CCO_Amsterdam2013_CC_2013_Phase_III_and_Approved分析课件.pptVIP

CCO_Amsterdam2013_CC_2013_Phase_III_and_Approved分析课件.ppt

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P/R, peginterferon alfa-2a + ribavirin; RGT, response-guided therapy; SMV, simeprevir; SVR, sustained virologic response. Stefan Zeuzem, MD: This slide shows the virologic outcomes of the QUEST-1 trial. The majority of patients achieved undetectable HCV RNA at Week 4, and the overall SVR rate at 12 weeks posttreatment was superior in the simeprevir-containing treatment arm: 80% vs 50% with the peginterferon/ribavirin control arm. ? The slide also shows how many patients met the response-guided therapy criteria and how this affected the SVR outcomes. In this trial, 85% of patients met the criteria for shortened therapy and were allowed to discontinue treatment after an overall treatment duration of 24 weeks. Only 15% of patients in the simeprevir arm underwent the full 48-week treatment. Patients who qualified for 24 weeks of therapy achieved an SVR rate of 91% compared with 21% for those patients who underwent 48 weeks of treatment. ? Paul Y. Kwo, MD: One important take-home point from QUEST-1 is that extending therapy to 48 weeks in patients who did not have an RVR was associated with poor SVR rates. For all practical purposes, I think this may be considered a futility endpoint. * CI, confidence interval; GT, genotype; HCV, hepatitis C virus; Pbo, placebo; P/R, peginterferon alfa-2a + ribavirin; SMV, simeprevir; SVR, sustained virologic response. Stefan Zeuzem, MD: The left-hand figure on this slide continues the common theme that patients with cirrhosis tend to have lower SVR rates than noncirrhotic patients. Although SVR rates were higher with triple therapy vs peginterferon/ribavirin in both cirrhotic and noncirrhotic patients, the response to triple therapy was also attenuated in patient with cirrhosis vs noncirrhotic patients. ? The lower figure highlights an important challenge for genotype 1 HCV–infected patients during simeprevir therapy—the presence of a naturally occurring HCV polymorphism, Q80K, may lower the response to therapy in patients with ge

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