SURVEYOR-I et II study – Part 2 in cirrhosis: Glecaprevir + Pibrentasvir in genotypes 1 or 3
        
Gane E. Gastroenterology 2016;151:651-9
		
		
		  Anti-HCV
Glecaprevir (ABT-493)
Pibrentasvir (ABT-530)
		
	    Glecaprevir (ABT-493)
Pibrentasvir (ABT-530)
		  Genotype
1
3
		
	    1
3
		  Treatment history
Naive
		
	    Naive
		  Cirrhosis
Yes
		
		Yes
Design

* Metavir > 3 or Ishak > 4 or Fibroscan ≥ 14.6 kPa or FibroTest ≥ 0.75 + APRI > 2
** Randomisation stratified by treatment history (naive or PEG-IFN + RBV experienced) 
*** Treatment extended to 16 weeks in 4 PEG-IFN 
+ RBV experienced patients
Objective
- SVR12 (HCV RNA< 25 IU /ml), by ITT
 
Baseline characteristics

SVR12 (HCV RNA < 25 IU/ml), % (95% CI)

Relapses

Resistance analysis (population sequencing with 15% threshold)
- SVR12 was achieved in 100% of patients without baseline substitutions and efficacy remained high in the presence of baseline substitutions
 - All 11 genotype 3-infected patients with baseline NS5A substitutions, including 4 patients with additional NS3 substitutions, achieved SVR12
 
Adverse events and laboratory abnormalities, %

Summary
- In this phase 2 study, the once-daily combination of Glecaprevir and Pibrentasvir for 12 weeks is sufficient to achieve high rates of SVR12 in patients with genotype 1 or genotype 3 infection and compensated cirrhosis
 - Adverse events were mostly mild in severity
 - Potential for a pangenotypic therapy without RBV co-administration
 






