ASTRAL-5: Efficacy and Safety of Sofosbuvir/Velpatasvir Fixed Dose Combination for 12 Weeks in Adults With Chronic Hepatitis C Virus (HCV) and Human Immunodeficiency Virus (HIV)-1 Coinfection
Study Details
Study Description
Brief Summary
The primary objectives of this study are to evaluate the efficacy, safety and tolerability of treatment with sofosbuvir/velpatasvir (SOF/VEL) for 12 weeks in participants with chronic HCV infection who were coinfected with HIV-1.
Condition or Disease | Intervention/Treatment | Phase |
---|---|---|
Phase 3 |
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
---|---|
Experimental: SOF/VEL Participants will receive SOF/VEL for 12 weeks |
Drug: SOF/VEL
400/100 mg fixed-dose combination (FDC) tablet administered orally once daily
Other Names:
|
Outcome Measures
Primary Outcome Measures
- Percentage of Participants With Sustained Virologic Response 12 Weeks After Discontinuation of Therapy (SVR12) [Posttreatment Week 12]
SVR12 was defined as HCV RNA < the lower limit of quantitation (LLOQ) 12 weeks following the last dose of study drug.
- Percentage of Participants Who Permanently Discontinued Any Study Drug Due to an Adverse Event [Up to 12 weeks]
Secondary Outcome Measures
- Percentage of Participants With Sustained Virologic Response 4 and 24 Weeks After Discontinuation of Therapy (SVR4 and SVR24) [Posttreatment Weeks 4 and 24]
SVR4 and SVR24 were defined as HCV RNA < LLOQ at 4 and 24 weeks following the last dose of study drug, respectively.
- Percentage of Participants With HCV RNA < LLOQ on Treatment [Up to 12 Weeks]
- HCV RNA Change From Baseline/Day 1 [Baseline to Week 12]
- Percentage of Participants With Virologic Failure [Up to Posttreatment Week 24]
Virologic failure was defined as: On-treatment virologic failure: Breakthrough (confirmed HCV RNA ≥ LLOQ after having previously had HCV RNA < LLOQ while on treatment), or Rebound (confirmed > 1 log10 IU/mL increase in HCV RNA from nadir while on treatment), or Non-response (HCV RNA persistently ≥ LLOQ through 8 weeks of treatment) Virologic relapse: Confirmed HCV RNA ≥ LLOQ during the posttreatment period having achieved HCV RNA < LLOQ at last on-treatment visit
- Percentage of Participants That Maintained HIV-1 RNA < 50 Copies/mL While On HCV Treatment [Up to 12 Weeks]
- Serum Creatinine Change From Baseline At the End of Treatment and At Posttreatment Week 12 [Week 12; Posttreatment Week 12]
Eligibility Criteria
Criteria
Key Inclusion Criteria:
-
HCV RNA ≥ 10^4 IU/mL at screening
-
HCV genotype 1, 2, 3, 4, 5, 6
-
Cirrhosis determination, a fibroscan or liver biopsy may be required
-
HIV-1 infection
-
Use of protocol specified method(s) of contraception
-
Screening laboratory values within defined thresholds
Key Exclusion Criteria:
-
Clinically-significant illness (other than HCV or HIV) or any other major medical disorder that may interfere with individual's treatment, assessment or compliance with the protocol
-
Current or prior history of clinical hepatic decompensation, hepatocellular carcinoma (HCC) or other malignancy (with the exception of certain resolved skin cancers)
-
Screening ECG with clinically significant abnormalities
-
Pregnant or nursing female or male with pregnant female partner
-
Infection with hepatitis B virus (HBV)
-
Use of any prohibited concomitant medications as described in the protocol
-
Chronic use of systemically administered immunosuppressive agents
NOTE: Other protocol defined Inclusion/ Exclusion criteria may apply.
