Good day folks, CCO launched a new learning activity which offers an overview of key clinical trial data relevant to the management of HCV in patients with advanced liver disease.
Easy Reading
Each presentation is followed up by expert analysis, making it easy for patients to follow.
Genotype 3 HCV: Still Difficult to Treat?
In addition future treatment options for treating HCV genotype 3 is highlighted in an article written by Jordan J. Feld, MD, MPH, including the NS5A inhibitor GS-5816 combined with sofosbuvir, here is an excerpt; Genotype 3 HCV: Still Difficult to Treat?
In genotype 3 treatment-experienced cirrhotics, 96% achieved SVR with 12 weeks of GS-5816 plus sofosbuvir and ribavirin. The fixed-dose combination of sofosbuvir/GS-5816 with and without ribavirin is now being evaluated in phase III trials. If the results hold up, genotype 3 may soon become the “easy-to-cure” genotype it once was....
I Would Rather.....
Checking out this CME may not be on your agenda today, so lets inspire you a bit with a little sample of the activity; HCV Special Populations and Other Highlights.
TRIO Real-World Outcomes: 12-Week Simeprevir- and Sofosbuvir-Based Regimens in Cirrhotic Patients
Stefan Zeuzem, MD:
Flamm and colleagues[1] presented results of an efficacy analysis of sofosbuvir-based regimens in the TRIO network, a collaboration of academic medical centers, community physicians, and specialty pharmacies that manages more than 6000 patients with HCV infection....
Overall, I found the results from this analysis to be somewhat disappointing because some of these SVR12 outcomes are lower than what was seen in the pivotal clinical trials.[2-5] For example, the overall SVR was 93% among cirrhotic patients treated with simeprevir plus sofosbuvir with or without ribavirin in the COSMOS trial vs 75% in the TRIO group. In the FISSION trial, 83% of treatment-naive patients with genotype 2 HCV achieved SVR with sofosbuvir and ribavirin vs only 65% in this real-world cohort. Why might this be?....
Jordan J. Feld, MD, MPH:I agree that overall, the SVR12 rates were lower than expected, particularly for patients infected with genotype 2 HCV. This group achieved....
Paul Y. Kwo, MD:I agree. In addition, I believe it would be useful to obtain more granularity regarding the findings from this study. For example, I was surprised to see that among patients with genotype 2 HCV.....
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Links:
HCV Special Populations and Other Highlights
Source: Official Conference Coverage
2014 Annual Meeting of the American Association for the Study of Liver Diseases
Faculty: Jordan J. Feld MD, MPH, Paul Y. Kwo MD, Stefan Zeuzem MD
Released: 2/10/2015
Genotype 3 HCV: Still Difficult to Treat?
The current influx of newly approved all-oral therapies for HCV has meant that every day in clinic, I am able to start treatment for patients who for years have had no treatment options. For patients with genotype 1 HCV infection, who still comprise the majority in the United States, the options are plentiful and highly effective, and access is the only barrier remaining. However, for patients with genotype 3 HCV infection, the details matter. For treatment-naive patients, even if they have advanced fibrosis or compensated cirrhosis, sofosbuvir with ribavirin for 24 weeks is an excellent option with high cure rates and generally very good tolerability. Unfortunately, many of the patients I see with genotype 3 HCV have failed previous therapy, often more than once, and have clear evidence of cirrhosis. Most were originally told that they were fortunate to have an “easy-to-cure” genotype and could expect a ≥ 80% response rate with peginterferon and ribavirin. What they were often not told was that genotype 3 HCV infection causes more rapidly progressive liver disease than other genotypes and that the SVR rate with peginterferon and ribavirin was closer to 50% in those with cirrhosis. These patients are now very disappointed to learn that the new generation of highly effective drugs are less effective for treatment-experienced patients with genotype 3 HCV infection and cirrhosis.
Continue reading....
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Continue reading....
*Free registration is required
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My Take on the Guidance From AASLD/IDSA for Managing Treatment-Experienced Patients With Genotype 3 HCV Infection and Cirrhosis
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My Take on the Guidance From AASLD/IDSA for Treating PI-Experienced Patients With Genotype 1 HCV Infection
My Take on the Guidance From AASLD/IDSA for Managing Treatment-Experienced Patients With Genotype 3 HCV Infection and Cirrhosis
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My Take on the Guidance From AASLD/IDSA for Treating PI-Experienced Patients With Genotype 1 HCV Infection
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