Pivotal Phase III STARTVerso data shows efficacy of faldaprevir in genotype-1 infected HCV patients

Nov 5 2013

Boehringer Ingelheim today announced new data from its Phase III clinical trial programme, STARTVerso™, which evaluates faldaprevir in combination with pegylated interferon and ribavirin (PegIFN/RBV). Patients with genotype-1 (GT-1) hepatitis C (HCV) who have not received previous treatment (treatment-naïve: STARTVerso™1&2), treatment-experienced patients (STARTVerso™3), and HIV co-infected patients (STARTVerso™4) participated in this study programme. The results from these and additional studies will be presented at the 64th Annual Meeting of the American Association for the Study of Liver Diseases (AASLD), also known as The Liver Meeting®, taking place 1-5 November in Washington, D.C. 

In STARTVerso™1&2, 84% of treatment-naïve patients receiving faldaprevir were able to shorten the total time on treatment from 48 to 24 weeks; 83% of these patients achieved viral cure (SVR12). Overall, 73% and 72% of patients achieved SVR12 with faldaprevir 120mg and 240mg regimens, respectively. Interim results from STARTVerso™4 showed that 74% of patients with HCV/HIV co-infection treated with faldaprevir had undetectable HCV 4 weeks after the conclusion of treatment (SVR4), a response rate similar to that seen with HCV mono-infection.3 Additionally, treatment of difficult-to-cure patients who have relapsed on previous HCV treatment (STARTVerso™3) demonstrated viral cure rates of 70% with faldaprevir. In the same study, patients who partially responded and those who showed no response to previous treatment achieved viral cure rates of up to 58% and 33%, respectively.

“These data are encouraging and reinforce the potential benefits of faldaprevir as an effective treatment for genotype-1 infected HCV patients,” said Ira Jacobson, M.D., Chief of the Division of Gastroenterology and Hepatology, Weill Cornell Medical College, New York. “The broad populations studied in STARTVerso™ and the fact that very few patients discontinued treatment due to adverse events provides physicians with confidence in faldaprevir as an important potential addition to the available agents for the treatment of hepatitis C.”

More than 2,200 patients have been studied in the STARTVerso™ trial programme, including patients with difficult-to-cure types of HCV: 

• Over 300 patients in the programme have HCV/HIV co-infection; these patients have higher levels of HCV in their blood and can be more difficult to cure
• 677 patients were  treatment-experienced, meaning they had attempted previous HCV treatment but did not achieve viral cure
• 40% of patients in STARTVerso™3 had advanced liver disease (≥F3 fibrosis)
• 59% of patients in STARTVerso™1&2 had a non-CC IL28B genotype; in previous studies, these patients were less likely to achieve viral cure

“The STARTVerso™ trial results are particularly promising given the inclusion of a broad range of patients and the similar success rates seen in both HCV mono and HCV/HIV co-infected patients. These data will form the basis of regulatory submissions and we look forward to the outcome,” said Professor Klaus Dugi, Senior Vice President Medicine at Boehringer Ingelheim. “Faldaprevir may offer a simple and convenient option for patients, due to once-daily dosing and no food restrictions. Faldaprevir is the foundation of our HCV pipeline and we look forward to presenting pivotal Phase III HCVerso® data for the treatment of HCV as part of an interferon-free regimen in 2014.”

Faldaprevir as part of this interferon-based regimen is likely to offer advantages over first generation protease inhibitors with fewer skin reactions, gastrointestinal events and no additional anaemia. In the STARTVerso™ clinical trial programme, adverse events (AEs) were generally mild and well manageable. Most common AEs included jaundice due to transient bilirubin elevation (unconjugated hyperbilirubinemia), nausea, fatigue, diarrhoea, headache, anaemia and rash. 95% of patients completed faldaprevir treatment.