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8-week triple DAA combo cures most people with genotype 1-6 hepatitis C
Liz Highleyman, 2016-11-21 07:10:00

A three-drug regimen of sofosbuvir, velpatasvir and voxilaprevir taken for 8 weeks demonstrated an overall sustained virological response rate of 95% for previously untreated people with all hepatitis C virus (HCV) genotypes, while a 12-week regimen cured 96-97% of people who experienced prior treatment failure on direct-acting antivirals (DAAs), according to a set of phase 3 studies presented last week at the 2016 AASLD Liver Meeting in Boston.

The 8-week triple regimen failed to match a 12-week dual regimen of sofosbuvir and velpatasvir for treatment-naive patients due to a number of relapses among people with HCV genotype 1a. But the shorter regimen did cure 96-99% of the most difficult-to-treat genotype 3 patients with cirrhosis.

The advent of DAAs used in interferon-free regimens has made treatment for chronic hepatitis C shorter, more convenient and much more effective, but there is still room for better options for hard-to-treat patient groups. There is also an unmet need for pangenotypic regimens that are active against all HCV genotypes and could be used anywhere in the world without the need for genotypic testing.

Targeting multiple steps of the viral lifecycle makes for more effective therapy. Gilead Sciences is evaluating a new triple regimen combining pangenotypic agents from three different classes in a once-daily co-formulation: the previously approved HCV nucleotide polymerase inhibitor sofosbuvir (sold alone as Sovaldi), the NS5A inhibitor velpatasvir and the investigational HCV protease inhibitor voxilaprevir (formerly GS-9857).

Gilead already sells two highly effective dual co-formulations, sofosbuvir/ledipasvir (Harvoni) and sofosbuvir/velpatasvir (Epclusa), the latter of which is pangenotypic. However, it does not yet have an approved HCV protease inhibitor.