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Daclatasvir plus sofosbuvir works well for people with genotype 3 hepatitis C and advanced liver disease in real-world clinical practice
Liz Highleyman, 2015-11-20 13:00:00

Interferon-free treatment with daclatasvir plus sofosbuvir, with or without ribavirin, led to sustained virological response in a majority of people with genotype 3 hepatitis C virus (HCV) and advanced liver disease treated in a real-world setting in compassionate use programs in Europe, according to a pair of studies presented at the 2015 AASLD Liver Meeting last week in San Francisco, USA.

While interferon-free direct-acting antiviral therapy has revolutionised treatment for chronic hepatitis C, better options are still needed for people with HCV genotype 3. This genotype, which accounts for an estimated 30% of all hepatitis C cases worldwide, is associated with faster liver disease progression and is more likely than other genotypes to lead to cirrhosis and liver cancer.

Researchers reported findings from studies looking at people with genotype 3 who were treated with Bristol-Myers Squibb's pangenotypic HCV NS5A replication complex inhibitor daclatasvir (Daklinza) and Gilead Sciences' HCV polymerase inhibitor sofosbuvir (Sovaldi), with or without ribavirin, in two compassionate use programmes. Compassionate use allows people with urgent medical needs and no other treatment options to receive experimental therapies prior to regulatory approval.

In the previous ALLY-3 study, daclatasvir plus sofosbuvir taken for 12 weeks led to a 12-week post-treatment sustained virological response (SVR12) rate of 96% for people without cirrhosis, but only 63% for those with cirrhosis. As reported at the Liver Meeting, the follow-up ALLY-3+ study found that adding ribavirin increased cure rates to 88% with 12 weeks and 92% with 16 weeks of treatment. But good outcomes in clinical trials are not always reflected in real-world settings where patients may be more difficult to treat.

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