Pharmacokinetics and safety of glecaprevir and pibrentasvir in HCV-negative subjects with hepatic impairment.

Purpose: This study characterized the effects of hepatic impairment on the pharmacokinetics and safety of glecaprevir and pibrentasvir, two direct-acting antivirals used for treatment of chronic HCV infection.Methods: HCV-negative subjects with normal hepatic function, or with mild (Child-Pugh [CP]-...

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Publicado en:European Journal of Clinical Pharmacology Vol. 75; no. 2; pp. 217 - 227
Autores principales: Kosloski, Matthew P., Liu, Wei, Wang, Haoyu, Pugatch, David, Mensa, Federico J., Gane, Edward, Lawitz, Eric, Marbury, Thomas C., Preston, Richard A., Kort, Jens
Formato: research tables/charts Journal Article
Publicado: Springer Nature Feb2019
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Feb2019
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00228-018-2576-4
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        atl: Pharmacokinetics and safety of glecaprevir and pibrentasvir in HCV-negative subjects with hepatic impairment.
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        au:
          Kosloski, Matthew P.
          Liu, Wei
          Wang, Haoyu
          Pugatch, David
          Mensa, Federico J.
          Gane, Edward
          Lawitz, Eric
          Marbury, Thomas C.
          Preston, Richard A.
          Kort, Jens
        affil: Clinical Pharmacology and Pharmacometrics, AbbVie Inc., North Chicago, IL, USA
      sug:
        subj:
          Protease Inhibitors Pharmacokinetics
          Antiviral Agents Pharmacokinetics
          Hepatitis C Drug Therapy
          Liver Diseases Metabolism
          Protease Inhibitors Therapeutic Use
          Antiviral Agents Therapeutic Use
          Patient Safety
          Human
          Hepatitis C Diagnosis
          Severity of Illness
          Protease Inhibitors Administration and Dosage
          Antiviral Agents Administration and Dosage
          Biochemical Phenomena
          Drug Therapy, Combination
          Headache Chemically Induced
          Protease Inhibitors Adverse Effects
          Antiviral Agents Adverse Effects
          Protease Inhibitors Blood
          Antiviral Agents Blood
      ab: Purpose: This study characterized the effects of hepatic impairment on the pharmacokinetics and safety of glecaprevir and pibrentasvir, two direct-acting antivirals used for treatment of chronic HCV infection.Methods: HCV-negative subjects with normal hepatic function, or with mild (Child-Pugh [CP]-A), moderate (CP-B), or severe (CP-C) hepatic impairment received single doses of pibrentasvir 120 mg alone or with glecaprevir 200 mg or 300 mg (n = 6/functional group/dose). Plasma pharmacokinetics and protein binding were evaluated. Doses were separated by ≥ 14 days of washout.Results: For the approved combination of glecaprevir 300 mg with pibrentasvir 120 mg, glecaprevir AUC was increased by 33% (CP-A), to 2.0-fold (CP-B), and to 11-fold (CP-C) relative to normal subjects; pibrentasvir AUC was ≤ 26% different (CP-A or CP-B) and increased to 2.1-fold (CP-C). For glecaprevir 200 mg with pibrentasvir 120 mg, glecaprevir AUC was increased by 80% (CP-A) or to 2.8-fold (CP-B), while pibrentasvir AUC was unaffected in the same subjects (≤ 12% difference). Pibrentasvir 120 mg alone AUC increased 51% (CP-A), 31% (CP-B), and to 5.2-fold (CP-C). The unbound fraction of glecaprevir was higher in CP-C subjects than normal subjects and pibrentasvir protein binding was similar across groups. The most common adverse event was headache; no events were serious.Conclusion: This study supported evaluation of the glecaprevir 300 mg with pibrentasvir 120-mg combination in HCV-infected subjects with CP-A hepatic impairment without dose adjustment. Elevated glecaprevir and/or pibrentasvir exposures are expected in HCV-infected patients with CP-B or CP-C hepatic impairment.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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