Enanta Pharmaceuticals Inc (ENTA)

[willyw]

https://www.journal-of-hepatology.eu/article/S0168-8278(21)00158-6/fulltext (complete text) (partial text available @ natap https://www.natap.org/

Glecaprevir/pibrentasvir + sofosbuvir + ribavirin offers high cure rate for hepatitis C virus retreatment in real-world settings
(My comment- this only has 6 people in it but the implications on re-treating those with DAA resistance AND cirrhosis is of interest. ~Willy)

We read with interest the recent publication by Dietz et al: “Failure on voxilaprevir, velpatasvir, sofosbuvir and efficacy of rescue therapy” and would like to present additional data regarding salvage hepatitis C virus (HCV) treatment in this difficult-to-cure patient population.

Patients who fail to achieve sustained virologic response (SVR) with approved direct-acting antiviral (DAA) regimens have limited options for successful retreatment. Usage of a regimen containing an NS3/4A protease inhibitor, NS5A replication complex inhibitor, and NS5B polymerase inhibitor with weight-based ribavirin is appropriate for patients for whom even triple-DAA rescue therapy with sofosbuvir/velpatasvir/voxilaprevir did not achieve cure.
........

Results

Six patients began 16-24 weeks of HCV retreatment with glecaprevir/pibrentasvir, sofosbuvir, and ribavirin between July 2018 and March 2020. All patients achieved SVR. Baseline resistance was present in most patients (5/5 assessed for NS5A and 3/4 for NS3), and all had cirrhosis. No patients were on dialysis or had HIV or hepatitis B virus. No patients experienced serious adverse events or died during treatment. See Table 1 for additional patient details.

(One final comment- with newer more effective treatments the vast multitude of infected can be cured. That small segment that fails can be "rescued" with various therapies. That small group which fails those still has hope for a cure. Add to this people who are cured and become re-infected but have DAA resistant variants are not without options. ~W)