Sustained virological response in patients with HCV treated with daclatasvir plus sofosbuvir, with or without ribavirin: a large, field-practice study.

HCV NS5A inhibitors HCV replication complex daclatasvir direct-acting antivirals ribavirin sofosbuvir

Journal

Drugs in context
ISSN: 1745-1981
Titre abrégé: Drugs Context
Pays: England
ID NLM: 101262187

Informations de publication

Date de publication:
2020
Historique:
received: 04 04 2020
revised: 03 11 2020
accepted: 14 11 2020
entrez: 7 1 2021
pubmed: 8 1 2021
medline: 8 1 2021
Statut: epublish

Résumé

The once-daily oral combination of daclatasvir (DCV) and sofosbuvir (SOF), with or without ribavirin (RBV), is effective and well tolerated in patients with hepatitis C virus (HCV). However, further field-practice studies are necessary to investigate the effectiveness and safety of the DCV+SOF combination in diverse subpopulations of patients with HCV, including those who are more challenging to treat such as patients with a genotype 3 (G3) infection. The aim of this retrospective, multicenter, field-practice study was to investigate the therapeutic efficacy and safety of the oral combination of DCV and SOF, with or without RBV (DCV+SOF±RBV), in a large unselected cohort of patients with chronic HCV infection (CHC). Consecutive patients received DCV+SOF±RBV for 12 or 24 weeks. The efficacy endpoint was sustained virological response at 12 weeks after the end of treatment (SVR12). Safety factors were also considered. A total of 620 patients were included in this study; the predominant genotype was G3 (55.3%). Of the total sample, 248 (40%) patients were treated with DCV+SOF+RBV and 372 (60%) did not receive RBV. The majority of patients assessed at week 12 (98%, 596/608) achieved SVR12. Among G3 patients, 98.8% (335/339) achieved SVR12. The most common adverse event was elevated bilirubin (30.6%), recorded in 4.9% of cases as a grade 3-4 adverse event. This study shows the high pan-genotypic effectiveness and safety of the DCV+SOF±RBV combination in a large, unselected sample of CHC patients with G1-4, including a wide proportion of G3 CHC patients.

Sections du résumé

BACKGROUND BACKGROUND
The once-daily oral combination of daclatasvir (DCV) and sofosbuvir (SOF), with or without ribavirin (RBV), is effective and well tolerated in patients with hepatitis C virus (HCV). However, further field-practice studies are necessary to investigate the effectiveness and safety of the DCV+SOF combination in diverse subpopulations of patients with HCV, including those who are more challenging to treat such as patients with a genotype 3 (G3) infection. The aim of this retrospective, multicenter, field-practice study was to investigate the therapeutic efficacy and safety of the oral combination of DCV and SOF, with or without RBV (DCV+SOF±RBV), in a large unselected cohort of patients with chronic HCV infection (CHC).
PATIENTS AND METHODS METHODS
Consecutive patients received DCV+SOF±RBV for 12 or 24 weeks. The efficacy endpoint was sustained virological response at 12 weeks after the end of treatment (SVR12). Safety factors were also considered.
RESULTS RESULTS
A total of 620 patients were included in this study; the predominant genotype was G3 (55.3%). Of the total sample, 248 (40%) patients were treated with DCV+SOF+RBV and 372 (60%) did not receive RBV. The majority of patients assessed at week 12 (98%, 596/608) achieved SVR12. Among G3 patients, 98.8% (335/339) achieved SVR12. The most common adverse event was elevated bilirubin (30.6%), recorded in 4.9% of cases as a grade 3-4 adverse event.
CONCLUSION CONCLUSIONS
This study shows the high pan-genotypic effectiveness and safety of the DCV+SOF±RBV combination in a large, unselected sample of CHC patients with G1-4, including a wide proportion of G3 CHC patients.