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
---|---|---|---|---|---|
1 | Birmingham | Alabama | United States | ||
2 | Los Angeles | California | United States | ||
3 | San Diego | California | United States | ||
4 | San Francisco | California | United States | ||
5 | Torrance | California | United States | ||
6 | Atlanta | Georgia | United States | ||
7 | Chicago | Illinois | United States | ||
8 | Baltimore | Maryland | United States | ||
9 | Lutherville | Maryland | United States | ||
10 | Boston | Massachusetts | United States | ||
11 | Bronx | New York | United States | ||
12 | New York | New York | United States | ||
13 | Durham | North Carolina | United States | ||
14 | Cincinnati | Ohio | United States | ||
15 | Richmond | Virginia | United States |
Sponsors and Collaborators
- Gilead Sciences
Investigators
- Study Director: Gilead Study Director, Gilead Sciences
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- GS-US-342-1202
Study Results
Participant Flow
Recruitment Details | Participants were enrolled at 17 study sites in the United States. The first participant was screened on 01 July 2015. The last study visit occurred on 22 June 2016. |
---|---|
Pre-assignment Detail | 149 participants were screened. |
Arm/Group Title | SOF/VEL 12 Weeks |
---|---|
Arm/Group Description | Sofosbuvir/velpatasvir (SOF/VEL; Epclusa®) (400/100 mg) fixed-dose combination (FDC) tablet orally once daily in HCV treatment-naive and treatment-experienced (including treatment intolerant) participants with chronic HCV infection who were coinfected with HIV-1 |
Period Title: Overall Study | |
STARTED | 107 |
COMPLETED | 96 |
NOT COMPLETED | 11 |
Baseline Characteristics
Arm/Group Title | SOF/VEL 12 Weeks |
---|---|
Arm/Group Description | SOF/VEL (400/100 mg) FDC tablet orally once daily in HCV treatment-naive and treatment-experienced (including treatment intolerant) participants with chronic HCV infection who were coinfected with HIV-1 |
Overall Participants | 106 |
Age (years) [Mean (Standard Deviation) ] | |
Mean (Standard Deviation) [years] |
54
(9.0)
|
Sex: Female, Male (Count of Participants) | |
Female |
15
14.2%
|
Male |
91
85.8%
|
Race/Ethnicity, Customized (Count of Participants) | |
Black or African American |
48
45.3%
|
White |
54
50.9%
|
Asian |
3
2.8%
|
Other |
1
0.9%
|
Race/Ethnicity, Customized (Count of Participants) | |
Hispanic or Latino |
15
14.2%
|
Not Hispanic or Latino |
91
85.8%
|
IL28b Status (Count of Participants) | |
CC |
24
22.6%
|
CT |
52
49.1%
|
TT |
30
28.3%
|
HCV RNA (log10 IU/mL) [Mean (Standard Deviation) ] | |
Mean (Standard Deviation) [log10 IU/mL] |
6.3
(0.57)
|
HCV RNA Category (Count of Participants) | |
< 800,000 IU/mL |
28
26.4%
|
≥ 800,000 IU/mL |
78
73.6%
|
HIV RNA category (Count of Participants) | |
HIV RNA < 50 copies/mL |
55
51.9%
|
HIV RNA ≥ 50 copies/mL |
1
0.9%
|
HIV RNA < 50 copies/mL |
35
33%
|
HIV RNA ≥ 50 copies/mL |
0
0%
|
HIV RNA < 50 copies/mL |
14
13.2%
|
HIV RNA ≥ 50 copies/mL |
1
0.9%
|
Serum Creatinine (mg/dL) [Mean (Standard Deviation) ] | |
Boosted TDF Containing Regimens |
1.02
(0.194)
|
Non-Boosted TDF Containing Regimens |
0.98
(1.44)
|
Non TDF Containing Regimens |
1.02
(0.255)
|
Outcome Measures
Title | Percentage of Participants With Sustained Virologic Response 12 Weeks After Discontinuation of Therapy (SVR12) |
---|---|
Description | SVR12 was defined as HCV RNA < the lower limit of quantitation (LLOQ) 12 weeks following the last dose of study drug. |
