Efficacy, safety, and pharmacokinetics of simeprevir, daclatasvir, and ribavirin in patients with recurrent hepatitis C virus genotype 1b infection after orthotopic liver transplantation: The Phase II SATURN study

Transpl Infect Dis. 2017 Jun;19(3). doi: 10.1111/tid.12696. Epub 2017 May 4.

Abstract

Background: Recurrent hepatitis C virus (HCV) infection following liver transplantation is associated with accelerated progression to graft failure and reduced patient survival.

Methods: The Phase II, open-label SATURN study (NCT01938625) investigated the combination of simeprevir (SMV), daclatasvir (DCV), and ribavirin (RBV) administered for 24 weeks in 35 patients with recurrent HCV genotype (GT) 1b infection after orthotopic liver transplantation (OLT).

Results: High rates of both on-treatment and sustained virologic response 12 weeks after end of treatment (SVR12) were achieved in patients who were either treatment-naïve or had failed post-OLT treatment with peginterferon and RBV. Overall, 91% of patients (32/35) achieved SVR12. The combination was generally well tolerated, with an adverse event profile consistent with that observed in previous clinical trials of SMV or DCV separately. Co-administration of SMV with cyclosporine resulted in significantly increased SMV plasma exposures, which was not the case with the co-administration of SMV with tacrolimus. Therefore, the concomitant use of SMV with cyclosporine is not recommended.

Conclusion: The interferon-free combination of SMV, DCV, and RBV administered for 24 weeks was shown to be effective and well tolerated in the treatment of post-OLT HCV GT1b-infected patients.

Keywords: daclatasvir; hepatitis C virus; liver transplantation; ribavirin; simeprevir.

Publication types

  • Clinical Trial, Phase II
  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Antiviral Agents / pharmacokinetics*
  • Antiviral Agents / therapeutic use*
  • Carbamates
  • Cyclosporine / therapeutic use
  • Drug Therapy, Combination / adverse effects
  • Drug Therapy, Combination / methods
  • Female
  • Genotype
  • Graft Rejection / epidemiology
  • Graft Rejection / prevention & control
  • Hepacivirus / genetics
  • Hepacivirus / isolation & purification*
  • Hepatitis C, Chronic / therapy*
  • Hepatitis C, Chronic / virology
  • Humans
  • Imidazoles / pharmacokinetics
  • Imidazoles / therapeutic use
  • Immunosuppressive Agents / therapeutic use*
  • Interferon-alpha / therapeutic use
  • Liver Transplantation / adverse effects*
  • Liver Transplantation / methods
  • Male
  • Middle Aged
  • Pyrrolidines
  • RNA, Viral / isolation & purification
  • Recurrence
  • Ribavirin / pharmacokinetics
  • Ribavirin / therapeutic use
  • Simeprevir / pharmacokinetics
  • Simeprevir / therapeutic use
  • Tacrolimus / therapeutic use
  • Treatment Outcome
  • Valine / analogs & derivatives
  • Viral Load / drug effects

Substances

  • Antiviral Agents
  • Carbamates
  • Imidazoles
  • Immunosuppressive Agents
  • Interferon-alpha
  • Pyrrolidines
  • RNA, Viral
  • Ribavirin
  • Cyclosporine
  • Simeprevir
  • Valine
  • daclatasvir
  • Tacrolimus

Associated data

  • ClinicalTrials.gov/NCT01938625