12
Top 10%
Average
Top 10%
Green
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