Identifiants

pubmed: 33408749
doi: 10.7573/dic.2020-4-11
pii: dic-2020-4-11
pmc: PMC7747789
pii:
doi:

Types de publication

Journal Article

Langues

eng

Informations de copyright

Copyright © 2020 Sacco R, Messina V, Gentilucci UV, Adinolfi LE, Ascione A, Barbarini G, Barlattani A, Cariti G, Cozzolongo R, Fimiani B, Francavilla R, Furlan C, Garrucciu G, Iovinella V, Rinaldi L, Marignani M, Begini P, Palitti VP, Pellicelli AM, Scifo G, Facciorusso A, Giacomelli L, Shah A, Bertino G, Perazzo S, Bresci G, Izzi A.

Déclaration de conflit d'intérêts

Disclosure and potential conflicts of interest: The authors declare that they have no conflicts of interest relevant to this manuscript. The International Committee of Medical Journal Editors (ICMJE) Potential Conflicts of Interests form for the authors is available for download at: https://www.drugsincontext.com/wp-content/uploads/2020/12/dic.2020-4-11-COI.pdf

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Auteurs

Rodolfo Sacco (R)

Gastroenterology and Metabolic Diseases Unit - Pisa University Hospital, Pisa, Italy.

Vincenzo Messina (V)

Infectious Disease Unit Sant'Anna e San Sebastiano Hospital Caserta, Italy.

Umberto Vespasiani Gentilucci (UV)

Internal Medicine Unit Policlinico Campus Biomedico Rome, Italy.

Luigi Elio Adinolfi (LE)

Internal Medicine Unit "L Vanvitelli" University, Naples, Italy.

Antonio Ascione (A)

Center for Liver Diseases "Buon Consiglio-Fatebenefratelli" Hospital, Naples, Italy.

Giorgio Barbarini (G)

Infectious Diseases Unit IRCCS San Matteo, Pavia, Italy.

Angelo Barlattani (A)

Center for Liver Diseases, Rome, Italy.

Giuseppe Cariti (G)

Unit of Infectious Diseases, University of Turin, Amedeo di Savoia Hospital, Turin, Italy.

Raffaele Cozzolongo (R)

Division of Gastroenterology, IRCCS "S De Bellis Hospital", Castellana Grotte, Italy.

Basilio Fimiani (B)

Internal Medicine Unit, "Umberto I" Hospital, Nocera Inferiore, Italy.

Ruggiero Francavilla (R)

Center for Liver Diseases Bisceglie, Italy.

Caterina Furlan (C)

Infectious and Tropical Diseases Policlinico "Umberto I", Rome, Italy.

Giovanni Garrucciu (G)

Medical Pathology Unit University of Sassari Sassari, Italy.

Vincenzo Iovinella (V)

Internal Medicine Unit "San Paolo" Hospital Naples, Italy.

Luca Rinaldi (L)

Internal Medicine Unit "L Vanvitelli" University, Naples, Italy.

Massimo Marignani (M)

Digestive and Liver Diseases "S. Andrea" Hospital Rome, Italy.

Paola Begini (P)

Digestive and Liver Diseases "S. Andrea" Hospital Rome, Italy.

Valeria Pace Palitti (VP)

Hepatology Department of Medicine ASL Pescara, Pescara, Italy.

Adriano M Pellicelli (AM)

Liver Disease unit Department of Liver Transplantation "San Camillo" Hospital Rome, Italy.

Gaetano Scifo (G)

Infectious Disease Unit "Umberto I" Hospital, Siracusa, Italy.

Antonio Facciorusso (A)

Ospedali Riuniti di Foggia, Foggia, Italy.

Luca Giacomelli (L)

Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy.

Aashni Shah (A)

Polistudium srl, Milan, Italy.

Gaetano Bertino (G)

Hepatology Unit, Catania University, Italy.

Serena Perazzo (S)

Department of Infectious Diseases and Emergency Infectious Diseases "D. Cotugno" Hospital Naples, Italy.

Giampaolo Bresci (G)

Gastroenterology and Metabolic Diseases Unit - Pisa University Hospital, Pisa, Italy.

Antonio Izzi (A)

Department of Infectious Diseases and Emergency Infectious Diseases "D. Cotugno" Hospital Naples, Italy.

Classifications MeSH