%0 Journal Article
%A Llaneras, Jordi
%A Riveiro-Barciela, Mar
%A Lens, Sabela
%A Diago, Moisés
%A Cachero, Alba
%A García-Samaniego, Javier
%A Conde, Isabel
%A Arencibia, Ana
%A Arenas, Juan
%A Gea, Francisco
%A Torras, Xavier
%A Luis Calleja, José
%A Antonio Carrión, José
%A Fernández, Inmaculada
%A María Morillas, Rosa
%A Rosales, José Miguel
%A Carmona, Isabel
%A Fernández-Rodríguez, Conrado
%A Hernández-Guerra, Manuel
%A Llerena, Susana
%A Bernal, Vanesa
%A Turnes, Juan
%A González-Santiago, Jesús M
%A Montoliu, Silvia
%A Figueruela, Blanca
%A Badia, Ester
%A Delgado, Manuel
%A Fernández-Bermejo, Miguel
%A Iñarrairaegui, Mercedes
%A Pascasio, Juan Manuel
%A Esteban, Rafael
%A Mariño, Zoe
%A Buti, Maria
%T Effectiveness and safety of sofosbuvir/velpatasvir/voxilaprevir in patients with chronic hepatitis C previously treated with DAAs.
%D 2019
%U http://hdl.handle.net/10668/14121
%X Around 5% of patients with chronic hepatitis C virus (HCV) infection treated with direct-acting antiviral (DAA) agents do not achieve sustained virological response (SVR). The currently approved retreatment regimen for prior DAA failure is a combination of sofosbuvir, velpatasvir, and voxilaprevir (SOF/VEL/VOX), although there is little data on its use in clinical practice. The aim of this study was to analyse the effectiveness and safety of SOF/VEL/VOX in the real-world setting. This was a prospective multicentre study assessing the efficacy of retreatment with SOF/VEL/VOX in patients who had experienced a prior DAA treatment failure. The primary endpoint was SVR 12 weeks after the completion of treatment (SVR12). Data on safety and tolerability were also recorded. A total of 137 patients were included: 75% men, 35% with liver cirrhosis. Most were infected with HCV genotype (GT) 1 or 3. The most common prior DAA combinations were sofosbuvir plus an NS5A inhibitor or ombitasvir/paritaprevir/r+dasabuvir. A total of 136 (99%) patients achieved undetectable HCV RNA at the end of treatment. Overall SVR12 was 95% in the 135 patients reaching this point. SVR12 was lower in patients with cirrhosis (89%, p = 0.05) and those with GT3 infection (80%, p  Real-world data show that SOF/VEL/VOX is an effective, safe rescue therapy for patients with prior DAA treatment failure despite the presence of resistance-associated substitutions. However, patients with liver cirrhosis infected by GT3 remain the most-difficult-to-treat group. Treatment with sofosbuvir/velpatasvir/voxilaprevir (SOF/VEL/VOX) for 12 weeks is the current recommendation for the 5% of patients infected with HCV who do not achieve eradication of the virus under treatment with direct-acting antivirals. In a Spanish cohort of 137 patients who failed a previous combination of direct-acting antivirals, a cure rate of 95% was achieved with SOF/VEL/VOX. Genotypic characteristics of the virus (genotype 3) and the presence of cirrhosis were factors that decreased the rate of cure. Treatment with SOF/VEL/VOX is an effective and safe rescue therapy due to its high efficacy and very good safety profile.
%K HCV genotype 3
%K Hepatitis C
%K Sofosbuvir
%K Treatment failures
%K Velpatasvir
%K Voxilaprevir
%~