Time Frame | Posttreatment Week 12 |
Outcome Measure Data
Analysis Population Description |
---|
Full Analysis Set: All enrolled participants who received at least one dose of study drug. |
Arm/Group Title | SOF/VEL 12 Weeks |
---|---|
Arm/Group Description | SOF/VEL (400/100 mg) FDC tablet orally once daily in HCV treatment-naive and treatment-experienced (including treatment intolerant) participants with chronic HCV infection who were coinfected with HIV-1 |
Measure Participants | 106 |
Number (95% Confidence Interval) [percentage of participants] |
95.3
89.9%
|
Title | Percentage of Participants Who Permanently Discontinued Any Study Drug Due to an Adverse Event |
---|---|
Description | |
Time Frame | Up to 12 weeks |
Outcome Measure Data
Analysis Population Description |
---|
Safety Analysis Set |
Arm/Group Title | SOF/VEL 12 Weeks |
---|---|
Arm/Group Description | SOF/VEL (400/100 mg) FDC tablet orally once daily in HCV treatment-naive and treatment-experienced (including treatment intolerant) participants with chronic HCV infection who were coinfected with HIV-1 |
Measure Participants | 106 |
Number [percentage of participants] |
1.9
1.8%
|
Title | Percentage of Participants With Sustained Virologic Response 4 and 24 Weeks After Discontinuation of Therapy (SVR4 and SVR24) |
---|---|
Description | SVR4 and SVR24 were defined as HCV RNA < LLOQ at 4 and 24 weeks following the last dose of study drug, respectively. |
Time Frame | Posttreatment Weeks 4 and 24 |
Outcome Measure Data
Analysis Population Description |
---|
Full Analysis Set |
Arm/Group Title | SOF/VEL 12 Weeks |
---|---|
Arm/Group Description | SOF/VEL (400/100 mg) FDC tablet orally once daily in HCV treatment-naive and treatment-experienced (including treatment intolerant) participants with chronic HCV infection who were coinfected with HIV-1 |
Measure Participants | 106 |
SVR4 |
95.3
89.9%
|
SVR24 |
95.3
89.9%
|
Title | Percentage of Participants With HCV RNA < LLOQ on Treatment |
---|---|
Description | |
Time Frame | Up to 12 Weeks |
Outcome Measure Data
Analysis Population Description |
---|
Participants in the Full Analysis Set with available data were analyzed. |
Arm/Group Title | SOF/VEL 12 Weeks |
---|---|
Arm/Group Description | SOF/VEL (400/100 mg) FDC tablet orally once daily in HCV treatment-naive and treatment-experienced (including treatment intolerant) participants with chronic HCV infection who were coinfected with HIV-1 |
Measure Participants | 106 |
Week 1 |
25.7
24.2%
|
Week 2 |
68.0
64.2%
|
Week 4 |
92.2
87%
|
Week 6 |
99.0
93.4%
|
Week 8 |
100.0
94.3%
|
Week 10 |
100.0
94.3%
|
Week 12 |
100.0
94.3%
|
Title | HCV RNA Change From Baseline/Day 1 |
---|---|
Description | |
Time Frame | Baseline to Week 12 |
Outcome Measure Data
Analysis Population Description |
---|
Participants in the Full Analysis Set with available data were analyzed. |
Arm/Group Title | SOF/VEL 12 Weeks |
---|---|
Arm/Group Description | SOF/VEL (400/100 mg) FDC tablet orally once daily in HCV treatment-naive and treatment-experienced (including treatment intolerant) participants with chronic HCV infection who were coinfected with HIV-1 |
Measure Participants | 106 |
Change at Week 1 |
-4.47
(0.606)
|
Change at Week 2 |
-4.97
(0.577)
|
Change at Week 4 |
-5.15
(0.560)
|
Change at Week 6 |
-5.18
(0.572)
|
Change at Week 8 |
-5.17
(0.575)
|
Change at Week 10 |
-5.17
(0.575)
|
Change at Week 12 |
-5.17
(0.575)
|
Title | Percentage of Participants With Virologic Failure |
---|---|
