High Efficacy of Sofosbuvir/Velpatasvir Plus GS-9857 for 12 Weeks in Treatment-Experienced Genotype 1-6 HCV-Infected Patients, Including Those Previously Treated with Direct-Acting Antivirals

Lawitz, Eric; Kowdley, Kris V.; Curry, Michael P.; Reau, Nancy; Nguyen, M.; Kwo, P.; Jacobson, Ira M.; Tran, Thien; Nahass, Ronald; Hinestrosa, Federico; Herring, Robert; Bennet, M.; Yang, Jenny C.; Stamm, Luisa M.; An, Di; Dvory‐Sobol, Hadas; Brainard, Diana M.; McHutchison, John G.; Schiff, Eugene R.; Davis, Mitchell; Etzkorn, K. Peter; Chung, Raymond T.; Pound, D.; Rodrı́guez-Torres, Maribel; Reddy, K. R. C.; Younes, Ziad; Gane, Ed

doi:10.1016/s0168-8278(16)01645-7

Cited by 10 publications

(10 citation statements)

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“…The nearby future is even looking bright for those few patients who failed to attain SVR with the currently available IFN-free regimens [3]. Although larger studies are needed, various combinations of pangenotypic and potent DAAs of various classes appear to result in SVR in almost all these patients [4,5].…”

Section: Introductionmentioning

confidence: 99%

Reversion of disease manifestations after HCV eradication

Meer

Berenguer

2016

Journal of Hepatology

157

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Chronic infection with the hepatitis C virus (HCV) may lead to hepatic fibrosis and eventually cirrhosis, at which stage, patients have a substantial risk of liver failure, hepatocellular carcinoma (HCC) and liver-related death. Moreover, HCV infection is associated with several extrahepatic manifestations which impact the quality of life and increase the non-liver-related mortality rate. For patients with compensated liver disease, interferon (IFN)-based antiviral therapy has been a treatment option for over two decades. Long-term follow-up studies indicated that among those with sustained virological response (SVR) the extend of hepatic fibrosis can regress and that their risk of cirrhosis-related complications (including HCC) is reduced, also in case of cirrhosis. Recent population-based studies extended these observations for solid extrahepatic outcomes, such as end-stage renal failure and cardiovascular events. Most importantly, SVR has been associated with prolonged overall survival. These results highlight the importance of the development of new direct-acting antivirals (DAAs), by which almost all patients are able to eradicate HCV in a comfortable manner. Based on the excellent first experiences with the DAAs, physicians gained confidence to use these drugs among patients with decompensated cirrhosis on a more regular basis as well. This was not possible with interferon therapy. Also in this high risk population the DAAs show high SVR rates with improvements in biochemical parameters of liver function shortly after therapy, especially in case of SVR. In fact, some patients could actually be removed from the liver transplantation waiting list due to clinical improvement following DAA therapy. How these short-term results translate into a prolonged (long-term) survival has yet to be determined, as well as which patients with decompensated liver disease are likely or not to benefit from viral eradication. Here we review the current data regarding the beneficial clinical outcome with antiviral therapy as well the remaining uncertainties in this field, both for patients with compensated liver disease and patients with decompensated liver disease.

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Section: Introductionmentioning

confidence: 99%

Reversion of disease manifestations after HCV eradication

Meer

Berenguer

2016

Journal of Hepatology

157

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“…These triple regimens include drugs against the main antiviral targets within the HCV replicase, i.e., a protease inhibitor, an NS5A inhibitor and a nucleos(t)idic HCV polymerase inhibitor. Encouraging preliminary results have already been reported [101][102][103].…”

Section: Resistance-associated Variantsmentioning

confidence: 68%

Future landscape of hepatitis C research – Basic, translational and clinical perspectives

Moradpour

Grakoui

Manns

2016

Journal of Hepatology

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With the latest all-oral interferon- and ribavirin-free regimens based on direct acting antivirals against the hepatitis C virus (HCV), sustained virological response rates of >90% are achieved, which is equivalent to cure. This has become possible for all genotypes and all subgroups of patients, including many of the most difficult-to-treat populations so far. Since a prophylactic HCV vaccine is not yet available, control of HCV infection will for the time being have to rely on the use of effective and safe antiviral treatments as well as their accessibility and affordability. Different approaches may apply to different parts of the world, eradication of HCV representing a major long-term goal. Whether hepatitis C becomes the first chronic viral infection to be eradicated without a prophylactic vaccine remains to be shown. Here, we briefly summarize advances in the molecular virology of hepatitis C, highlight lessons of biological relevance that were learned through the study of HCV, and its translational and clinical implications. We have also listed selected unsolved challenges, emphasizing that HCV is a unique model and that advances in this direction may yield knowledge of broad biological significance, novel technologies and insights into related important human pathogens.

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“…Among all GT3 patients in this study treated with SOF/VEL/VOX (including both treatment naïve and treatment experienced), 97% (34/35) achieved SVR12, with the single relapse being a patient with GT3 infection, cirrhosis, and a Y93H mutation. [28] In the POLARIS-1 and POLARIS-4 trials, 74/78 (95%) and 52/54 (96%) of GT3 infected patients receiving SOF/VEL/VOX for 12 weeks achieved SVR12, respectively. [22] In the POLARIS-1 trial, all four patients who had GT3 and failed SOF/VEL/VOX had cirrhosis.…”

Section: Current Strategies For Retreatmentmentioning

confidence: 99%

Retreatment Options Following HCV Direct-Acting Antiviral Failure

Zuckerman

Chastain

Naggie

2017

Curr Treat Options Infect Dis

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OPINION STATEMENT Despite the excellent efficacy of direct acting antivirals (DAA) for hepatitis C virus (HCV), treatment failures do occur. Until recently, retreatment decisions after DAA failure were influenced by the number of available agents, concerns about HCV drug resistance, and lack of data regarding retreatment. Recommended treatment approaches previously depended on limited clinical trials and expert opinion. In this article, we review the current state of the evidence for HCV retreatment after DAA failure. Based on recent clinical trial data, most patients who fail HCV treatment with DAA agents now have excellent retreatment options. While some patients may benefit from resistance testing after DAA therapy failure to select the optimal treatment and duration, newly approved salvage therapies are not significantly impacted by common mutations and have been approved by the Food and Drug Administration for HCV retreatment without regard for the presence of resistance associated substitutions. While prior retreatment efforts were limited to longer courses of therapy, the addition of ribavirin, or novel combinations of approved therapies based on expert guidance, current DAA options make HCV retreatment in the DAA era more streamlined and evidence-based.

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High Efficacy of Sofosbuvir/Velpatasvir Plus GS-9857 for 12 Weeks in Treatment-Experienced Genotype 1-6 HCV-Infected Patients, Including Those Previously Treated with Direct-Acting Antivirals

Cited by 10 publications

References 0 publications

Reversion of disease manifestations after HCV eradication

Reversion of disease manifestations after HCV eradication

Future landscape of hepatitis C research – Basic, translational and clinical perspectives

Retreatment Options Following HCV Direct-Acting Antiviral Failure

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