EXPEDITION-4

EXPEDITION-IV Study: glecaprevir/pibrentasvir in patients with renal impairment

Gane E. NEJM 2017 ; 377 :1448-55

Anti-HCV
Glecaprevir (ABT-493)
Pibrentasvir (ABT-530)
Genotype
1
2
3
4
Treatment history
Naive
IFN-Experienced
Cirrhosis
No
Special population
Chronic Kidney disease

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Design

  • GLE/PIB : 100/40 mg 3 tablets QD

Objective

  • SVR12 (HCV RNA < 15 IU/ml), with 2-sided 95% CI, by ITT

Baseline characteristics and SVR12

Adverse events and laboratory abnormalities, %


* Diarrhea ; pruritus ; pulmonary edema, hypertensive cardiomyopathy with congestive failure ; hypertensive crisis
** Serious adverse event of cerebral hemorrhage, not related to study drug, at post-treatment W2

Summary

  • GLE/PIB (300 mg/120 mg QD) achieved high efficacy in patients with stage 4 or 5 chronic kidney disease and HCV infection
    • 98% ITT SVR12 rate across all major HCV genotypes
    • No virologic failures
  • GLE/PIB was well tolerated with a favorable safety profile in this difficult-to-treat population:
    • No drug-related serious adverse event
    • No grade ≥ 2 laboratory abnormalities in ALT or AST