Glecaprevir/Pibrentasvir Effective, Well-Tolerated in Older HCV Patients

Glecaprevir/pibrentasvir, an oral pangenotypic direct-acting antiviral (DAA) medication administered once-daily, was found to be both safe and effective in the treatment of chronic hepatitis C virus (HCV) infection in patients ≥65 years old, according to the results of a recently published retrospective analysis.

Due to the limited amount of published literature analyzing treatment options for older chronic HCV infection patients, the study authors aimed to determine the efficacy and tolerability of glecaprevir/pibrentasvir in this population. “Data were pooled for treatment-naïve and -experienced patients with chronic HCV genotype (GT) 1–6 infections who received glecaprevir/pibrentasvir for 8, 12, or 16 weeks in 9 Phase 2 and 3 trials,” the study authors explained. Outcomes of the study included the percentage of patients who attained sustained virologic response 12 weeks post-treatment (SVR12; HCV RNA<15 IU/mL) as well as adverse events (AEs), which were compared for patients ≥65 years and <65 years.

Of a total of 2369 patients enrolled in the trials, 328 (14%) were ≥65 years old. Demographics of this older population included: 42% had GT1, 34% had GT2, 40% were treatment-experienced, and 20% had compensated cirrhosis. The study authors reported that SVR12 rates did not differ significantly for patients ≥65 years old and patients <65 years old (P =.555). “Glecaprevir/pibrentasvir treatment resulted in SVR12 rates of 97.9% (95% CI, 96.3–99.4; n/N = 321/328) for patients aged ≥65 years and 97.3% (95% CI, 96.6–98.0; n/N = 1986/2041) for patients aged <65 years.” 

The study authors also reported that glecaprevir/pibrentasvir was found to be generally well-tolerated in elderly patients. Rates of DAA-related AEs causing discontinuation of treatment and serious AEs were not only found to be similar among elderly and younger patients, but were also found to be very low in general (<0.5%). It was noted that the severity of the majority of AEs were considered Grade 1 (mild) to Grade 2 (moderate).

“In conclusion, glecaprevir/pibrentasvir is efficacious and well-tolerated for the treatment of chronic HCV infections in elderly patients,” the study authors stated. They added, “These findings add to the growing body of clinical trial and real-world data supporting that age should not be a barrier to the initiation and successful treatment of chronic HCV infection.”

Reference

Foster GR, Asselah T, Kopecky-Bromberg S, Lei Y, Asatryan A, Trinh R, et al. (2019) Safety and efficacy of glecaprevir/pibrentasvir for the treatment of chronic hepatitis C in patients aged 65 years or older. PLoS ONE 14(1): e0208506. https://doi.org/10.1371/journal.pone.0208506