Real-life effectiveness of sofosbuvir/velpatasvir/voxilaprevir in hepatitis C patients previously treated with sofosbuvir/velpatasvir or glecaprevir/pibrentasvir.

Fecha de publicación: 01/07/2024 Fecha Ahead of Print: 02/05/2024

Autores de IIS La Fe

• Mercedes Rodríguez Serna

  Autor

Participantes ajenos a IIS La Fe

• Ruiz-Cobo, Juan Carlos
• Llaneras, Jordi
• Forns, Xavier
• Gallego Moya, Adolfo
• Conde Amiel, Isabel
• Arencibia, Ana
• Diago, Moises
• Garcia-Samaniego, Javier
• Castellote, Jose
• Llerena, Susana
• Rodriguez-Seguel, Elisa
• Mateos, Beatriz
• Rosales Zabal, Jose Miguel
• Fernandez, Inmaculada
• Calleja, Jose Luis
• Morillas, Rosa Maria
• Montoliu, Silvia
• Andrade, Raul J
• Badia Aranda, Ester
• Hernandez-Guerra, Manuel
• Mate, Carlota Jimeno
• Gonzalez-Santiago, Jesus M
• de Cuenca, Beatriz
• Bernal-Monterde, Vanesa
• Delgado, Manuel
• Turnes, Juan
• Lens, Sabela
• Buti, Maria

Grupos

• Dermatología y Regeneración Tisular

  

  Leader

  Rafael Botella Estrada

Abstract

BACKGROUND: Sofosbuvir, velpatasvir and voxilaprevir (SOF/VEL/VOX) is the recommended rescue therapy for patients with chronic hepatitis C infection who fail direct-acting antivirals (DAAs). Data are limited on the effectiveness of this treatment after the current first-line therapies. Our aim was to analyse the effectiveness and safety of SOF/VEL/VOX among patients failing sofosbuvir/velpatasvir (SOF/VEL) or glecaprevir/pibrentasvir (GLE/PIB). METHODS: Retrospective multicentre study (26 Spanish hospitals), including chronic hepatitis C patients unsuccessfully treated with SOF/VEL or GLE/PIB, and retreated with SOF/VEL/VOX ± ribavirin for 12 weeks between December 2017 and December 2022. RESULTS: In total, 142 patients included: 100 (70.4%) had failed SOF/VEL and 42 (29.6%) GLE/PIB. Patients were mainly men (84.5%), White (93.9%), with hepatitis C virus genotype (GT) 3 (49.6%) and 47.2% had liver cirrhosis. Sustained virological response (SVR) was evaluated in 132 patients who completed SOF/VEL/VOX and were followed 12 weeks after end of treatment; 117 (88.6%) achieved SVR. There were no significant differences in SVR rates according to initial DAA treatment (SOF/VEL 87.9% vs. GLE/PIB 90.2%, p = 0.8), cirrhosis (no cirrhosis 90% vs. cirrhosis 87.1%, p = 0.6) or GT3 infection (non-GT3 91.9% vs. GT3 85.5%, p = 0.3). However, when considering the concurrent presence of SOF/VEL treatment, cirrhosis and GT3 infection, SVR rates dropped to 82.8%. Ribavirin was added in 8 (6%) patients, all achieved SVR. CONCLUSION: SOF/VEL/VOX is an effective rescue therapy for failures to SOF/VEL or GLE/PIB, with an SVR of 88.6%. Factors previously linked to lower SVR rates, such as GT3 infection, cirrhosis and first-line therapy with SOF/VEL were not associated with lower SVRs.

© 2024 The Authors. Alimentary Pharmacology & Therapeutics published by John Wiley & Sons Ltd.

Keywords

• VOXILAPREVIR; VELPATASVIR; SOFOSBUVIR; EFFICACY