Zha Jiuhong, Ding Bifeng, Wang Haoyu, Zhao Weihan, Yu Chen, Alves Katia, Mobashery Niloufar, Luo Yan, Menon Rajeev M
Clinical Pharmacology and Pharmacometrics, AbbVie Inc, 1 North Waukegan Road, Bldg. AP31-3, North Chicago, IL, 60064, USA.
Data and Statistical Sciences, AbbVie Inc., North Chicago, IL, USA.
Eur J Drug Metab Pharmacokinet. 2019 Feb;44(1):43-52. doi: 10.1007/s13318-018-0492-8.
BACKGROUND/PURPOSE: The 3 direct-acting antiviral (3D) regimen of ombitasvir/paritaprevir/ritonavir plus dasabuvir has recently been approved in several Asian geographic regions for the treatment of hepatitis C virus (HCV) genotype (GT) 1 infection. The pharmacokinetics of the components of the 3D regimen with or without ribavirin were evaluated in healthy Chinese subjects and HCV GT1b-infected Chinese, South Korean, and Taiwanese patients, with or without cirrhosis, to determine how the drug exposures in Asian populations compare with historical data in Western populations.
Participants received ombitasvir/paritaprevir/ritonavir 25/150/100 mg once daily plus dasabuvir 250 mg twice daily for 14 days (healthy subjects, n = 36) or 12 weeks (HCV patients, n = 754). Patients with compensated cirrhosis also received ribavirin 1000 or 1200 mg divided twice daily, per the local label. Intensive or sparse pharmacokinetic sampling was performed for assessments of plasma drug concentrations.
The exposures [maximum plasma concentration (C) and area under the plasma concentration-time curve (AUC)] of the components of the 3D regimen were comparable (< 20% difference) in healthy Chinese subjects residing in China or the United States. In addition, the trough plasma concentrations (C) in HCV GT1b-infected Asian patients were either similar to (ombitasvir) or within 75% of (paritaprevir and dasabuvir) those in Western patients without cirrhosis, or similar to (ombitasvir and paritaprevir) or within 100% of (dasabuvir) those in Western patients with cirrhosis, with widely overlapping ranges of individual values. Generally comparable drug exposures were observed among Chinese, South Korean, and Taiwanese ethnicities for noncirrhotic and cirrhotic patients.
Collectively, the results of these pharmacokinetic analyses support the use of the same dose of the 3D regimen for Asian and Western patients. CLINICALTRIALS.GOV: NCT02534870, NCT02517515, NCT02517528.
背景/目的:奥比他韦/帕利哌韦/利托那韦联合达沙布韦的三联直接抗病毒(3D)方案最近已在亚洲多个地区获批用于治疗丙型肝炎病毒(HCV)基因1型(GT1)感染。在健康中国受试者以及HCV GT1b感染的中国、韩国和台湾患者(有无肝硬化)中评估了3D方案各组分在联用或不联用利巴韦林情况下的药代动力学,以确定亚洲人群中的药物暴露量与西方人群的历史数据相比情况如何。
参与者接受奥比他韦/帕利哌韦/利托那韦25/150/100mg每日一次联合达沙布韦250mg每日两次,持续14天(健康受试者,n = 36)或12周(HCV患者,n = 754)。代偿期肝硬化患者还根据当地标签接受利巴韦林1000或1200mg,分两次每日服用。进行密集或稀疏药代动力学采样以评估血浆药物浓度。
在中国或美国的健康中国受试者中,3D方案各组分的暴露量[最大血浆浓度(C)和血浆浓度-时间曲线下面积(AUC)]具有可比性(差异<20%)。此外,HCV GT1b感染的亚洲患者的谷血浆浓度(C)与无肝硬化的西方患者相似(奥比他韦)或在其75%以内(帕利哌韦和达沙布韦),或与有肝硬化的西方患者相似(奥比他韦和帕利哌韦)或在其100%以内(达沙布韦),个体值范围广泛重叠。在非肝硬化和肝硬化患者的中国、韩国和台湾族裔中观察到总体上可比的药物暴露量。
总体而言,这些药代动力学分析结果支持亚洲和西方患者使用相同剂量的3D方案。临床试验注册编号:NCT02534870、NCT02517515、NCT02517528。