Hepatitis C

Sofosbuvir With Velpatasvir Highly Effective Against HCV

Combination therapy with sofosbuvir and velpatasvir is effective and well tolerated among patients with genotype 1-6 hepatitis C virus (HCV) infection, according to 2 recent studies.

In the first randomized, phase 2, open-label study, researchers divided adults with genotype 3 HCV without cirrhosis (cohort 1) and with compensated cirrhosis (cohort 2) and those with genotype 1 HCV unsuccessfully treated with protease inhibitor (cohort 3).1
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All patients received 12 weeks of 400 mg of sofosbuvir once daily. Patients were randomly assigned to 25 mg  or 100 mg of velpatasvir with or without ribavirin, once daily.

In cohort 1, sustained virologic response at 12 weeks (SRV12) was 85% with 25 mg of velpatasvir, 96% with 25 mg of velpatasvir plus ribavirin, 100% with 100 mg of velpatasvir, and 100% with 100 mg of velpatasvir plus ribavirin.

In cohort 2, SVR12 rates were 58% with 25 mg of velpatasvir, 84% with 25 mg of velpatasvir plus ribavirin, 88% with 100 mg of velpatasvir, and 96% with 100 mg of velpatasvir plus ribavirin.

In cohort 3, SVR12 rates were 100% with 25 mg of velpatasvir, 97% with 25 mg of velpatasvir plus ribavirin, 100% with 100 mg of velpatasvir, and 96% with 100 mg of velpatasvir plus ribavirin.

In the second study, researchers followed 377 treatment-naïve noncirrhotic patients with HCV genotypes 1-6, randomly assigning them to 400 mg of sofosbuvir with either 25 mg or 100 mg of velpatasvir for 12 weeks.2

Overall, SVR12 rates were 96% with velpatasvir, 25 mg, and 100% with velpatasvir, 100 mg, for genotype 1; 93% in both groups for genotype 3; and 96% with velpatasvir, 25 mg, and 95% with velpatasvir, 100 mg, for genotypes 2, 4, 5, and 6.

“Twelve weeks of sofosbuvir, 400 mg, and velpatasvir, 100 mg, was well-tolerated and resulted in high SVR in patients infected with HCV genotypes 1 to 6,” they concluded.

—Michael Potts

References:

  1. Pianko S, Flamm SL, Shiffman ML, et al. Sofosbuvir plus Velpatasvir combination therapy for treatment-experienced patients with genotype 1 or 3 hepatitis c virus infection: a randomized trial. Ann Intern Med. November 2015 [epub ahead of print]. doi:10.7326/M15-1014.
  2. Everson GT, Towner WJ, Davis MN, et al. Sofosbuvir With Velpatasvir in treatment-naive noncirrhotic patients with genotype 1 to 6 hepatitis c virus infection: a randomized trial. Ann Intern Med. November 2015 [epub ahead of print]. doi:10.7326/M15-1000.