2区 · 医学
Article
作者: Wang, Maorong ; Xie, Qing ; Chen, Chengwei ; Zheng, Sujun ; Yang, Dongliang ; Hou, Jinlin ; Yu, Yanhong ; Yang, Xingxiang ; Li, Yongguo ; Zhang, Jiming ; Guan, Yujuan ; Xie, Wen ; Chen, Liang ; Hua, Rui ; Kang, Yi ; He, Qing ; Wu, Jinzi J ; Li, Dongliang ; Wei, Lai ; Ning, Bo ; Ye, Yinong ; Huang, Yan ; Ma, Yuanji ; Wen, Xiaofeng ; Hu, Peng ; Nan, Yuemin ; Feng, Bo ; An, Ping ; Lin, Minghua ; Yang, Yongfeng ; Gong, Guozhong ; Li, Jun ; Wang, Fusheng ; Zhang, Quan ; Tan, Youwen ; Xu, Xiaoyuan ; Ning, Qin ; Liu, Huimin ; Sheng, Jifang ; Gong, Zuojiong ; Zhao, Yingren ; Huang, Wenxiang ; Jia, Jidong ; Jia, Zhansheng
Background and Aims: Ravidasvir (RDV) is a new generation pangenotypic hepatitis C virus (HCV) NS5A inhibitor, with high barrier to baseline resistance-associated species. This is the first phase 2/3 study conducted in Mainland China confirming the efficacy and safety of RDV + ritonavir-boosted danoprevir + ribavirin for 12 weeks in treatment-naïve noncirrhotic patients with genotype 1 infection in a large population. Methods: In this multicenter, randomized, double-blinded, placebo-controlled phase 2/3 trial (NCT03362814), we enrolled 424 treatment-naïve, noncirrhotic adult HCV genotype 1 patients. All patients were randomized at 3:1 ratio to receive a combination of RDV 200mg once daily plus ritonavir-boosted danoprevir 100mg/100mg twice daily and oral ribavirin 1000/1200mg/day (body weight <75/≥75 kg) (n = 318) or placebo (n = 106) for 12 weeks. The primary end-point was the rate of sustained virologic response 12 weeks after the end of treatment, and the safety was evaluated and compared between treatment and placebo groups. Results: The overall rate of sustained virological response at 12 weeks after treatment is 99% (306/309, 95%, CI: 97%-100%) under per protocol set analysis. All patients harboring baseline NS5A resistance-associated species in the treatment group (76/76, per protocol set) achieved sustained virological response at 12 weeks after treatment. No treatment-related serious adverse events were reported. Laboratory abnormalities showed mild or moderate severity (grade 1 and grade 2) in liver function tests. Conclusions: In treatment-naïve, noncirrhotic HCV Chinese patients infected with HCV genotype 1, all-oral regimen of RDV + ritonavir-boosted danoprevir + ribavirin for 12 weeks was highly efficacious, safe, and well tolerated.