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
 





