October 24, 2016
The approval of sofosbuvir/velpatasvir as Epclusa, a pan-genotypic regimen, will eliminate the need for genotype testing prior to treatment and could reduce treatment errors, said Vargas. Now that all genotypes are fairly well covered by available direct-acting antivirals, the next treatment challenge to address will be those small numbers of patients who fail treatment, he continued. All of the direct-acting antivirals approved today have at least a 95% cure rate, which means some patients will need to be re-treated.
Gilead Sciences, the makers of Epclusa, are planning to combine it with a new experimental drug called voxilaprevir, and this combination might one day be an option for patients who don't respond to currently available treatments, Vargas said. Moreover, Epclusa is essentially a stepping-stone in Gilead's plans for a future three-drug regimen that is pan-genotypic and does not include ribavirin, said Korenblat.
Merck, the makers of elbasvir/grazoprevir (Zepatier), are also testing the combination of elbasvir/grazoprevir and a "nuc" drug that will fill the same role as Gilead's sofosbuvir, the backbone of Harvoni and Epclusa. Overall, Vargas is impressed with the breakneck pace of drug development in hepatitis C. "I never would have imagined that we would be at this very nice space this early," he said. "The future is shaping itself very nicely."
Credit: Devonyu for iStock via Thinkstock.
Sony Salzman is a freelance journalist reporting on health care and medicine, who has won awards in both narrative writing and radio journalism. Follow Salzman on Twitter: @sonysalz.
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