A Safety And Pharmacokinetic Study of Setrobuvir Alone and In Combination With Ritonavir-Boosted Danoprevir in Subjects With Mild Hepatic Impairment Compared to Healthy Controls

Study Overview
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Brief Summary
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This multi-center, fixed-sequence, open-label, multiple-dose, 2-period study will evaluate the safety, tolerability and pharmacokinetics of setrobuvir alone or in combination with ritonavir-boosted danoprevir in subjects with mild hepatic impairment compared to healthy controls. All subjects will receive multiple doses of setrobuvir orally for 10 days in Period 1 and multiple doses of setrobuvir plus ritonavir-boosted danoprevir orally for 10 days in Period 2, with a washout phase of at least 9 days between treatments.

Official Title
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A Multi Center, Sequential, Open-Label, Multiple-Dose Study of Setrobuvir (STV) Alone and With Co-Administration of Ritonavir-boosted Danoprevir to Evaluate the Safety, Tolerability and Pharmacokinetics of STV, DNV, and Ritonavir (RTV) in Subjects With Mild Hepatic Impairment Compared to Healthy Controls

Conditions
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Healthy Volunteer

Intervention / Treatment
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* Drug: danoprevir
* Drug: ritonavir
* Drug: setrobuvir


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Male and female adults, 18-65 years of age, inclusive Weight >/= 45.0 kg Body mass index (BMI) 18.0 - 35.0 kg/m2, inclusive Females of childbearing potential and males and their female partners of childbearing potential must agree to use two forms of non-hormonal contraception as defined by protocol Subjects with a history of substance abuse may be enrolled provided they have not abused drugs or alcohol for at least 6 months Healthy subjects only: Medical history without major recent or ongoing pathology Laboratory values at screening and Day -1 within the normal range or showing no clinically relevant deviations Subjects with hepatic impairment only: Stable mild liver disease (Child-Pugh A) of cryptogenic, post-hepatic, hepatitis B/C, or alcoholic origin Stable hepatic impairment defined as no clinically significant change in disease status within the last 30 days Must be on stable dose of medication and/or treatment regimen at least 2 weeks before dosing of study medication Exclusion Criteria: Pregnant or lactating women or males with female partners who are pregnant or lactating Active infection or febrile illness </= 10 days prior to the first dose of study medication Uncontrolled/untreated hypertension Inadequate renal function Positive urine drug screen or positive breath alcohol test at screening and on Day -1 of each period An average alcohol intake of more than 2 units per day or 14 units per week until 48 hours prior to enrollment History of any significant drug-related allergy or hepatotoxicity Participation in other clinical studies with an investigational drug or new chemical entity within 3 months (6 months for biologic therapies) prior to the first dose of study medication Positive for HIV infection Any clinically significant cardiovascular or cerebrovascular disease Healthy subjects only: Any clinically significant concomitant disease or condition that could interfere with, or for which the treatment might interfere with, the conduct of the study, absorption of medication, or that would, in the opinion of the investigator, pose an unacceptable risk to the subject in this study Positive screening test for HBsAg or HCV antibody Subjects with hepatic impairment only: Severe ascites at screening or Day -1 History of or current severe hepatic encephalopathy (Grade 3 or higher) Biliary liver cirrhosis or other causes of hepatic impairment not related to parenchymal disorder and/or disease of the liver Positive screening test for HCV antigen

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: A: setrobuvir<br> | Drug: setrobuvir<br>* 200 mg orally every 12 hours<br>|
| Experimental: B: setrobuvir + DNV/r<br> | Drug: danoprevir<br>* 100 mg orally every 12 hours<br>Drug: ritonavir<br>* 100 mg orally every 12 hours<br>Drug: setrobuvir<br>* 200 mg orally every 12 hours<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Safety: Incidence of adverse events |  | approximately 40 days | 
| Pharmacokinetics: Maximum plasma concentration at steady-state (Css,max) |  | up to 16 days | 
| Pharmacokinetics: Total area under the concentration-time curve form time 0 to 12 hours post-dose at steady-state (AUCss,0-12h) |  | up to 16 days | 
| Pharmacokinetics: Plasma concentration at steady-state 12 hours post-dose (Css, 12h) |  | up to 16 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pharmacokinetics: Time to maximum plasma concentration (tmax) |  | up to 16 days | 
| Pharmacokinetics: Elimination half-life (t1/2) |  | up to 16 days | 
| Pharmacokinetics: Apparent oral clearance at steady-state (CLss/F) |  | up to 16 days | 
| Pharmacokinetics: Cumulative amount excreted at steady-state (Aess) |  | up to 16 days | 
| Pharmacokinetics: Fraction of orally administered drug excreted into urine (fe/f) |  | up to 16 days | 
| Pharmacokinetics of danoprevir in combination with setrobuvir: Area under the concentration-time curve (AUC) |  | up to 12 days | 
| Pharmacokinetics of ritonavir in combination with setrobuvir: Area under the concentration-time curve (AUC) |  | up to 12 days |