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Review
. 2018 Dec 2:11:1756284818812358.
doi: 10.1177/1756284818812358. eCollection 2018.

Sofosbuvir, velpatasvir and voxilaprevir: a new triple combination for hepatitis C virus treatment. One pill fits all? Is it the end of the road?

Marc Bourlière  1 , Olivia Pietri  2 , Paul Castellani  2 , Valérie Oules  2 , Xavier Adhoute  2
Affiliations
Review

Sofosbuvir, velpatasvir and voxilaprevir: a new triple combination for hepatitis C virus treatment. One pill fits all? Is it the end of the road?

Marc Bourlière et al. Therap Adv Gastroenterol. .

Abstract

The advent of oral direct-acting antiviral agents (DAAs) has dramatically improved the hepatitis C virus (HCV) treatment landscape in the last 4 years, providing cure rates over 95% with a shorter duration of treatment and a very good safety profile. This has enabled access to treatment in nearly all HCV infected patients. The launch of two pangenotypic fixed dose combinations (FDCs) in 2017 made a new step forward in HCV treatment by slightly increasing efficacy and more importantly allowing the treatment of patients without HCV genotyping, and in some cases without fibrosis assessment. However, retreatment of the few DAA failure patients was still an issue for some HCV genotypes. The launch of the triple regimen FDC, sofosbuvir/velpatasvir/voxilaprevir, solves this issue by providing a cure rate over 96% regardless of HCV genotype. In this review, we describe the current HCV treatment landscape and focus on the development of this triple FDC either in treatment-naïve or treatment-experienced patients with previous failure on a DAA regimen.

Keywords: DAA failure; fixed dose combination; glecaprevir; pibrentasvir; single pill tablet; sofosbuvir; velpatasvir; voxilaprevir.

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Conflict of interest statement

Conflict of interest statement: The following are declared: M. Bourlière: advisory board and speaker for: Gilead, AbbVie, MSD, BMS, Janssen, Boehringer-Ingelheim; Paul Castellani: speaker for Gilead, AbbVie, Janssen, and MSD; Valérie Oules: speaker for Gilead, AbbVie, Janssen, MSD; Xavier Adhoute: speaker for Bayer.

Figures

Figure 1.
Figure 1.
Treatment options with DAA combinations since 2013. DAA, direct-acting antiviral agent; NUC, nucleotide.
Figure 2.
Figure 2.
SVR in phase II studies with sofosbuvir/velpatasvir plus voxilaprevir. DAA, direct-acting antiviral agent; PI, protease inhibitors; PR, pegylated interferon plus ribavirin; SVR, sustained virological response; TE, treatment-experienced.
Figure 3.
Figure 3.
SVR in phase II studies with sofosbuvir/velpatasvir plus voxilaprevir. SVR, sustained virological response; TE, treatment-experienced.
Figure 4.
Figure 4.
SVR in phase II studies with sofosbuvir/velpatasvir plus voxilaprevir. DAA, direct-acting antiviral agent; RBV, ribavirin; SVR, sustained virological response; TE, treatment-experienced.
Figure 5.
Figure 5.
SVR in phase III studies with sofosbuvir/velpatasvir plus voxilaprevir.,, DAA, direct-acting antiviral agent; FDC, fixed dose combination; SVR, sustained virological response.
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