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JNJ-4178(阿得福韦、奥达司韦和西美瑞韦)治疗日本慢性丙型肝炎病毒基因型 1 或 2 感染伴或不伴代偿性肝硬化患者的 IIa 期 OMEGA-3 研究。

JNJ-4178 (adafosbuvir, odalasvir, and simeprevir) in Japanese patients with chronic hepatitis C virus genotype 1 or 2 infection with or without compensated cirrhosis: the Phase IIa OMEGA-3 study.

机构信息

Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka, 565-0871, Japan.

Department of Gastroenterology and Metabolism, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.

出版信息

J Gastroenterol. 2020 Jun;55(6):640-652. doi: 10.1007/s00535-020-01672-0. Epub 2020 Feb 17.

Abstract

BACKGROUND

The efficacy, safety, and pharmacokinetics of the combination of three direct-acting antiviral (DAA) agents (adafosbuvir [also known as AL-335], odalasvir, and simeprevir) were investigated in DAA treatment-naïve Japanese patients with genotype (GT)1 or GT2 chronic hepatitis C virus (HCV) infection, with or without compensated cirrhosis.

METHODS

In this Phase IIa, open-label, multicenter study-OMEGA-3 (NCT02993250)-patients received JNJ-4178 (adafosbuvir 800 mg once daily [QD], odalasvir 25 mg QD, and simeprevir 75 mg QD) for 8 (non-cirrhotic patients; Cohort 1) or 12 (cirrhotic patients; Cohort 2) weeks. Patients were followed-up to 24 weeks following the end of treatment (EOT). The primary endpoint was safety, including adverse events (AEs).

RESULTS

Overall, 33 patients were enrolled into Cohort 1 (N = 22) or 2 (N = 11) and received combined treatment with JNJ-4178. During the treatment and follow-up phases, a higher percentage of patients in Cohort 2 (81.8%) experienced AEs compared with Cohort 1 (68.2%), but the incidence of treatment-related AEs was similar. Most AEs were mild-to-moderate in severity and no patients discontinued due to an AE. There was one serious AE (cataract) in a patient in Cohort 2, which was not considered related to treatment. All patients achieved sustained virologic response 12 weeks after EOT (SVR12). No incidences of viral relapse were observed during follow-up.

CONCLUSIONS

In HCV GT1- and GT2-infected Japanese patients, treatment with JNJ-4178 was well tolerated and resulted in 100% of patients achieving SVR12.

摘要

背景

在未接受直接作用抗病毒药物(DAA)治疗的日本基因型(GT)1 或 GT2 慢性丙型肝炎病毒(HCV)感染患者中,联合使用三种直接作用抗病毒药物(adafosbuvir[也称为 AL-335]、odalasvir 和simeprevir)的疗效、安全性和药代动力学进行了研究,这些患者伴有或不伴有代偿性肝硬化。

方法

在这项 IIa 期、开放性、多中心研究-OMEGA-3(NCT02993250)中,患者接受 JNJ-4178(adafosbuvir 800mg 每日一次[QD],odalasvir 25mg QD,simeprevir 75mg QD)治疗 8 周(非肝硬化患者;队列 1)或 12 周(肝硬化患者;队列 2)。患者在治疗结束后随访 24 周(EOT)。主要终点是安全性,包括不良事件(AE)。

结果

总体而言,33 名患者被纳入队列 1(N=22)或队列 2(N=11),并接受 JNJ-4178 联合治疗。在治疗和随访期间,队列 2(81.8%)中较队列 1(68.2%)有更高比例的患者发生 AE,但治疗相关 AE 的发生率相似。大多数 AE 为轻至中度严重程度,没有患者因 AE 而停药。队列 2 中有 1 例严重 AE(白内障),但未认为与治疗相关。所有患者在 EOT 后 12 周时均达到持续病毒学应答 12 周(SVR12)。在随访期间未观察到病毒复发。

结论

在 HCV GT1 和 GT2 感染的日本患者中,JNJ-4178 治疗耐受性良好,100%的患者达到 SVR12。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5876/7242285/5994156b9007/535_2020_1672_Fig1_HTML.jpg

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