Featured news from NHIVNA
HIV-related news from NAM
Sofosbuvir + ribavirin cures most genotype 2 hepatitis C, but genotype 3 response is lower
Liz Highleyman, 2013-04-26 09:50:00
A dual oral regimen containing the hepatitis C nucleotide polymerase inhibitor sofosbuvir plus ribavirin produced high sustained virological rates overall, but this was driven by very good response amongst people with HCV genotype 2, whilst those with genotype 3 fared more poorly, researchers reported yesterday at the 48th International Liver Congress 2013 (EASL) in Amsterdam.
The advent of direct-acting antivirals has changed the treatment paradigm for chronic hepatitis C, but many patients and clinicians continue to await all-oral regimens that avoid interferon and its difficult side-effects.
Gilead Science's sofosbuvir (formerly GS-7977) is a once-daily nucleotide analogue that targets the HCV NS5B polymerase. Studies have shown that it has potent antiviral activity, a high barrier to resistance, and is generally safe and well tolerated.
A simple, short-duration regimen of sofosbuvir plus weight-based ribavirin was evaluated in people with HCV genotypes 2 or 3, traditionally considered 'easier to treat'.
Edward Gane from Auckland City Hospital in New Zealand presented final results from the phase 3 FISSION trial, looking at a 12-week regimen in treatment-naive patients. David Nelson from the University of Florida College of Medicine followed with findings from the FUSION trial, comparing the oral regimen for 12 or 16 weeks in patients who were not cured with prior interferon-based therapy.
As Gane first reported at the 2011 AASLD Liver Meeting, 12 weeks of sofosbuvir (then known as PSI-7977) plus ribavirin cured 100% of previously untreated genotype 2 or 3 patients without liver cirrhosis in the smaller phase 2 ELECTRON trial.
The 12-week post-treatment sustained virological response (SVR12) rate fell to 68% for treatment-experienced patients, however, prompting phase 3 researchers to test an additional month of dual therapy. Further analysis of newly added ELECTRON arms showed that sofosbuvir plus ribavirin was not adequate for people with HCV genotype 1, especially prior null responders, who had an SVR12rate of just 10%.
Source:1
