Other secondary objectives included evaluating selleck chemicals llc the PK of TVR, PEG-IFN,

and RBV and to investigate PK-pharmacodynamic relationships for safety and efficacy. Changes from baseline in the amino acid sequence of the HCV NS3/4A region were also assessed. Patients were randomized (1:1) to receive TVR twice daily or every 8 hours and were stratified according to liver fibrosis stage and IL28B rs12979860 genotype CC, CT, or TT. 4, 5 and 6 Randomization was performed using a central, computer-generated schedule prepared under supervision of the sponsor before the study. An interactive telephone or Internet system assigned a unique code that dictated the treatment assignment and matching study drug kit for the patient. Fibrosis stage was assessed by liver biopsy and graded locally as no/mild fibrosis and portal fibrosis (METAVIR F0–F2; Ishak score ≤3) or bridging fibrosis and cirrhosis (METAVIR F3–F4; Ishak score ≥4). 7 All patients received 12 weeks of treatment with TVR twice daily or every 8 hours, each in combination with PEG-IFN/RBV. TVR was administered orally at a dose of either 750 mg every 8 hours or 1125 mg twice

daily (with a time window of 10–14 hours between twice-daily drug intake). The dosage of PEG-IFN was 180 μg/wk, and the dosage of RBV was 1000 mg/day in patients weighing <75 kg or 1200 mg/day in patients weighing ≥75 kg. Patients assigned to the TVR twice daily group took RBV with their dose of TVR. Patients assigned to TVR every selleck products 8 hours could take RBV with 2 of the 3 daily doses of TVR, with the first dose always

to be taken with the morning dose of TVR. At week 12, TVR dosing ended and patients continued on standard PEG-IFN/RBV treatment. If a patient achieved a rapid virological response (RVR; HCV RNA <25 IU/mL, target not detected at week 4 of treatment), the total treatment duration was 24 weeks; otherwise, the total treatment duration was 48 weeks. An electronic diary (e-diary), completed by the patients, captured the amount and timing of TVR dosing relative to the prescribed regimen. Futility rules were applied to all patients to minimize the risk of 6-phosphogluconolactonase viral resistance in patients without an adequate antiviral response. HCV RNA results were monitored, and all treatment was stopped if HCV RNA levels were >1000 IU/mL at week 4 or ≥25 IU/mL at weeks 12, 24, 32, or 40. TVR was permanently discontinued for any grade 4 adverse event (AE) or toxicity that was considered at least possibly related to TVR or for any patient experiencing a severe skin reaction. TVR was not restarted once discontinued due to an AE or toxicity considered at least possibly related to TVR. RBV dosing, including modifications to manage anemia, followed local prescribing instructions. If RBV was permanently discontinued for the management of anemia, TVR was also permanently discontinued. RBV could be restarted as per the dosing modification guidelines.