Gilead Sciences’ Epclusa (sofosbuvir/velpatasvir) is highly effective at curing hepatitis C virus (HCV) among a broad array of subgroups.
Presenting their findings at the Annual Meeting of the American Association for the Study of Liver Diseases in San Francisco (The Liver Meeting), researchers analyzed data from the British Columbia Hepatitis Testers Cohort. They assembled a cohort of 1,801 people with hep C who filled at least one prescription for HCV treatment with Epclusa through June 30, 2018, in routine clinical care and about whom there were at least 12 weeks of follow-up data.
After receiving Epclusa with or without ribavirin, 93 percent (584 of 628) of those with genotype 1, 96 percent (338 of 351) of those with genotype 2 and 92 percent (670 of 725) of those with genotype 3 achieved a sustained virologic response 12 weeks after completing therapy (SVR12, considered a cure).
Among those with genotype 3, 88 percent of those who had been treated before were cured, compared with 93 percent of first-timers to treatment. Eighty percent and 93 percent of those with and without diabetes were cured, respectively.
Among those with genotype 1, a respective 83 percent and 93 percent of those with and without cirrhosis, and a respective 86 percent and 94 percent of those with and without HIV were cured.
After adjusting the data to account for various differences between the study cohort members, the researchers found that compared with no history of injection drug use, recent use was associated with a 3.48-fold greater likelihood of not being cured, and former use was linked to a 2.07-fold greater likelihood of such an outcome. The lower cure rates associated with injection drug use were in part due to individuals dropping out of medical care.
Compared with taking Epclusa without ribavirin, taking the regimen with ribavirin was associated with a 1.72-fold increased likelihood of not being cured.