AASLD 2014 - LB-33. C-SWIFT: MK-5172 + MK-8742 + Sofosbuvir in Treatment-Naive Patients With Hepatitis C Virus Genotype 1 Infection, With and Without Cirrhosis, for Durations of 4, 6, or 8 Weeks
E.Lawitz, et al.
Background: The safety and efficacy of several oral direct acting antiviral (DAA) regimens for 8-24 weeks has recently been demonstrated. Shorter durations of therapy using novel combinations of DAAs may offer benefits such as increased compliance, greater adherence, and broader usage and acceptance by treating providers.
Conclusion: This novel study uses 3 potent, once-daily DAAs, MK-5172/MK-8742 fixed-dose combination plus sofosbuvir, combined in a pan-genotypic regimen to assess treatment durations of 4 to 8 weeks in cirrhotic and noncirrhotic patients with G1 HCV infection. This study will expand the understanding of treatment duration and help determine how to minimize drug exposure while maximizing SVR rates. This will allow cost-effective and precise dosing while minimizing adverse events.
CARE Faculty Perspective:
This important proof-of-concept study of a NS3/4A protease inhibitor (MK 5172- grazoprevir) and a NS5A inhibitor (MK 8742- elbasvir) and a nucleotide NS5B polymerase inhibitor (sofosbuvir) provides a high SVR-4/8 rate of 87% in a non-cirrhotic cohort treated for 6 weeks, and 95% in a cirrhotic population treated for 8 weeks. It was also apparent that this regimen was not effective at a 4-week course. The virologic failures are all due to relapses. This data has to be further evaluated in a larger study before utilization in clinical practice.