IFN-free Therapy in Treatment-experienced Patients With HCV
IFN-free Therapy in Treatment-experienced Patients With HCV
Two clinical trials evaluated SOF in combination with RBV to treat HCV genotype 2 (HCV-2) treatment-experienced patients: FUSION and VALENCE. In the FUSION study, patients were treated with daily SOF (400 mg) and weight-based RBV [1000 mg (<75 kg) to 1200 mg (≥75 kg)] for 12 or 16 weeks. The SVR12 with 12 weeks was 86% and with 16 weeks was 94%. The VALENCE study evaluated SOF/RBV for 12 weeks and reported an overall SVR12 of 93%. The presence of cirrhosis in the VALENCE study led to lower SVR rates, 77.8% in treatment-experienced patients compared to 93.8% in those without cirrhosis. Similarly in the FUSION study, patients with cirrhosis had lower SVR rates than those without cirrhosis, but the SVR was higher in that population when the duration was extended to 16 weeks from 12 weeks (78 and 60% respectively). Patients with cirrhosis may benefit from extending treatment to 16 weeks, while the EASL guidelines recommend up to 20 weeks in this population.
Sofosbuvir/RBV for HCV-2 optimized: SOF 400 mg daily + RBV weight-based 1000 mg or 1200 mg in patients <75 mg or ≥75 mg, respectively, in a divided dose for 12 weeks. Consider extending treatment to 16 weeks in the presence of cirrhosis.
Genotype 2
SOF + RBV: 86–94% of SVR
Two clinical trials evaluated SOF in combination with RBV to treat HCV genotype 2 (HCV-2) treatment-experienced patients: FUSION and VALENCE. In the FUSION study, patients were treated with daily SOF (400 mg) and weight-based RBV [1000 mg (<75 kg) to 1200 mg (≥75 kg)] for 12 or 16 weeks. The SVR12 with 12 weeks was 86% and with 16 weeks was 94%. The VALENCE study evaluated SOF/RBV for 12 weeks and reported an overall SVR12 of 93%. The presence of cirrhosis in the VALENCE study led to lower SVR rates, 77.8% in treatment-experienced patients compared to 93.8% in those without cirrhosis. Similarly in the FUSION study, patients with cirrhosis had lower SVR rates than those without cirrhosis, but the SVR was higher in that population when the duration was extended to 16 weeks from 12 weeks (78 and 60% respectively). Patients with cirrhosis may benefit from extending treatment to 16 weeks, while the EASL guidelines recommend up to 20 weeks in this population.
Sofosbuvir/RBV for HCV-2 optimized: SOF 400 mg daily + RBV weight-based 1000 mg or 1200 mg in patients <75 mg or ≥75 mg, respectively, in a divided dose for 12 weeks. Consider extending treatment to 16 weeks in the presence of cirrhosis.