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The lower prevalence of NS5A velpatasvir-specific RAS compared to NS5A class RASs is due to the improved resistance barrier of velpatasvir, according to the researchers. The SVR rates for patients with genotypes 1 through 6 and velpatasvir-specific RASs ranged from 93% to 100% compared with 98% to 100% in patients without velpatasvir-specific RASs. Twenty of the 1,778 patients treated with sofosbuvir/velpatasvir for 12 weeks did not achieve SVR.
The researchers conducted resistance analyses of six phase 3 clinical trials of Epclusa (sofosbuvir/velpatasvir, Gilead Sciences) for 12 weeks in a total of 1,778 patients with chronic HCV genotypes 1 through 6. Trials included the ASTRAL 1, 2, 3 and 5 studies and POLARIS-2 and POLARIS-3 studies.
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Of those, seven had HCV genotype 1, 12 had genotype 3, and one had genotype 4. by Talitha Bennett Disclosure: reports he served as a clinical investigator and speaker or consultant for AbbVie, Boehringer Ingelheim, Bristol-Myers Squibb, Gilead Sciences, Merck Sharp & Dohme and Roche. Please see the full study for the other researchers relevant financial disclosures. Treatment with Epclusa for 12 weeks resulted in high sustained virologic response rates among patients with hepatitis C genotypes 1 through 6, irrespective of baseline NS5A resistance-associated substitutions, according to recently published data. The researchers detected NS5A inhibitor resistance, but not resistance to sofosbuvir, in the few patients who did not achieve SVR. Treatment with [Epclusa] for 12 weeks was effective across highly diverse HCV subtypes, Christophe MD, PhD, from the Universite Paris-Est, France, and colleagues wrote. Most of the few patients who experienced virologic failure after treatment with [Epclusa] for 12 weeks had single class resistance to NS5A inhibitor velpatasvir, but not to the NS5B inhibitor sofosbuvir allowing for a possible retreatment with sofosbuvir-containing regimens.