Real-world effectiveness and safety of glecaprevir/pibrentasvir for the treatment of patients with chronic HCV infection: a meta-analysis

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• dc.contributor.author Lampertico, Pietro
• dc.contributor.author Carrión Rodríguez, José Antonio
• dc.contributor.author Curry, Michael
• dc.contributor.author Turnes, Juan
• dc.contributor.author Cornberg, Markus
• dc.contributor.author Negro, Francesco
• dc.contributor.author Brown, Ashley
• dc.contributor.author Persico, Marcello
• dc.contributor.author Wick, Nicole
• dc.contributor.author Porcalla, Ariel
• dc.contributor.author Pangerl, Andreas
• dc.contributor.author Crown, Eric
• dc.contributor.author Larsen, Lois
• dc.contributor.author Yu, Yao
• dc.contributor.author Wedemeyer, Heiner
• dc.date.accessioned 2020-06-09T06:47:56Z
• dc.date.available 2020-06-09T06:47:56Z
• dc.date.issued 2020
• dc.description.abstract Background & aims: Glecaprevir/pibrentasvir is approved for treating adults infected with HCV genotypes 1-6. In clinical trials, glecaprevir/pibrentasvir was associated with high rates of sustained virologic response at post-treatment week 12 (SVR12) and was well tolerated. A systematic review and meta-analysis of the real-world effectiveness and safety of glecaprevir/pibrentasvir were undertaken. Methods: Real-world studies reporting SVR12 in adults with HCV infection (n ≥20) treated with glecaprevir/pibrentasvir were identified in journal publications from January 1, 2017, to February 25, 2019, and congress presentations through April 14, 2019. Random-effects meta-analysis was used to determine SVR12 rates using data from ≥2 cohorts; intention-to-treat (ITT) analyses included patients treated with glecaprevir/pibrentasvir who had SVR12 data available, discontinued early, or were lost to follow-up; modified ITT (mITT) analyses excluded those with non-virologic failure. Naïve pooling was used to calculate adverse event (AE) rates. Results: Overall, 12,531 adults were treated with glecaprevir/pibrentasvir (18 cohorts). Of patients with post-treatment week 12 data, SVR12 rates were 96.7% (95% CI 95.4-98.1) in the ITT population (n = 8,583, 15 cohorts) and 98.1% (95% CI 97.1-99.2) in the mITT population (n = 7,001, 14 cohorts). SVR12 rates were ≥95% across subgroups (HCV genotype, cirrhosis status, treatment history, treatment duration, on-label treatment, and subgroups of interest). AEs were reported in 17.7% (1,271/7,199) of patients (8 cohorts). Serious AEs were reported in 1.0% (55/5,522) of patients (6 cohorts). The most frequent AEs were pruritus, fatigue, and headache. AE-related treatment discontinuations were reported in 0.6% (33/5,595) of patients (6 cohorts). Conclusions: Consistent with clinical trials, real-world evidence indicates that glecaprevir/pibrentasvir is a well-tolerated and highly effective pangenotypic treatment for a broad range of HCV-infected patients. Lay summary: It is important to assess treatments for hepatitis C virus (HCV) in the real world, as patient populations tend to be more diverse and potentially less adherent to treatment compared to those in clinical trials. Results from 18 studies performed in real-world clinics were pooled and analyzed to investigate the effectiveness and safety of a direct-acting antiviral combination glecaprevir/pibrentasvir) in routine clinical practice. This analysis showed that glecaprevir/pibrentasvir is highly effective and well tolerated across all HCV genotypes and patient groups studied. It also showed that results seen in the real world are similar to the results seen in clinical trials, even in patients historically considered more challenging to treat.
• dc.format.mimetype application/pdf
• dc.identifier.citation Lampertico P, Carrión JA, Curry M, Turnes J, Cornberg M, Negro F, et al. Real-world effectiveness and safety of glecaprevir/pibrentasvir for the treatment of patients with chronic HCV infection: a meta-analysis. J Hepatol. 2020 Jun; 72(6):1112-21. DOI: 10.1016/j.jhep.2020.01.025
• dc.identifier.doi http://dx.doi.org/10.1016/j.jhep.2020.01.025
• dc.identifier.issn 0168-8278
• dc.identifier.uri http://hdl.handle.net/10230/44938
• dc.language.iso eng
• dc.publisher Elsevier
• dc.rights © 2020 European Association for the Study of the Liver. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). J. Hepatol. 2020, 72, 1112–1121
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/4.0/
• dc.subject.keyword Clinical practice
• dc.subject.keyword Hepatitis C virus
• dc.subject.keyword Meta-analysis
• dc.subject.keyword On-label
• dc.subject.keyword Pangenotypic
• dc.title Real-world effectiveness and safety of glecaprevir/pibrentasvir for the treatment of patients with chronic HCV infection: a meta-analysis
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion