97% Cures of Genotype 3 Hep C In Glecaprevir and Pibrentasvir Combination

AbbVie's pangenotypic direct-acting antiviral combination of two drugs - glecaprevir and pibrentasvir - cured 97% of people with early-stage genotype 3 hepatitis C virus (HCV), the hardest genotype to treat, according to results of the ENDURANCE-3 trial presented at the International Liver Congress in Amsterdam on Friday.

The AbbVie second-generation direct-acting antiviral combination consists of a protease inhibitor and an NS5A inhibitor. Glecaprevir is an HCV NS3/4A protease inhibitor active against all genotypes of hepatitis C. Pibrentasvir is an NS5A inhibitor also active against all genotypes of hepatitis C.

A pangenotypic combination should be similarly effective against all genotypes of hepatitis C. Direct-acting antiviral combinations have tended to show slightly lower efficacy in people with genotype 3 to date. Patients with cirrhosis or with previous experience of treatment – the hardest to treat.

The ENDURANCE-3 study was planned to test the combination of glecaprevir and pibrentasvir in people with genotype 3 infection without cirrhosis, stated Professor Graham Foster of Queen Mary University, London.

Genotype 3 is especially prevalent in South Asia and in South Asian populations in the United Kingdom, but these patients tend to have more advanced disease. Genotype 3 is also found in people who inject drugs, and most recent infections in Europe and North America occur in people who inject drugs.

“Genotype 3 is spreading in the US among young injectors, especially young men. For every patient that we treat and cure, that’s ten of his friends who don’t get infected,” said Prof. Foster.