Epclusa achieves best SVR rates in patients with HCV genotype 3
VIENNA — Patients with hepatitis C genotype 3 and compensated cirrhosis had higher rates of sustained virologic response after treatment with Epclusa and ribavirin than with Epclusa alone or combined Sovaldi and Daklinza with ribavirin.
Kate Drysdale, MBBCh, from the Queen Mary University of London in the United Kingdom, presented data gathered from a national registry of patients with hepatitis C in England. According to Drysdale, HCV treatment within this registry is dictated by local prioritization and the lowest cost of acquisition determines choice of direct-acting antivirals.
Drysdale and colleagues analyzed registry data on 37,693 patients with HCV. Of the 14,603 adult patients treated with DAAs with a per protocol 12-week outcome, 13,959 achieved sustained virologic response for an overall SVR rate of 95.59%.
Among patients with genotype 3 and moderate fibrosis, SVR rates were similar between those treated with Mavyret (glecaprevir/pibrentasvir, AbbVie) for 8 weeks and those treated with Epclusa (sofosbuvir/velpatasvir, Gilead Sciences) for 12 weeks.
In a subgroup of patients with genotype 3 and compensated cirrhosis, SVR rates were significantly higher in those treated with sofosbuvir/velpatasvir and ribavirin for 12 weeks (97.96%) than those treated with sofosbuvir/velpatasvir alone (91.6%; P = .005) or combined Sovaldi (sofosbuvir, Gilead Sciences) and Daklinza (daclatasvir, Bristol-Myers Squibb) with ribavirin (92.17%; P = .002).
Additionally, while the subgroup of patients with decompensated cirrhosis was numerically small, the researchers found no significant difference in outcomes between the different DAA regimens.
“The SVR rate for those with genotype 3 hepatitis C was not significantly lower than [the overall per protocol rate], however there are nuances to this when we look at subgroups,” Drysdale concluded, and noted that she and her colleagues were pleased to find that the sofosbuvir/velpatasvir treatment was comparable with glecaprevir/pibrentasvir. – by Talitha Bennett
Drysdale K. Abstract LB-07. Presented at: International Liver Congress; April 10-14, 2019; Vienna, Austria.
Disclosures: Drysdale reports no relevant financial disclosures.