Comparative effectiveness of 8 versus 12 weeks of Ombitasvir/Paritaprevir/ritonavir and Dasabuvir in treatment-naïve patients infected with HCV genotype 1b with non-advanced hepatic fibrosis

Adv Med Sci. 2020 Mar;65(1):12-17. doi: 10.1016/j.advms.2019.09.002. Epub 2019 Dec 13.

Abstract

Purpose: Since 2017 treatment-naïve patients infected with genotype 1b of hepatitis C virus and minimal or moderate fibrosis can be treated with Ombitasvir/Paritaprevir/ritonavir + Dasabuvir (OPrD) for 8 weeks according to updated Summary of Product Characteristics. The aim of our study was to assess the comparative efficacy of 8 and 12-weeks therapy with OPrD in large cohort of patients eligible for 8 weeks regimen treated in real-world setting.

Materials and methods: We analysed data of 3067 HCV genotype 1b infected patients treated with OPrD between 2015 and 2017. Final analysis included patients with none, minimal or moderate fibrosis (F0-F2).

Results: A total of 771 patients were enrolled in the study, including 197 (26%) treated for 8-weeks and 574 patients fulfilling criteria for 8-weeks but assigned to 12-weeks regimen. Majority of patients had no or minimal fibrosis (F0-F1). Longer treatment duration was more often administered in patients with moderate fibrosis, comorbidities, concomitant medications. SVR was achieved in 186 (94%) patients treated for 8 weeks and 558 (97%) for 12 weeks (p = 0.07). After exclusion of lost to follow-up patients, sustained virological response (SVR) rate reached 95% and 99%, respectively (p = 0.01). We were not able to identify factors associated with non-response.

Conclusions: This real-word experience study confirmed similar, high effectiveness of 8 and 12-weeks regimens of OPrD in genotype 1b HCV infected patients with non-advanced fibrosis. Despite of reduced SVR rate after 8-weeks regimen, there is no need to extend therapy to 12-weeks in vast majority of such patients and no need to add ribavirin.

Keywords: Dasabuvir; Genotype 1b; Hepatitis C; Ombitasvir/paritaprevir/ritonavir; Treatment-naïve.

MeSH terms

  • 2-Naphthylamine
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anilides / therapeutic use*
  • Antiviral Agents / therapeutic use*
  • Carbamates / therapeutic use*
  • Cyclopropanes / therapeutic use*
  • Drug Therapy, Combination
  • Female
  • Follow-Up Studies
  • Genotype
  • Hepacivirus / genetics*
  • Hepatitis C / complications
  • Hepatitis C / virology
  • Humans
  • Lactams, Macrocyclic / therapeutic use*
  • Liver Cirrhosis / drug therapy*
  • Liver Cirrhosis / epidemiology
  • Liver Cirrhosis / virology
  • Male
  • Middle Aged
  • Prognosis
  • Proline / analogs & derivatives*
  • Proline / therapeutic use
  • Retrospective Studies
  • Ritonavir / therapeutic use*
  • Sulfonamides / therapeutic use*
  • Sustained Virologic Response
  • Uracil / analogs & derivatives*
  • Uracil / therapeutic use
  • Valine
  • Young Adult

Substances

  • Anilides
  • Antiviral Agents
  • Carbamates
  • Cyclopropanes
  • Lactams, Macrocyclic
  • Sulfonamides
  • ombitasvir
  • Uracil
  • Proline
  • 2-Naphthylamine
  • dasabuvir
  • Valine
  • Ritonavir
  • paritaprevir