IMPACT

IMPACT Study: SMV + DCV + SOF in HCV genotype 1 with decompensated liver disease
IMPACT Study: SMV + DCV + SOF in HCV genotype 1 with decompensated liver disease
Lawitz E. J Viral Hepat 2017; 24:287-94

Anti-HCV
Simeprevir
Daclatasvir
Sofosbuvir
Genotype
1
1a
1b
Treatment history
Naive
IFN-Experienced
Cirrhosis
Yes
Special population
Decompensated liver disease

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BROWSE SLIDES

Design

  • SMV 150 mg qd + DCV 90 mg qd + SOF 400 mg qd

Objective

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

Baseline characteristics

Outcome

SMV, DCV and SOF pharmacokinetics following administration of SMV + DCV + SOF

  • Intensive PK analysis performed at Week 2 and Week 8
    • Mean SMV exposure: 2.2-fold higher in CP B than CP A
    • Mean DCV exposure: similar in CP B and CP A
    • Mean SOF exposure: 1.4-fold higher in CP B than CP A
    • Mean GS-331007 exposure (SOF metabolite): similar in CP B and CP A

Adverse events and laboratory abnormalities, N (%)

Summary

  • Treatment for 12 weeks with SMV, SOF, and DCV resulted in 100% response rate; all 19 Child-Pugh A patients and all 21 Child-Pugh B patients achieved SVR12
  • High virologic response was observed regardless
    • of Child-Pugh class (<7 or 7–9)
    • or the presence of resistance-associated variants at baseline
  • This 3-DAA combination was generally safe and well tolerated
    • No discontinuations due to adverse events
    • No deaths
  • 5-year follow-up will be important in providing long-term outcomes in association with SVR