Ledipasvir and sofosbuvir for previously treated HCV genotype 1 infection.
By N. Afdhal, K. Reddy, D. Nelson, E. Lawitz, S. Gordon, E. Schiff, R. Nahass, R. Ghalib, N. Gitlin, R. Herring and 15 more. New England Journal of Medicine, 2014
1,363 citations recorded by the source corpus.
BACKGROUND Effective treatment for hepatitis C virus (HCV) genotype 1 infection in patients who have not had a sustained virologic response to prior interferon-based therapy represents an unmet medical need. METHODS We conducted a phase 3, randomized, open-label study involving patients infected with HCV genotype 1 who had not had a sustained virologic response after treatment with peginterferon and ribavirin, with or without a protease inhibitor. Patients were randomly assigned to receive the NS5A inhibitor ledipasvir and the nucleotide polymerase inhibitor sofosbuvir in a once-daily, fixed-dose combination tablet for 12 weeks, ledipasvir-sofosbuvir plus ribavirin for 12 weeks, ledipasvir-sofosbuvir for 24 weeks, or ledipasvir-sofosbuvir plus ribavirin for 24 weeks. The primary end point was a sustained virologic response at 12 weeks after the end of therapy. RESULTS Among the 440 patients who underwent randomization and were treated, 20% had cirrhosis and 79% had HCV genotype 1a infection. The rates of sustained virologic response were high in all treatment groups: 94% (95% confidence interval [CI], 87 to 97) in the group that received 12 weeks of ledipasvir-sofosbuvir; 96% (95% CI, 91 to 99) in the group that received 12 weeks of ledipasvir-sofosbuvir and ribavirin; 99% (95% CI, 95 to 100) in the group that received 24 weeks of ledipasvir-sofosbuvir; and 99% (95% CI, 95 to 100) in the group that received 24 weeks of ledipasvir-sofosbuvir and ribavirin. No patient discontinued treatment owing to an adverse event. The most common adverse events were fatigue, headache, and nausea. CONCLUSIONS Treatment with a once-daily, single-tablet regimen of ledipasvir and sofosbuvir resulted in high rates of sustained virologic response among patients with HCV genotype 1 infection who had not had a sustained virologic response to prior interferon-based treatment. (Funded by Gilead Sciences; ION-2 ClinicalTrials.gov number, NCT01768286.).
Subfields: Hematology, Hepatology, Infectious Diseases
View Paper: https://www.semanticscholar.org/paper/a1d89edde7356193f94f850e8a4128ac0ad95af4
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In Hepatology
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Citations in the corpus
- EASL Recommendations on Treatment of Hepatitis C 2015. (2015, background): “In the ION-2 trial, the SVR rates in patients without cirrhosis retreated with sofosbuvir and ledipasvir for 12 weeks, without or with ribavirin, were 96% (50/52) and 100% (50/51), respectively; they were 97% (35/ 36) and 100% (38/38) after 24 weeks of therapy without and with ribavirin, respectivel”
- Hepatitis C guidance: AASLD‐IDSA recommendations for testing, managing, and treating adults infected with hepatitis C virus (2015, background): “In patients with cirrhosis, treatment with ledipasvir/sofosbuvir for 24 weeks produced higher SVR rates than did 12 weeks of treatment, supporting the recommendation that HCV treatment–experienced patients with cirrhosis receive 24 weeks of treatment.(89,91) However, ledipasvir/sofosbuvir with weigh”
- Ledipasvir and Sofosbuvir Plus Ribavirin for Treatment of HCV Infection in Patients With Advanced Liver Disease. (2015, neutral): “14 (64) 19 (79) 15 (68) 16 (73) 3 (75) 3 (75) 4 (100) 1 (100) 8 (36) 5 (21) 7 (32) 6 (27) 1 (25) 1 (25) 0 0 8.”
- EASL Recommendations on Treatment of Hepatitis C 2018. (2018, background): “In ION-2, in treatment-experienced patients (previously treated with pegylated IFN-a and ribavirin, or with pegylated IFN-a, ribavirin and either telaprevir or boceprevir), including approximately 20% with cirrhosis, the SVR12 rate was 87% (20/23; 3 relapses) in patients infected with HCV genotype 1”
- Ledipasvir and sofosbuvir for untreated HCV genotype 1 infection. (2014, neutral): “Insomnia 17 (8) 45 (21) 26 (12) 47 (22)”