C-SURGE: uprifosbuvir/grazoprevir/ruzasvir for genotype 1 with prior DAA-failure
Wyles D. Hepatology 2017 ; 66 :1794-1804
Anti-HCV
Grazoprevir
Ruzasvir (MK-8408)
Uprifosbuvir (MK-3682)
Grazoprevir
Ruzasvir (MK-8408)
Uprifosbuvir (MK-3682)
Genotype
1a
1a
Treatment history
NS5A experienced
SOF-experienced
NS5A experienced
SOF-experienced
Cirrhosis
Yes
No
Yes
No
Design
* Randomisation stratified by genotype (1a vs 1b),
prior DAA regimen and cirrhosis
** Liver biopsy or Fibroscan® > 12.5 kPa or Fibrotest® ≥ 0.75 + APRI ≥ 2
- MK3: Uprifosbuvir 225 mg/GZR 50 mg/RZR 30 mg FDC (MK3) = 2 tablets QD
- RBV dose based on body weight (< 65 kg = 800 mg/d ; 65-85 kg = 1000 mg/d ; > 85-105 kg = 1200 mg/d ; > 105 kg = 1400 mg/d)
Objective
- SVR12 (HCV RNA < 15 IU/mL), full analysis set (≥ 1 dose of study medication)
Baseline characteristics
* Exclusion of a participant who withdrew prior to beginning treatment
SVR12 (HCV RNA <15 IU/mL)
*
One patient from the 16W + RBV arm withdrew from the study after taking 3 doses of study medication (this patient was excluded in the mFAS analysis)
Adverse events, %
* N = 5 (hospitalization for cervical spine disc herniation ; hospitalization for chest pain ; hospitalization for dizziness ; pancreatitis without hospitalization ; and hospitalization for shoulder cyst surgery)
Summary
- MK3 (uprifosbuvir/grazoprevir/ruzasvir) ± ribavirin was highly effective in cirrhotic and non-cirrhotic genotype 1 patients who previously failed an NS5A inhibitor-containing antiviral regimen
- 98% (43/44) of patients receiving MK3 + RBV for 16 weeks achieved SVR12
- One patient withdrew from the study after receiving 3 doses
- 100% (49/49) of patients receiving MK3 alone for 24 weeks have achieved SVR12
- High efficacy was observed despite a high prevalence of baseline NS3 and NS5A RAVs in this population
- Treatment was generally safe and well-tolerated