P0783 : Viral kinetics during interferon-free sofosbuvir containing treatment regimens in a real-life cohort of chronic hepatitis C patients with advanced liver disease

Kozbial, K; Freissmuth, C; Straßl, Robert; Al‐Zoairy, Ramona; Maieron, A; Stauber, Rudolf; Gschwantler, Michael; Straßer, Michael; Laferl, Hermann; Bamberger, T; Moser, Stephan; Eder, Michael; Beinhardt, Sandra; Staettermayer, A.F.; Mandorfer, Mattias; Ferlitsch, Arnulf; Zoller, Heinz; Knoflach, P; Staufer, Katharina; Peck‐Radosavljevic, Markus; Munda, P; Vogel, Wolfgang; Ferenci, Péter; Hofer, Harald

doi:10.1016/s0168-8278(15)30986-7

Cited by 3 publications

(5 citation statements)

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“…not significant; *F3+4, § all study groups. $ 18 weeks treatment, * includes all fibrosis stages $ treatment naïve and experienced; § mostly GT1 patients (SVR in GT1: advanced cirrhosis: 85%, post OLT: 92%) Legend to figure 1: A tentative response guided algorhytm to select the optimal treatment duration in patients with cirrhosis (based on data from Kozbial et al 69 ).…”

Section: Discussionmentioning

confidence: 99%

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HCV targeting of patients with cirrhosis

Ferenci

Kozbial

Mandorfer

et al. 2015

Journal of Hepatology

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Interferon (IFN)-free treatments are now the treatment of choice for patients with chronic hepatitis C. Previously difficult to treat patients by IFN-containing treatments can now be treated safely by IFN-free therapies. More than 90% of hepatitis C genotype 1 and 4 patients with compensated cirrhosis or after orthotopic liver transplantation (OLT) can be cured by sofosbuvir combined with simeprevir, daclatasvir or ledipasvir, or by the paritaprevir/ritona-vir/ombitasvir/±dasabuvir (3D) combination. Addition of ribavirin confers to a minimal, if any, benefit to increase SVR. The need for ribavirin is controversial and remains to be studied. The optimal length of treatment is still unknown, and an individual approach may be needed. Most patients require only 12weeks of therapy. The safety of these drugs is not fully explored in patients with decompensated cirrhosis (Child-Pugh C), who should not be treated with protease inhibitors. In cirrhosis hepatitis C virus eradication does not necessarily mean a cure of the disease and patients regularly require follow-up. Drug-drug interactions with immunosuppressant in patients after OLT are easier to manage but still require attention. Better drugs are needed for genotype 3 patients.

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Section: Discussionmentioning

confidence: 99%

“…Preliminary data indicate that viral clearance on IFN-and RBV-free regimens is slower in patients with cirrhosis than in noncirrhotic patients ( 69,70 ), although the degree of portal hypertension does not affect viral clearance ( 71 ). The differences of SVR rates in patients treated for 12 weeks or longer were minimal.…”

Section: Treatment Durationmentioning

confidence: 99%

HCV targeting of patients with cirrhosis

Ferenci

Kozbial

Mandorfer

et al. 2015

Journal of Hepatology

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“…Although evidence for IFN-free regimens is very limited in patients with clinically significant portal hypertension, these treatments have already been prescribed in the USA 28 or have been used within named patient programmes in Europe. 29 Moreover, health insurance providers in many European countries currently restrict the access to these regimens to patients with advanced liver fibrosis for economical reasons. As access to these regimens steadily increases, treatment rates are likely to continue to rise in the near future.…”

Section: Discussionmentioning

confidence: 99%

“…As access to these regimens steadily increases, treatment rates are likely to continue to rise in the near future. 29 Thus, in this patient population, clinical routine currently surpasses clinical trials, emphasising the importance of studies utilising the emerging real-life data.…”

Section: Discussionmentioning

confidence: 99%

Interferon‐free regimens for chronic hepatitis C overcome the effects of portal hypertension on virological responses

Mandorfer

Kozbial

Freissmuth

et al. 2015

Aliment Pharmacol Ther

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“…Even in patients with decompensated cirrhosis, LDV/SOF treatment resulted in undetectable HCV RNA in 81%-100% of patients by week 4 (32). In contrast, Kozbial et al (35), concluded from phase 3 trials that viral elimination was slower in patients with severe liver disease compared to patients with chronic HCV infection and low fibrosis scores. Having the advantage of high rate of early virological response, short term DAA-based treatment may improve patient and graft survival following transplantation with the establishment of undetectable HCV RNA before transplantation.…”

Section: Specific Issues For Ifn-free Regimens In Patients Awaiting Ltmentioning

confidence: 94%

New modalities in the treatment of HCV in pre and post - transplantation setting

Araz

Durand²,

Gürakar³

2015

Turk J Gastroenterol

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End-stage liver disease and hepatocellular carcinoma (HCC) secondary to hepatitis C virus (HCV) infection are the leading indications for liver transplantation (LT) in developed countries. Recurrence of HCV following LT is universal if the recipient has detectable serum HCV RNA at the time of LT. Recurrent HCV has an accelerated course and is associated with poor long term patient and graft survival. Interferon (IFN)-based regimens have achieved low Sustained Virological Rates (SVR) in this setting and are associated with a high rate of adverse events, resulting in treatment discontinuation. With advances in understanding the HCV life cycle, drugs targeting specific steps, particularly inhibiting the NS3/4A protease, NS5B RNA dependent RNA polymerase and the NS5A protein, have been developed. Sofosbuvir (SOF), a nucleotide analogue inhibitor of NS5B polymerase was the first compound to enter the market. Combinations of SOF with new HCV antivirals from other classes have allowed for IFN-free regimens with low rates of adverse events and SVR rates >90%. With the availability of newer agents, the approach to the treatment of HCV infection during the pre-and post-liver transplantation period has changed. We will hereby review the current status of HCV treatment and discuss the potential future therapies in the transplant setting.

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P0783 : Viral kinetics during interferon-free sofosbuvir containing treatment regimens in a real-life cohort of chronic hepatitis C patients with advanced liver disease

Cited by 3 publications

References 0 publications

HCV targeting of patients with cirrhosis

HCV targeting of patients with cirrhosis

Interferon‐free regimens for chronic hepatitis C overcome the effects of portal hypertension on virological responses

New modalities in the treatment of HCV in pre and post - transplantation setting

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