Sofosbuvir Ribavirin to Prevent PostTransplant HCV Recurrence Phase 2 Curry MP et al Gastroenterology 20151481007 Treatment Naïve and Treatment Experienced Liver Transplantation Source Curry MP et ID: 766790
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Sofosbuvir + Ribavirin to Prevent Post-Transplant HCV Recurrence Phase 2 Curry MP, et al. Gastroenterology. 2015;148:100-7. Treatment Naïve and Treatment Experienced Liver Transplantation
Source: Curry MP, et al. Gastroenterology. 2015;148:100-7. Sofosbuvir + Ribavirin to Prevent Post-Transplant HCV Recurrence Sofosbuvir + Ribavirin to Prevent Post-Transplant HCV Recurrence Design : Open-label, pilot, phase 2 trial of up to 48 weeks of sofosbuvir + ribavirin in patients with HCV of any genotype and cirrhosis awaiting liver transplantation for hepatocellular cancer Setting : International Study in United States, New Zealand, and Spain Entry Criteria - N = 61 patients with chronic hepatitis C and cirrhosis and any genotype - Age: ≥ 18 - HCV RNA ≥ 10 4 IU/mL - Treatment naïve and treatment experience - CTP score ≤ 7 and MELD score ≤ 17 - Excluded if decompensated liver disease Regimen Given Prior to Transplant (up to 48 weeks of therapy ) - Sofosbuvir + Ribavirin (weight based) Primary End-Point : SVR 12 weeks post transplant
Source: Curry MP, et al. Gastroenterology. 2015;148:100-7. Sofosbuvir + Ribavirin to Prevent Post-Transplant HCV Recurrence Study Design92 screened 63 enrolled 61 dosed 46 underwent liver transplantation 43 with HCV RNA <LLOQ at transplantation These 43 patients analyzed for post-transplant SVR
Source: Curry MP, et al. Gastroenterology. 2015;148:100-7. Sofosbuvir + Ribavirin to Prevent Post-Transplant HCV Recurrence Study DesignDrug Dosing Sofosbuvir: 400 mg once daily Ribavirin (weight-based and divided bid): 1000 mg/day if < 75 kg or 1200 mg/day if ≥ 75 kg Sofosbuvir + Ribavirin N = 61 SVR12 Week 0 Post-12 24 12 48 Treatment for 12 to 48 weeks while awaiting liver transplant Dosing discontinued within 24 hours before transplantation Liver Transplant Required Duration
Source: Curry MP, et al. Gastroenterology. 2015;148:100-7. Sofosbuvir + Ribavirin to Prevent Post-Transplant HCV Recurrence Baseline Characteristic (n = 40)All patients dosed(N=61)Patients with HCV RNA <25 IU/mL at time of transplant (N=43) Median Age , years 59 59 Male sex, % 80 74 White, %9093 Median Body Mass Index (BMI) kg/m227.427.1HCV genotype 1 (%) 73 72 IL28B genotype CC, (%) 22 23 Median baseline HCV RNA, log 10 IU/ml 6.2 6.3 Previous HCV treatment, %7579
Sofosbuvir + Ribavirin to Prevent Post- Transplant HCV RecurrenceVirologic Response at Transplant and Post-Transplant Source: Curry MP, et al. Gastroenterology. 2015;148:100-7. 43/46 30/43
Sofosbuvir + Ribavirin to Prevent Post- Transplant HCV RecurrenceVirologic Response at Transplant and Post-Transplant Source: Curry MP, et al. Gastroenterology. 2015;148:100-7. 43/46 31/43 30/43 31/43 Data for the 43 patients with HCV RNA <25 IU/mL at time of transplant
Source: Curry MP, et al. Gastroenterology. 2015;148:100-7. Sofosbuvir + Ribavirin to Prevent Post-Transplant HCV Recurrence Duration of Undetectable HCV RNA and Risk of Recurrence500 4 00 300 100 2 00 0 1.00 0.75 0.50 0.25 0 .00 Days Continuously Target Not Detected Probability of No Recurrence Median duration of undetectable HCV RNA prior to transplant - Patients with recurrent HCV = 5.5 days - Patients without recurrent HCV = 99.5 days
Source: Curry MP, et al. Gastroenterology. 2015;148:100-7. Sofosbuvir + Ribavirin to Prevent Post-Transplant HCV Recurrence Event Sofosbuvir + Ribavirin (N=61)Any adverse event (%)54 (8%) Any serious adverse event 11 (18%) Hemoglobin decrease to <10 g/ dL 18 (30%) Hemoglobin decrease to <8.5 g/ dL 3 (5%) Adverse event occurring in >10% of patients Fatigue 23 (38%) Headache 14 (23%) Nausea 10 (16%) Rash 9 (15%) Cough 7 (11%) Dyspnea 7 (11%) Insomnia 7 (11%)
Source: Curry MP, et al. Gastroenterology. 2015;148:100-7. Sofosbuvir + Ribavirin to Prevent Post-Transplant HCV RecurrenceConclusions Conclusions: “Administration of sofosbuvir and ribavirin before liver transplantation can prevent post-transplant HCV recurrence.”
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