Title

PATIENT CHARACTERISTICS AND EFFICACY OF PANGENOTYPIC DIRECT-ACTING ANTIVIRAL REGIMENS AMONG A COHORT OF CHRONIC HEPATITIS C PATIENTS RECEIVING ROUTINE CLINICAL CARE IN THE US

Document Type

Conference Proceeding

Publication Date

11-2020

Publication Title

Hepatology

Abstract

Background: Using recent data from the Chronic Hepatitis Cohort study (CHeCS), we report patient characteristics and “real world” efficacy of three pangenotypic direct-acting antiviral (DAA) regimens used to treat chronic hepatitis C (CHC) patients with a range of HCV genotypes (GT 1-4 and 6) under routine care.

Methods: CHeCS CHC patients were followed through mid-2019. Baseline patient characteristics and rates of sustained virological response 12 weeks after end of treatment (SVR12) were compared among the three pangenotypic regimens (SOF/VEL, SOF/VEL/VOX, and GLE/PIB).

Results: A total of 1842 patients were included, of which 1019 were treated with SOF/VEL, 753 with GLE/ PIB, and 70 with SOF/VEL/VOX. There were statistically significant differences in patient characteristics among the three groups (p-values <0.05): (1) 46% and 54% of patients treated with SOF/VEL and GLE/PIB were aged 60 years and older, respectively, versus only 25% of those treated with SOF/VEL/VOX; (2) 7% of patients treated with SOF/VEL had decompensated cirrhosis (DCC) while almost none treated with the other regimens had DCC (≤1%); (3) 93% of the SOF/ VEL/VOX-treated group were DAA experienced, compared with only 2-4% in the other treated groups; (4) GT distribution varied among the three regimens (Table). Observed rates of SVR12 were 97%, 98% and 97% with SOF/VEL, GLE/PIB, and SOF/VEL/VOX, respectively, with no significant difference observed (p-values in the range of 0.50 to 0.62 from pairwise comparisons). Among the 48 patients that did not achieve SVR12: (1) 19% were DAA experienced (vs. 6% of those that achieved SVR12); (2) 10% had DCC (vs. 4% of those that achieved SVR12); (3) 21% experienced a toxicity (vs. 11% of those that achieved SVR12); (4) 31% had diabetes and 4% were on proton pump inhibitor therapy at time of DAA initiation (vs. 21% and 1%, respectively, of those that achieved SVR12).

Conclusion: Observed rates of SVR12 were very high for all three pangenotypic regimens, with no significant difference between them. A sizeable majority of CHC patients treated with SOF/VEL/VOX and GLE/PIB had GT 1, while the largest proportion of patients treated with SOF/VEL had GT 2. Patients with DCC were mostly treated with SOF/VEL, as would be expected based on treatment guidelines. Patients who did not achieve SVR12 had higher rates of prior DAA experience, DCC, diabetes, and on-treatment toxicities.

Volume

2020

Issue

72

First Page

540A

Last Page

541A

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