Simeprevir plus sofosbuvir (12 and 8 weeks) in hepatitis C virus genotype 1‐infected patients without cirrhosis: OPTIMIST‐1, a phase 3, randomized study

Effective antiviral therapy is essential for achieving sustained virological response (SVR) in hepatitis C virus (HCV)‐infected patients. The phase 2 COSMOS study reported high SVR rates in treatment‐naive and prior null‐responder HCV genotype (GT) 1‐infected patients receiving simeprevir+sofosbuvir...

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Veröffentlicht in:Hepatology (Baltimore, Md.) Md.), 2016-08, Vol.64 (2), p.370-380
Hauptverfasser: Kwo, Paul, Gitlin, Norman, Nahass, Ronald, Bernstein, David, Etzkorn, Kyle, Rojter, Sergio, Schiff, Eugene, Davis, Mitchell, Ruane, Peter, Younes, Ziad, Kalmeijer, Ronald, Sinha, Rekha, Peeters, Monika, Lenz, Oliver, Fevery, Bart, De La Rosa, Guy, Scott, Jane, Witek, James
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container_end_page 380
container_issue 2
container_start_page 370
container_title Hepatology (Baltimore, Md.)
container_volume 64
creator Kwo, Paul
Gitlin, Norman
Nahass, Ronald
Bernstein, David
Etzkorn, Kyle
Rojter, Sergio
Schiff, Eugene
Davis, Mitchell
Ruane, Peter
Younes, Ziad
Kalmeijer, Ronald
Sinha, Rekha
Peeters, Monika
Lenz, Oliver
Fevery, Bart
De La Rosa, Guy
Scott, Jane
Witek, James
description Effective antiviral therapy is essential for achieving sustained virological response (SVR) in hepatitis C virus (HCV)‐infected patients. The phase 2 COSMOS study reported high SVR rates in treatment‐naive and prior null‐responder HCV genotype (GT) 1‐infected patients receiving simeprevir+sofosbuvir±ribavirin for 12 or 24 weeks. OPTIMIST‐1 (NCT02114177) was a multicenter, randomized, open‐label study assessing the efficacy and safety of 12 and 8 weeks of simeprevir+sofosbuvir in HCV GT1‐infected treatment‐naive and treatment‐experienced patients without cirrhosis. Patients were randomly assigned (1:1; stratified by HCV GT/subtype and presence or absence of NS3 Q80K polymorphism [GT1b, GT1a with Q80K, GT1a without Q80K]), prior HCV treatment history, and IL28B GT [CC, non‐CC]) to simeprevir 150 mg once daily+sofosbuvir 400 mg once daily for 12 or 8 weeks. The primary efficacy endpoint was SVR rate 12 weeks after end of treatment (SVR12). Superiority in SVR12 was assessed for simeprevir+sofosbuvir at 12 and 8 weeks versus a composite historical control SVR rate. Enrolled were 310 patients, who were randomized and received treatment (n = 155 in each arm). SVR12 with simeprevir+sofosbuvir for 12 weeks (97% [150/155; 95% confidence interval 94%‐100%]) was superior to the historical control (87%). SVR12 with simeprevir+sofosbuvir for 8 weeks (83% [128/155; 95% confidence interval 76‐89%]) was not superior to the historical control (83%). The most frequent adverse events were nausea, headache, and fatigue (12‐week arm: 15% [23/155], 14% [22/155], and 12% [19/155]; 8‐week arm: 9% [14/155], 17% [26/155], and 15% [23/155], respectively). No patients discontinued treatment due to an adverse event. One (1%, 12‐week arm) and three (2%, 8‐week arm) patients experienced a serious adverse event (all unrelated to study treatment). Conclusion: Simeprevir+sofosbuvir for 12 weeks is highly effective in the treatment of HCV GT1‐infected patients without cirrhosis, including those with Q80K. (Hepatology 2016;64:370‐380)
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The phase 2 COSMOS study reported high SVR rates in treatment‐naive and prior null‐responder HCV genotype (GT) 1‐infected patients receiving simeprevir+sofosbuvir±ribavirin for 12 or 24 weeks. OPTIMIST‐1 (NCT02114177) was a multicenter, randomized, open‐label study assessing the efficacy and safety of 12 and 8 weeks of simeprevir+sofosbuvir in HCV GT1‐infected treatment‐naive and treatment‐experienced patients without cirrhosis. Patients were randomly assigned (1:1; stratified by HCV GT/subtype and presence or absence of NS3 Q80K polymorphism [GT1b, GT1a with Q80K, GT1a without Q80K]), prior HCV treatment history, and IL28B GT [CC, non‐CC]) to simeprevir 150 mg once daily+sofosbuvir 400 mg once daily for 12 or 8 weeks. The primary efficacy endpoint was SVR rate 12 weeks after end of treatment (SVR12). Superiority in SVR12 was assessed for simeprevir+sofosbuvir at 12 and 8 weeks versus a composite historical control SVR rate. Enrolled were 310 patients, who were randomized and received treatment (n = 155 in each arm). SVR12 with simeprevir+sofosbuvir for 12 weeks (97% [150/155; 95% confidence interval 94%‐100%]) was superior to the historical control (87%). SVR12 with simeprevir+sofosbuvir for 8 weeks (83% [128/155; 95% confidence interval 76‐89%]) was not superior to the historical control (83%). The most frequent adverse events were nausea, headache, and fatigue (12‐week arm: 15% [23/155], 14% [22/155], and 12% [19/155]; 8‐week arm: 9% [14/155], 17% [26/155], and 15% [23/155], respectively). No patients discontinued treatment due to an adverse event. One (1%, 12‐week arm) and three (2%, 8‐week arm) patients experienced a serious adverse event (all unrelated to study treatment). Conclusion: Simeprevir+sofosbuvir for 12 weeks is highly effective in the treatment of HCV GT1‐infected patients without cirrhosis, including those with Q80K. 