BACKGROUND: The current recommendations for treatment of cirrhosis in HCV genotype 1 patients are dependent on prior treatment. 12 week ledipasvir/sofosbuvir (LDV/SOF) is recommended in treatment-naive patients whereas 24 week LDV/ SOF is recommended for prior treatment failures. In addition, 12 week LDV/SOF + RBV has been suggested as an alternative to 24 week LDV/SOF for treatment failures (Bourliere M, et al. Abs #82, AASLD 2014). No data is really available comparing these regimens in real-world patients that previously failed treatment. AIM: To evaluate real-world SVR12 in treatment failure patients with HCV genotype 1 and cirrhosis treated with 12 or 24 weeks of LDV/SOF or 12 weeks of LDV/SOF + RBV. METHODS: Data were obtained through Trio Health's Innervation Platform, a cloud-based disease management platform, and directly from specialty pharmacies for 250 treatment-experienced, genotype 1 patients with cirrhosis that initiated LDV/SOF +/- RBV between Oct 2014 and Mar 2015. 20% (50/250) of the patients were treated in community practices with the remainder from academic centers. RESULTS: Patient demographics for 3 groups are shown in the table. Intended treatments were: 21% (52/250 patients) 12 week LDV/SOF, 72% (180/250) 24 week LDV/SOF and 7% (18/250) 12 week LDV/SOF + RBV. SUMMARY: An examination of a real-world heterogeneous Hepatitis C population revealed a preference for 24 week LDV/SOF in this sample of treatment-experienced patients with cirrhotic genotype 1 HCV. The use of 12 week LDV/SOF + RBV is minimal, suggesting that RBV was viewed as an unnecessary addition to the shorter duration course, though subsequent analyses may find a shift in preferences. SVR data on this population will be available at the meeting. (Table Presented).
Curry, M., Bacon, B., Dieterich, D., Flamm, S., Guest, L., Kowdley, K., … Younossi, Z. (2016). EFFECTIVENESS OF 12 OR 24 WEEK LDV/SOF AND 12 WEEK LDV/SOF+RBV IN TREATMENT-EXPERIENCED PATIENTS WITH CIRRHOTIC, GENOTYPE 1 HEPATITIS C: REAL-WORLD EXPERIENCE FROM THE TRIO NETWORK. Value in Health, 19(3), A312–A313. https://doi.org/10.1016/j.jval.2016.03.991