Pharmacokinetics, Safety, and Tolerability of Ledipasvir/Sofosbuvir and Sofosbuvir/Velpatasvir in Healthy Chinese Subjects

Clin Ther. 2020 Mar;42(3):448-457. doi: 10.1016/j.clinthera.2020.01.013. Epub 2020 Feb 27.

Abstract

Purpose: Ledipasvir/sofosbuvir and sofosbuvir/velpatasvir have been approved worldwide for the treatment of chronic hepatitis C virus (HCV) infection. Although both have been approved in China, there are currently no data on their pharmacokinetic profiles in Chinese individuals. Two studies investigated the pharmacokinetic properties, safety, and tolerability of ledipasvir/sofosbuvir and sofosbuvir/velpatasvir, respectively, in healthy Chinese subjects.

Methods: Two Phase I, open-label, single- and multiple-dose studies were conducted in healthy Chinese subjects. Ledipasvir/sofosbuvir (90/400 mg) or sofosbuvir/velpatasvir (400/100 mg), respectively, was administered orally once daily under fasted conditions. Subjects received a single dose (day 1) and multiple doses (days 8-17 [ledipasvir/sofosbuvir]; days 8-14 [sofosbuvir/velpatasvir]). Plasma pharmacokinetic parameters were estimated by using noncompartmental models, and safety was assessed through clinical evaluation and monitoring of adverse events.

Findings: Fourteen subjects were enrolled in each study (7 men, 7 women each; mean age, 30 years [ledipasvir/sofosbuvir] and 29 years [sofosbuvir/velpatasvir]). The pharmacokinetic parameters for sofosbuvir, GS-566500, GS-331007, and ledipasvir or velpatasvir were similar to historical values in non-Chinese subjects. Consistent with the t1/2 of ledipasvir relative to 24-h dosing, accumulation of 177% (AUC) and 107% (Cmax) was observed. There was no significant accumulation of velpatasvir, sofosbuvir, GS-566500, or GS-331007. Both drugs were generally well tolerated; no serious adverse events or discontinuations due to adverse events were reported.

Implications: Overall, ledipasvir/sofosbuvir and sofosbuvir/velpatasvir exhibited pharmacokinetic and safety profiles in healthy Chinese subjects similar to those in non-Chinese subjects in historical studies, supporting their use in the Chinese population with HCV infection. ChinaDrugTrials.org.cn identifiers: CTR20160149 (ledipasvir/sofosbuvir); CTR20160602 (sofosbuvir/velpatasvir).

Keywords: chinese; hepatitis C virus; ledipasvir; pharmacokinetics; sofosbuvir; velpatasvir.

Publication types

  • Clinical Trial, Phase I
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antiviral Agents* / adverse effects
  • Antiviral Agents* / blood
  • Antiviral Agents* / pharmacokinetics
  • Benzimidazoles* / adverse effects
  • Benzimidazoles* / blood
  • Benzimidazoles* / pharmacokinetics
  • Carbamates* / adverse effects
  • Carbamates* / blood
  • Carbamates* / pharmacokinetics
  • China
  • Female
  • Fluorenes* / adverse effects
  • Fluorenes* / blood
  • Fluorenes* / pharmacokinetics
  • Heterocyclic Compounds, 4 or More Rings* / adverse effects
  • Heterocyclic Compounds, 4 or More Rings* / blood
  • Heterocyclic Compounds, 4 or More Rings* / pharmacokinetics
  • Humans
  • Male
  • Sofosbuvir* / adverse effects
  • Sofosbuvir* / blood
  • Sofosbuvir* / pharmacokinetics

Substances

  • Antiviral Agents
  • Benzimidazoles
  • Carbamates
  • Fluorenes
  • Heterocyclic Compounds, 4 or More Rings
  • ledipasvir
  • velpatasvir
  • Sofosbuvir