Description | Virologic failure was defined as: On-treatment virologic failure: Breakthrough (confirmed HCV RNA ≥ LLOQ after having previously had HCV RNA < LLOQ while on treatment), or Rebound (confirmed > 1 log10 IU/mL increase in HCV RNA from nadir while on treatment), or Non-response (HCV RNA persistently ≥ LLOQ through 8 weeks of treatment) Virologic relapse: Confirmed HCV RNA ≥ LLOQ during the posttreatment period having achieved HCV RNA < LLOQ at last on-treatment visit |
Time Frame | Up to Posttreatment Week 24 |
Outcome Measure Data
Analysis Population Description |
---|
Full Analysis Set |
Arm/Group Title | SOF/VEL 12 Weeks |
---|---|
Arm/Group Description | SOF/VEL (400/100 mg) FDC tablet orally once daily in HCV treatment-naive and treatment-experienced (including treatment intolerant) participants with chronic HCV infection who were coinfected with HIV-1 |
Measure Participants | 106 |
Number [percentage of participants] |
1.9
1.8%
|
Title | Percentage of Participants That Maintained HIV-1 RNA < 50 Copies/mL While On HCV Treatment |
---|---|
Description | |
Time Frame | Up to 12 Weeks |
Outcome Measure Data
Analysis Population Description |
---|
Participants in the Safety Analysis Set with available data were analyzed by TDF-containing ART at baseline: Boosted TDF-containing regimens Non-boosted TDF-containing regimens Non TDF-containing regimens |
Arm/Group Title | SOF/VEL 12 Weeks (Boosted TDF Containing Regimens) | SOF/VEL 12 Weeks (Non-Boosted TDF Containing Regimens) | SOF/VEL 12 Weeks (Non TDF Containing Regimens) |
---|---|---|---|
Arm/Group Description | SOF/VEL (400/100 mg) FDC tablet orally once daily in HCV treatment-naive and treatment-experienced (including treatment intolerant) participants with chronic HCV infection who were coinfected with HIV-1. Data for participants who took boosted TDF-containing regimens (defined as regimens containing TDF and ritonavir (RTV) or cobicistat (COBI)-boosted protease inhibitors (PIs) or other agents (eg, elvitegravir (EVG)/COBI)) are summarized in this group. | SOF/VEL (400/100 mg) FDC tablet orally once daily in HCV treatment-naive and treatment-experienced (including treatment intolerant) participants with chronic HCV infection who were coinfected with HIV-1. Data are summarized for participants who took non-boosted TDF-containing regimens (defined as regimens containing TDF and non-RTV or COBI-boosted PIs or other agents). | SOF/VEL (400/100 mg) FDC tablet orally once daily in HCV treatment-naive and treatment-experienced (including treatment intolerant) participants with chronic HCV infection who were coinfected with HIV-1. Data are summarized for participants taking regimens that do not contain TDF. |
Measure Participants | 56 | 35 | 15 |
Week 4 |
94.4
89.1%
|
97.1
NaN
|
100
NaN
|
Week 8 |
96.3
90.8%
|
97.1
NaN
|
100
NaN
|
Week 12 |
96.2
90.8%
|
100
NaN
|
92.9
NaN
|
Title | Serum Creatinine Change From Baseline At the End of Treatment and At Posttreatment Week 12 |
---|---|
Description | |
Time Frame | Week 12; Posttreatment Week 12 |
Outcome Measure Data
Analysis Population Description |
---|
Participants in the Safety Analysis Set with available data were analyzed by TDF-containing ART at baseline: Boosted TDF-containing regimens Non-boosted TDF-containing regimens Non TDF-containing regimens |
Arm/Group Title | SOF/VEL 12 Weeks (Boosted TDF Containing Regimens) | SOF/VEL 12 Weeks (Non-Boosted TDF Containing Regimens) | SOF/VEL 12 Weeks (Non TDF Containing Regimens) |
