EASL 2018 – New first-line options for HCV-4


  • HCV Conference Roundups
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • Effective treatments are needed against the highly prevalent HCV genotype 4 (GT4).
  • Preliminary data suggest that an 8-week course of elbasvir/grazoprevir (EBR/GZR) yields high rates of sustained virologic response at 12 weeks post-therapy (SVR12) with a good safety profile.

Why this matters

  • Approximately 15% of HCV infections worldwide are due to GT4.
  • GT4 prevalence is increasing in Europe, Asia and North America.
  • Use of an 8-week EBR/GZR course is currently limited to treatment-naive patients with GT1 infection; a 12-week regimen is used for GT4.

Study design

  • Ongoing open label study of treatment-naive patients with GT4 infection and mild-moderate fibrosis randomly assigned to EBR/GZR for 8 (n=53) or 12 weeks (n=64).

Key points

  • Preliminary data in the 8-week arm show that:
    • 28 out of 53 patients have completed 12-week follow up
    • There were high SVR rates in the 8-week arm (end of treatment SVR was 100%  and SVR12 was 93%)
    • 2 participants experienced virologic failure
    • There were no serious adverse events, no discontinuations, nor late transaminase elevations in this arm

Limitations

  • Final results of the 8-week arm and outcomes in the 12-week arm are expected to provide further information regarding this 8-week regimen

Expert comment

Pr Tarik Asselah, from the Hepatology department of the Hôpital Beaujon, has stressed the relevance of an 8-week regimen vs other already existing therapeutic options: « In countries with high prevalence and less capacities, shortened therapy is very important, because with shortened therapy you have less visits, less costs at the national level". Dr Asselah said that shortened therapy may also increase adherence.