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An 8-week triple combination of Gilead Sciences’ sofosbuvir, velpatasvir and GS-9857 showed a high sustained response rate in a phase 2 study of people with difficult-to-treat hepatitis C virus (HCV), including treatment-experienced people with HCV genotype 3 and liver cirrhosis, according to results presented on Sunday at the 2015 AASLD Liver Meeting in San Francisco, USA. A 6-week regimen appeared inadequate, however, and more than 8 weeks may be needed for people who have previously used direct-acting antivirals.
Interferon-free direct-acting antiviral (DAA) therapy has revolutionised treatment for chronic hepatitis C, but there is still room to optimise therapy for difficult-to-treat patients, enabling them to take advantage of shorter-duration, ribavirin-sparing regimens like those currently available for easier-to-treat people. Ideally, such a regimen would be pan-genotypic, meaning it could be routinely prescribed without the need for genotype testing.
Edward Gane of Auckland Clinical Studies in New Zealand presented final results from a phase 2 trial (NCT02202980) evaluating a three-drug regimen consisting of the HCV NS5B polymerase inhibitor sofosbuvir, the pan-genotypic NS5A inhibitor velpatasvir (formerly GS-5816) and the pan-genotypic NS3/4A protease inhibitor GS-9857. Combining drugs that attack HCV at three different steps of its lifecycle may improve efficacy and enable shorter treatment.
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