---|---|---|---|
Arm/Group Description | SOF/VEL (400/100 mg) FDC tablet orally once daily in HCV treatment-naive and treatment-experienced (including treatment intolerant) participants with chronic HCV infection who were coinfected with HIV-1. Data for participants who took boosted TDF-containing regimens (defined as regimens containing TDF and RTV or COBI-boosted PIs or other agents (eg, EVG/COBI)) are summarized in this group. | SOF/VEL (400/100 mg) FDC tablet orally once daily in HCV treatment-naive and treatment-experienced (including treatment intolerant) participants with chronic HCV infection who were coinfected with HIV-1. Data are summarized for participants who took non-boosted TDF-containing regimens (defined as regimens containing TDF and non-RTV or COBI-boosted PIs or other agents). | SOF/VEL (400/100 mg) FDC tablet orally once daily in HCV treatment-naive and treatment-experienced (including treatment intolerant) participants with chronic HCV infection who were coinfected with HIV-1. Data are summarized for participants taking regimens that do not contain TDF. |
Measure Participants | 56 | 35 | 15 |
Change at Week 12 |
0.09
(0.196)
|
0.04
(0.107)
|
0.00
(0.083)
|
Change at Posttreatment Week 12 |
0.04
(0.153)
|
0.02
(0.142)
|
-0.06
(0.204)
|
Adverse Events
Time Frame | Up to 12 Weeks Plus 30 Days | |||||
---|---|---|---|---|---|---|
Adverse Event Reporting Description | Safety Analysis Set | |||||
Arm/Group Title | SOF/VEL 12 Weeks (Boosted TDF Containing Regimens) | SOF/VEL 12 Weeks (Non-Boosted TDF Containing Regimens) | SOF/VEL 12 Weeks (Non TDF Containing Regimens) | |||
Arm/Group Description | SOF/VEL (400/100 mg) FDC tablet orally once daily in HCV treatment-naive and treatment-experienced (including treatment intolerant) participants with chronic HCV infection who were coinfected with HIV-1. Data for participants who took boosted TDF-containing regimens (defined as regimens containing TDF and RTV or COBI-boosted PIs or other agents (eg, EVG/COBI)) are summarized in this group. | SOF/VEL (400/100 mg) FDC tablet orally once daily in HCV treatment-naive and treatment-experienced (including treatment intolerant) participants with chronic HCV infection who were coinfected with HIV-1. Data are summarized for participants who took non-boosted TDF-containing regimens (defined as regimens containing TDF and non-RTV or COBI-boosted PIs or other agents). | SOF/VEL (400/100 mg) FDC tablet orally once daily in HCV treatment-naive and treatment-experienced (including treatment intolerant) participants with chronic HCV infection who were coinfected with HIV-1. Data are summarized for participants taking regimens that do not contain TDF. | |||
All Cause Mortality |
||||||
SOF/VEL 12 Weeks (Boosted TDF Containing Regimens) | SOF/VEL 12 Weeks (Non-Boosted TDF Containing Regimens) | SOF/VEL 12 Weeks (Non TDF Containing Regimens) | ||||
Affected / at Risk (%) | # Events | Affected / at Risk (%) | # Events | Affected / at Risk (%) | # Events | |
Total | / (NaN) | / (NaN) | / (NaN) | |||
Serious Adverse Events |
||||||
SOF/VEL 12 Weeks (Boosted TDF Containing Regimens) | SOF/VEL 12 Weeks (Non-Boosted TDF Containing Regimens) | SOF/VEL 12 Weeks (Non TDF Containing Regimens) | ||||
Affected / at Risk (%) | # Events | Affected / at Risk (%) | # Events | Affected / at Risk (%) | # Events | |
Total | 2/56 (3.6%) | 0/35 (0%) | 0/15 (0%) | |||
Infections and infestations | ||||||
Localised infection | 1/56 (1.8%) | 0/35 (0%) | 0/15 (0%) | |||
