Premium
Real‐world effectiveness of ombitasvir/paritaprevir/ritonavir±dasabuvir±ribavirin in patients with hepatitis C virus genotype 1 or 4 infection: A meta‐analysis
Author(s) -
Wedemeyer H.,
Craxí A.,
Zuckerman E.,
Dieterich D.,
Flisiak R.,
Roberts S. K.,
Pangerl A.,
Zhang Z.,
Martinez M.,
Bao Y.,
Calleja J.L.
Publication year - 2017
Publication title -
journal of viral hepatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.329
H-Index - 100
eISSN - 1365-2893
pISSN - 1352-0504
DOI - 10.1111/jvh.12722
Subject(s) - ombitasvir , paritaprevir , dasabuvir , ritonavir , medicine , decompensation , ribavirin , gastroenterology , regimen , cirrhosis , hepatitis c , hepatitis c virus , discontinuation , virology , virus , viral load , antiretroviral therapy
Summary The direct‐acting antiviral regimen of ombitasvir ( OBV )/paritaprevir ( PTV )/ritonavir (r)±dasabuvir ( DSV )±ribavirin ( RBV ) demonstrated high rates of sustained viral response at post‐treatment week 12 ( SVR 12) in clinical trials for treatment of hepatitis C virus ( HCV ) genotypes ( GT ) 1 and 4. To confirm the effectiveness of this regimen in the real world, we conducted meta‐analyses of published literature on 30 April 2016. Freeman‐Tukey transformation determined the SVR rate within GT s 1a, 1b and 4, as well as specific SVR rates by cirrhosis or prior treatment experience status. Rates of virologic relapse, hepatic decompensation, drug discontinuation and serious adverse events were also analysed. In total, 20 cohorts across 12 countries were identified, totalling 5158 patients. The overall SVR 12 rates were 96.8% (95% CI 95.8‐97.7) for GT 1 and 98.9% (95% CI 94.2‐100) for GT 4. For GT 1a patients, the SVR rates were 94% and 97% for those with or without cirrhosis, and 94% overall. For GT 1b patients, the SVR rates were 98% and 99% for those with or without cirrhosis, and 98% overall. The virologic relapse rate of GT 1 patients was 1.3%, across 3524 patients in nine studies that reported this parameter. The rate of hepatic decompensation was less than 1% across five studies, including 3440 patients, 70% of which had cirrhosis. Conclusions: Real‐world SVR 12 rates for OBV / PTV /r± DSV ± RBV were consistently high across HCV GT 1 and four irrespective of cirrhosis status or prior HCV treatment experience, confirming effectiveness within a diverse patient population across multiple cohorts and countries.