There has been – justifiably – so much good news about very effective treatments for chronic hepatitis C virus (HCV) infections that it’s easy to lose sight of the fact that not everyone is cured with these treatments. Yes, the sustained viral responses are incredibly high for most genotypes of infection. However, there are some patients who do not clear the virus during their first round of treatment.
About a week ago, the U.S. Food and Drug Administration (FDA) approved the first medication that can be used as salvage therapy in patients who failed initial treatment with sofosbuvir or other medications for HCV genotypes 1-6. This means that there is another treatment option for patients who did not achieve a successful outcome with a prior treatment. This medication, Vosevi™, from Gilead Sciences is a once-daily combination pill containing sofosbuvir/velpatasvir and voxilaprevir.
Vosevi is approved to treat adults with chronic infection from genotypes 1-6 of the hepatitis C virus without cirrhosis or with mild cirrhosis. Vosevi was approved by the FDA after a series of Phase 3 clinical trials (based on a total of 750 individuals who failed a prior HCV treatment) were shown to have successfully treated 96-97% of cases.
On the heels of Vosevi is another medication, called Maviret (glecaprevir/pibrentasvir) from AbbVie, which is poised for potential FDA approval. As with Vosevi, Maviret works on all six genotypes of HCV and can be used by patients who failed a previous therapy. Maviret is also predicted to serve as an alternative to Epclusa.
It continues to be a hopeful time for those with hepatitis C, even if one treatment has failed – new breakthroughs and treatment options can still set patients on the path to an eventual cure.