Simeprevir, sofosbuvir more effective for HCV with cirrhosis
the Clinical Advisor take:
Compared with peginterferon, ribavirin, and sofosbuvir, the combination of simeprevir and sofosbuvir more effectively treated patients with chronic genotype 1 hepatitis C virus (GT-1 HCV) infections and compensated cirrhosis, according to a study published in Gastroenterology.
Each year, HCV-associated liver disease results in at least 350,000 worldwide. GT-1 HCV is both the most common strain of HCV and the most difficult to treat, especially when patients also have cirrhosis. Traditionally, GT-1 HCV infections have been treated with interferon. However, only moderate rates of sustained virologic response (SVR) were achieved, and the treatment caused adverse somatic and psychiatric effects.
This open-label trial included 82 participants who had HCV GT-1a infection and Child’s grade A cirrhosis. Of these patients, 32 were treatment naïve and 50 had previously been unsuccessfully treated with peginterferon and ribavirin. Each patient was randomized to either 12 weeks of simeprevir (150mg per day) and sofosbuvir (400mg per day) or peginterferon alfa 2b (1.5mcg/kg per week), ribavirin (1000-1200mg per day), and sofosbuvir (400mg per day).
Out of the 58 patients in the simeprevir-sofosbuvir group, 54 (93%) had undetectable levels of HCV RNA at 12 weeks. Out of the 24 patients in the interferon group, only 18 (75%) had undetectable levels of HCV RNA at 12 weeks. Additionally, the interferon group had a higher rate of virologic relapse, worse self-reported outcomes, and more side effects compared with the simeprevir-sofosbuvir group.
HCV treatments including interferon had lower rates of SVR and more side effects.