- HCV treatment with glecaprevir/pibrentasvir (GLE/PIB; Mavyret) is 93% effective among active drug users and 97% effective among former drug users.
Why this matters
- Treatment of people who use drugs (PWUD) remains suboptimal because of concerns about adherence, efficacy, and reinfection.
- Pooled data from ENDURANCE 1-3 and EXPEDITION 1-4 evaluating 8/12 weeks of GLE/PIB in 1819 patients with HCV genotypes 1-6.
- Treatment-experienced and -naive patients with/without cirrhosis were included.
- Recent PWUD: (5%: injection drug use [IDU] ≤12 months ago, positive urine drug screen [UDS] and/or drug-related event).
- Former PWUD: (34%: IDU >12 months ago, negative UDS).
- Non-PWUD: (61%).
- Funding: AbbVie.
- HCV-3 frequency was higher in recent/former PWUD than non-PWUD (40% vs 13%).
- Treatment adherence/completion rates, ≥96% across groups.
- Sustained viral response at 12 weeks posttherapy (SVR12) rate was lower in recent and former PWUD vs non-PWUD (93% and 97% vs >99%; both P<.0001>
- Modified intent-to-treat (mITT) SVR12 rates were 99%, 99%, and >99%, respectively, after excluding nonresponses unrelated to failure.
- Virologic failure rates, ≤1.5% across groups.
- No HCV reinfections reported in recent PWID.
- Rate of serious adverse events, or adverse events leading to discontinuation, ≤1%.
- Enrollment bias.
- Proportion of injection vs other drug use not captured.