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Ribavirin-Free Regimen With Sofosbuvir and Velpatasvir Is Associated With High Efficacy and Improvement of Patient-Reported Outcomes in Patients With Genotypes 2 and 3 Chronic Hepatitis C: Results From Astral-2 and -3 Clinical Trials.

Publication ,  Journal Article
Younossi, ZM; Stepanova, M; Sulkowski, M; Foster, GR; Reau, N; Mangia, A; Patel, K; Bräu, N; Roberts, SK; Afdhal, N; Nader, F; Henry, L; Hunt, S
Published in: Clin Infect Dis
October 15, 2016

BACKGROUND: Until recently, the approved treatment regimens for patients with hepatitis C virus (HCV) genotypes (GTs) 2 and 3 contain sofosbuvir (SOF) and ribavirin (RBV) for 12 or 24 weeks. The impact of RBV-free pan-genotypic regimen with SOF and velpatasvir (SOF/VEL) on patient-reported outcomes (PROs) of patients with genotype 2 and 3 has not been described. METHODS: PROs data were collected from participants of ASTRAL-2 and ASTRAL-3 studies before, during, and after treatment using 4 PRO instruments (Short Form-36, Chronic Liver Disease Questionnaire-HCV, Functional Assessment of Chronic Illness Therapy-Fatigue, and Work Productivity and Activity Index: Specific Health Problem), and compared between the SOF/VEL and SOF + RBV groups. RESULTS: A total of 818 HCV patients were included: 78% treatment naive, 25% cirrhosis. The rates of nearly all adverse events were lower in the RBV-free SOF/VEL group (all P < .03). The SOF/VEL group also experienced improvement of their PROs by treatment week 4 (+1.8% on average across all PROs), which continued throughout treatment (+4.1%) and post-treatment (+5.5%). In contrast, those in the SOF + RBV group had a modest decline in their PROs starting at treatment week 4 (up to -3.7%), which lasted until the end of treatment (up to -6.4%). In multiple regression analysis, the association of a treatment regimen with end-of-treatment PROs was significant for nearly all PROs; the average beta was +5.0% for the use of SOF/VEL (reference: SOF + RBV). CONCLUSIONS: Patients receiving ribavirin-free SOF/VEL reported significantly better PRO scores during treatment compared with those receiving the RBV-containing regimen. Furthermore, the interferon- and ribavirin-free SOF/VEL regimen resulted in a rapid improvement of PROs in HCV GTs 2 and 3 patients during treatment and after achieving sustained virologic response.

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Published In

Clin Infect Dis

DOI

EISSN

1537-6591

Publication Date

October 15, 2016

Volume

63

Issue

8

Start / End Page

1042 / 1048

Location

United States

Related Subject Headings

  • Viral Load
  • Treatment Outcome
  • Sofosbuvir
  • Ribavirin
  • Patient Reported Outcome Measures
  • Middle Aged
  • Microbiology
  • Male
  • Humans
  • Heterocyclic Compounds, 4 or More Rings
 

Citation

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Younossi, Z. M., Stepanova, M., Sulkowski, M., Foster, G. R., Reau, N., Mangia, A., … Hunt, S. (2016). Ribavirin-Free Regimen With Sofosbuvir and Velpatasvir Is Associated With High Efficacy and Improvement of Patient-Reported Outcomes in Patients With Genotypes 2 and 3 Chronic Hepatitis C: Results From Astral-2 and -3 Clinical Trials. Clin Infect Dis, 63(8), 1042–1048. https://doi.org/10.1093/cid/ciw496
Younossi, Zobair M., Maria Stepanova, Mark Sulkowski, Graham R. Foster, Nancy Reau, Alessandra Mangia, Keyur Patel, et al. “Ribavirin-Free Regimen With Sofosbuvir and Velpatasvir Is Associated With High Efficacy and Improvement of Patient-Reported Outcomes in Patients With Genotypes 2 and 3 Chronic Hepatitis C: Results From Astral-2 and -3 Clinical Trials.Clin Infect Dis 63, no. 8 (October 15, 2016): 1042–48. https://doi.org/10.1093/cid/ciw496.
Younossi ZM, Stepanova M, Sulkowski M, Foster GR, Reau N, Mangia A, Patel K, Bräu N, Roberts SK, Afdhal N, Nader F, Henry L, Hunt S. Ribavirin-Free Regimen With Sofosbuvir and Velpatasvir Is Associated With High Efficacy and Improvement of Patient-Reported Outcomes in Patients With Genotypes 2 and 3 Chronic Hepatitis C: Results From Astral-2 and -3 Clinical Trials. Clin Infect Dis. 2016 Oct 15;63(8):1042–1048.
Journal cover image

Published In

Clin Infect Dis

DOI

EISSN

1537-6591

Publication Date

October 15, 2016

Volume

63

Issue

8

Start / End Page

1042 / 1048

Location

United States

Related Subject Headings

  • Viral Load
  • Treatment Outcome
  • Sofosbuvir
  • Ribavirin
  • Patient Reported Outcome Measures
  • Middle Aged
  • Microbiology
  • Male
  • Humans
  • Heterocyclic Compounds, 4 or More Rings