HCV-1 and OST: PrOD ± RBV maintains efficacy despite lower adherence

  • Grebely J & al.
  • Open Forum Infect Dis
  • 1 Nov 2018

  • curated by Yael Waknine
  • Clinical Essentials
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

  • Adherence to ritonavir-boosted ombitasvir, paritaprevir, and dasabuvir (PrOD) ± ribavirin (RBV) is lower among opioid substitution therapy (OST) recipients, but has no discernible effect on treatment completion or HCV-1 clearance rates.

Why this matters

  • Findings support use of direct-acting antivirals in this population.

Study design

  • Post-hoc analysis of data for 4747 patients receiving PrOD±RBV for HCV-1 across 12 phase 2, 3, and 3b clinical trials; 149 (3%) were receiving OST at baseline.
  • Efficacy defined as sustained virologic response at 12 weeks posttherapy (SVR12).
  • Funding: AbbVie.

Key results

  • OST recipients vs nonrecipients were more often infected with genotype 1a (82% vs 52%) and treatment-naive (76% vs 61%); cirrhosis prevalence was similar between groups (17% vs 18%).
  • OST recipients were less likely to have ≥90% treatment adherence (88% vs 97%; P<.001 style="list-style-type:circle;">
  • Difference driven by PrOD+RBV subset, showing lower adherence to both PrOD (92% vs 99%; P<.001 and rbv vs p>
  • PrOD±RBV completion rate was similar between groups (97% vs 98%; P=.211).
  • SVR12 rates were similar for OST recipients vs nonrecipients (94% vs 96%; P=.273).
  • Safety profile was similar between groups.
  • Limitations

    • Small OST sample.
    • Exclusion of patients with ongoing drug use.
    • Less adherence data captured for OST recipients (81% vs 91%).

    Please confirm your acceptance

    To gain full access to GPnotebook please confirm:

    By submitting here you confirm that you have accepted Terms of Use and Privacy Policy of GPnotebook.

    Submit