Gilead's triple therapy
Overall, 27% were NS5A-experienced, 52% were non-NS5A, DAA-experienced, and 21% had no prior DAA-experience. Baseline RAVs were detected in 60% of patients (20% NS5A; 15% NS3, 2% NS5B (no S282T), and 23% had resistance to multiple classes)
compare to ABBVIE/ENTA's
There are limited HCV treatment options for patients with prior DAA treatment failure. We evaluated the efficacy and safety of the combination regimen of the NS3/4A protease inhibitor ABT-493 plus the NS5A inhibitor ABT-530 with or without ribavirin (RBV) in HCV genotype 1 (GT1)-infected patients without cirrhosis who have failed DAA-containing regimens that included a protease inhibitor and/or NS5A inhibitor, with or without an NS5B polymerase inhibitor.
"Results: Fifty patients were randomised, of whom 42 (84%) had GT1a infection and 33 (66%) had treatment experience with regimens that contained 2 or 3 DAAs. Deep sequencing revealed baseline resistance-associated variants (RAVs) in 41 (82%) patients, 15 in NS3, 10 in NS5A, and 16 with RAVs in both targets.
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(my comment) it is difficult to compare the two groups. Abbvies is smaller, abbvies did not include cirrhotics.
Gilead makes for a more difficult to interpret study; it really blends groups. It has a certain % of cirrhotics, it also blends in IFN and RBV past treatment failures, which are almost no harder to treat than treatment naives by today's best DAA standards.
I would like to see the results, head to head with the standard of care failures removed from Gileads, and the percentage of cirrhotics removed, so that it was purely non-cirrhotic past DAA failures compared. I would wager that Gileads triple therapy might look dfar more comparable, possible even inferior to Abbvie/Enta's doublet; the 21% IFN/RBV failures in Gilead's trials are included to obfuscate and raise the SVR rates.
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