Daclatasvir plus asunaprevir dual therapy for chronic HCV genotype 1b infection: results of Turkish early access program

Ann Hepatol. 2017;16(1):71-76. doi: 10.5604/16652681.1226817.

Abstract

Background. Daclatasvir and asunaprevir dual therapy is approved for the treatment of HCV genotype 1b infection in several countries.

Aim: To evaluate the efficacy and safety of daclatasvir and asunaprevir dual therapy in Turkish patients.

Material and methods: Sixty-one patients with HCV genotype 1b were enrolled in the Turkish early access program. Most of the patients were in difficult-to-treat category. Patients were visited at each 4 week throughout the follow-up period. Laboratory findings and adverse events were recorded at each visit.

Results: Fifty-seven of 61 enrolled patients completed 24 weeks of treatment. Two patients died as a result of underlying diseases at 12-14th weeks of treatment. Two patients stopped the treatment early as a consequence of virological breakthrough, and 2 patients had viral relapse at the post-treatment follow-up. Overall SVR12 rates were 90% (55/61) and 93.2% (55/59) according to intention-to-treat (ITT) and per protocol (PP) analysis respectively. In ITT analysis, SVR12 was achieved by 93% (13/14) in relapsers, 80% (12/15) in interferon-ineligible patients and 91% (20/22) in previous nonresponder patients. SVR12 rates were 86.5% and 91.4% in patients with cirrhosis according to ITT and PP analysis respectively. SVR12 was 95.8% in non-cirrhosis group in both analysis. Patients with previous protease inhibitor experience had an SVR12 of 87.5%. Common adverse events developed in 28.8% of patients. There were no treatment related severe adverse event or grade-4 laboratory abnormality.

Conclusions: Daclatasvir and asunaprevir dual therapy is found to be effective and safe in difficult-to-treat Turkish patients with HCV genotype 1b infection.

MeSH terms

  • Aged
  • Antiviral Agents / adverse effects
  • Antiviral Agents / economics
  • Antiviral Agents / therapeutic use*
  • Carbamates
  • Cost-Benefit Analysis
  • Drug Costs
  • Drug Therapy, Combination
  • Female
  • Genotype
  • Health Services Accessibility* / economics
  • Hepacivirus / drug effects*
  • Hepacivirus / genetics
  • Hepatitis C, Chronic / diagnosis
  • Hepatitis C, Chronic / drug therapy*
  • Hepatitis C, Chronic / economics
  • Hepatitis C, Chronic / virology
  • Humans
  • Imidazoles / adverse effects
  • Imidazoles / economics
  • Imidazoles / therapeutic use*
  • Isoquinolines / adverse effects
  • Isoquinolines / economics
  • Isoquinolines / therapeutic use*
  • Male
  • Middle Aged
  • Program Evaluation
  • Pyrrolidines
  • RNA, Viral / genetics
  • Sulfonamides / adverse effects
  • Sulfonamides / economics
  • Sulfonamides / therapeutic use*
  • Time Factors
  • Treatment Outcome
  • Turkey
  • Valine / analogs & derivatives
  • Viral Load

Substances

  • Antiviral Agents
  • Carbamates
  • Imidazoles
  • Isoquinolines
  • Pyrrolidines
  • RNA, Viral
  • Sulfonamides
  • Valine
  • daclatasvir
  • asunaprevir