Sepsis | 1/56 (1.8%) | 0/35 (0%) | 0/15 (0%) | |||
Urinary tract infection bacterial | 1/56 (1.8%) | 0/35 (0%) | 0/15 (0%) | |||
Nervous system disorders | ||||||
Radial nerve palsy | 1/56 (1.8%) | 0/35 (0%) | 0/15 (0%) | |||
Other (Not Including Serious) Adverse Events |
||||||
SOF/VEL 12 Weeks (Boosted TDF Containing Regimens) | SOF/VEL 12 Weeks (Non-Boosted TDF Containing Regimens) | SOF/VEL 12 Weeks (Non TDF Containing Regimens) | ||||
Affected / at Risk (%) | # Events | Affected / at Risk (%) | # Events | Affected / at Risk (%) | # Events | |
Total | 34/56 (60.7%) | 19/35 (54.3%) | 9/15 (60%) | |||
Gastrointestinal disorders | ||||||
Abdominal distension | 3/56 (5.4%) | 2/35 (5.7%) | 0/15 (0%) | |||
Constipation | 2/56 (3.6%) | 2/35 (5.7%) | 0/15 (0%) | |||
Diarrhoea | 6/56 (10.7%) | 2/35 (5.7%) | 0/15 (0%) | |||
Nausea | 4/56 (7.1%) | 2/35 (5.7%) | 1/15 (6.7%) | |||
Toothache | 0/56 (0%) | 0/35 (0%) | 1/15 (6.7%) | |||
Vomiting | 1/56 (1.8%) | 1/35 (2.9%) | 1/15 (6.7%) | |||
General disorders | ||||||
Chest discomfort | 0/56 (0%) | 1/35 (2.9%) | 1/15 (6.7%) | |||
Fatigue | 16/56 (28.6%) | 7/35 (20%) | 3/15 (20%) | |||
Immune system disorders | ||||||
Seasonal allergy | 0/56 (0%) | 2/35 (5.7%) | 0/15 (0%) | |||
Infections and infestations | ||||||
Bronchitis | 3/56 (5.4%) | 0/35 (0%) | 0/15 (0%) | |||
Fungal infection | 0/56 (0%) | 0/35 (0%) | 1/15 (6.7%) | |||
Nasopharyngitis | 3/56 (5.4%) | 2/35 (5.7%) | 0/15 (0%) | |||
Upper respiratory tract infection | 8/56 (14.3%) | 1/35 (2.9%) | 0/15 (0%) | |||
Urinary tract infection | 2/56 (3.6%) | 0/35 (0%) | 2/15 (13.3%) | |||
Musculoskeletal and connective tissue disorders | ||||||
Arthralgia | 6/56 (10.7%) | 1/35 (2.9%) | 1/15 (6.7%) | |||
Back pain | 0/56 (0%) | 2/35 (5.7%) | 0/15 (0%) | |||
Flank pain | 0/56 (0%) | 0/35 (0%) | 1/15 (6.7%) | |||
Muscle spasms | 1/56 (1.8%) | 0/35 (0%) | 1/15 (6.7%) | |||
Osteoarthritis | 0/56 (0%) | 0/35 (0%) | 1/15 (6.7%) | |||
Pain in extremity | 2/56 (3.6%) | 1/35 (2.9%) | 1/15 (6.7%) | |||
Nervous system disorders | ||||||
Headache | 7/56 (12.5%) | 6/35 (17.1%) | 1/15 (6.7%) | |||
Psychiatric disorders | ||||||
Abnormal dreams | 3/56 (5.4%) | 1/35 (2.9%) | 0/15 (0%) | |||
Depression | 3/56 (5.4%) | 1/35 (2.9%) | 0/15 (0%) | |||
Insomnia | 4/56 (7.1%) | 3/35 (8.6%) | 0/15 (0%) | |||
Nervousness | 0/56 (0%) | 0/35 (0%) | 1/15 (6.7%) | |||
Respiratory, thoracic and mediastinal disorders | ||||||
Cough | 1/56 (1.8%) | 2/35 (5.7%) | 0/15 (0%) | |||
Sinus congestion | 2/56 (3.6%) | 2/35 (5.7%) | 0/15 (0%) | |||
Skin and subcutaneous tissue disorders | ||||||
Pruritus | 2/56 (3.6%) | 0/35 (0%) | 1/15 (6.7%) | |||
Rash | 1/56 (1.8%) | 0/35 (0%) | 1/15 (6.7%) |
Limitations/Caveats
More Information
Certain Agreements
Principal Investigators are NOT employed by the organization sponsoring the study.
After conclusion of the study and without prior written approval from Gilead, investigators in this study may communicate, orally present, or publish in scientific journals or other media only after the following conditions have been met: The results of the study in their entirety have been publicly disclosed by or with the consent of Gilead in an abstract, manuscript, or presentation form; or The study has been completed at all study sites for at least 2 years
Results Point of Contact
Name/Title | Clinical Trial Disclosures |
---|---|
Organization | Gilead Sciences |
Phone | |
ClinicalTrialDisclosures@gilead.com |
- GS-US-342-1202