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Enrolled were 310 patients, who were randomized and received treatment (n = 155 in each arm). SVR12 with simeprevir+sofosbuvir for 12 weeks (97% [150/155; 95% confidence interval 94%‐100%]) was superior to the historical control (87%). SVR12 with simeprevir+sofosbuvir for 8 weeks (83% [128/155; 95% confidence interval 76‐89%]) was not superior to the historical control (83%). The most frequent adverse events were nausea, headache, and fatigue (12‐week arm: 15% [23/155], 14% [22/155], and 12% [19/155]; 8‐week arm: 9% [14/155], 17% [26/155], and 15% [23/155], respectively). No patients discontinued treatment due to an adverse event. One (1%, 12‐week arm) and three (2%, 8‐week arm) patients experienced a serious adverse event (all unrelated to study treatment). Conclusion: Simeprevir+sofosbuvir for 12 weeks is highly effective in the treatment of HCV GT1‐infected patients without cirrhosis, including those with Q80K. 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Gitlin, Norman ; Nahass, Ronald ; Bernstein, David ; Etzkorn, Kyle ; Rojter, Sergio ; Schiff, Eugene ; Davis, Mitchell ; Ruane, Peter ; Younes, Ziad ; Kalmeijer, Ronald ; Sinha, Rekha ; Peeters, Monika ; Lenz, Oliver ; Fevery, Bart ; De La Rosa, Guy ; Scott, Jane ; Witek, James</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c6407-e159846efd2e14fa17221be2b378b73d2672b9aad7ec76fbf2f2479d49e9c9c23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Adverse events</topic><topic>Aged</topic><topic>Antiviral agents</topic><topic>Antiviral Agents - administration &amp; dosage</topic><topic>Cirrhosis</topic><topic>Confidence intervals</topic><topic>Cosmos</topic><topic>Drug Therapy, Combination</topic><topic>Female</topic><topic>Gene polymorphism</topic><topic>Hepacivirus - genetics</topic><topic>Hepatitis C</topic><topic>Hepatitis C virus</topic><topic>Hepatitis C, Chronic - drug therapy</topic><topic>Hepatitis C, Chronic - virology</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Liver cirrhosis</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Nausea</topic><topic>Patients</topic><topic>Ribavirin</topic><topic>Simeprevir - administration &amp; 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The phase 2 COSMOS study reported high SVR rates in treatment‐naive and prior null‐responder HCV genotype (GT) 1‐infected patients receiving simeprevir+sofosbuvir±ribavirin for 12 or 24 weeks. OPTIMIST‐1 (NCT02114177) was a multicenter, randomized, open‐label study assessing the efficacy and safety of 12 and 8 weeks of simeprevir+sofosbuvir in HCV GT1‐infected treatment‐naive and treatment‐experienced patients without cirrhosis. Patients were randomly assigned (1:1; stratified by HCV GT/subtype and presence or absence of NS3 Q80K polymorphism [GT1b, GT1a with Q80K, GT1a without Q80K]), prior HCV treatment history, and IL28B GT [CC, non‐CC]) to simeprevir 150 mg once daily+sofosbuvir 400 mg once daily for 12 or 8 weeks. The primary efficacy endpoint was SVR rate 12 weeks after end of treatment (SVR12). Superiority in SVR12 was assessed for simeprevir+sofosbuvir at 12 and 8 weeks versus a composite historical control SVR rate. Enrolled were 310 patients, who were randomized and received treatment (n = 155 in each arm). SVR12 with simeprevir+sofosbuvir for 12 weeks (97% [150/155; 95% confidence interval 94%‐100%]) was superior to the historical control (87%). SVR12 with simeprevir+sofosbuvir for 8 weeks (83% [128/155; 95% confidence interval 76‐89%]) was not superior to the historical control (83%). The most frequent adverse events were nausea, headache, and fatigue (12‐week arm: 15% [23/155], 14% [22/155], and 12% [19/155]; 8‐week arm: 9% [14/155], 17% [26/155], and 15% [23/155], respectively). No patients discontinued treatment due to an adverse event. One (1%, 12‐week arm) and three (2%, 8‐week arm) patients experienced a serious adverse event (all unrelated to study treatment). Conclusion: Simeprevir+sofosbuvir for 12 weeks is highly effective in the treatment of HCV GT1‐infected patients without cirrhosis, including those with Q80K. (Hepatology 2016;64:370‐380)</abstract><cop>United States</cop><pub>Wolters Kluwer Health, Inc</pub><pmid>26799692</pmid><doi>10.1002/hep.28467</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record>
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ispartof Hepatology (Baltimore, Md.), 2016-08, Vol.64 (2), p.370-380
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1527-3350
language eng
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source MEDLINE; Access via Wiley Online Library; EZB-FREE-00999 freely available EZB journals
subjects Adult
Adverse events
Aged
Antiviral agents
Antiviral Agents - administration & dosage
Cirrhosis
Confidence intervals
Cosmos
Drug Therapy, Combination
Female
Gene polymorphism
Hepacivirus - genetics
Hepatitis C
Hepatitis C virus
Hepatitis C, Chronic - drug therapy
Hepatitis C, Chronic - virology
Hepatology
Humans
Liver cirrhosis
Male
Middle Aged
Nausea
Patients
Ribavirin
Simeprevir - administration & dosage
Sofosbuvir - administration & dosage
Treatment Outcome
Viral Hepatitis
Young Adult
title Simeprevir plus sofosbuvir (12 and 8 weeks) in hepatitis C virus genotype 1‐infected patients without cirrhosis: OPTIMIST‐1, a phase 3, randomized study
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