Abstract
A fixed-dose combination of the hepatitis C virus (HCV) NS5B polymerase inhibitor sofosbuvir, the HCV NS5A inhibitor velpatasvir and the HCV NS3/4A protease inhibitor voxilaprevir (sofosbuvir/velpatasvir/voxilaprevir; Vosevi®) is approved in the EU for the treatment of chronic HCV genotype 1, 2, 3, 4, 5 or 6 infection in adults. In the phase III POLARIS trials, in patients who had HCV genotype 1–6 infection with or without compensated cirrhosis, overall rates of sustained virological response at 12 weeks post-treatment (SVR12) with sofosbuvir/velpatasvir/voxilaprevir were high after 8 weeks of treatment in direct-acting antiviral (DAA)-naïve patients and 12 weeks of treatment in DAA-experienced patients. However, 8 weeks of sofosbuvir/velpatasvir/voxilaprevir was inferior to 12 weeks of sofosbuvir/velpatasvir in cirrhotic or non-cirrhotic DAA-naïve patients with HCV genotype 1, 2, 4, 5 or 6 infection and non-cirrhotic DAA-naïve patients with HCV genotype 3 infection, mostly due to an insufficient treatment period. Sofosbuvir/velpatasvir/voxilaprevir was generally well tolerated, with most adverse events being of mild or moderate intensity. The most common adverse events included headache, fatigue, nausea and diarrhoea. In conclusion, sofosbuvir/velpatasvir/voxilaprevir is an important and effective option for the treatment of HCV genotype 1–6 infection in adults, especially those who have previously failed a DAA therapy with or without an HCV NS5A inhibitor.
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During the peer review process, the manufacturer of sofosbuvir/velpatasvir/voxilaprevir was also offered an opportunity to review this article. Changes resulting from comments received were made on the basis of scientific and editorial merit.
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The preparation of this review was not supported by any external funding.
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Young-A Heo and Emma Deeks are salaried employees of Adis/Springer, are responsible for the article content and declare no relevant conflicts of interest.
Additional information about this Adis Drug Review can be found at http://www.medengine.com/Redeem/A9FCF0601B400E10.
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The manuscript was reviewed by: L. Benítez-Gutiérrez, Internal Medicine Department & Liver Transplant Uni, Puerta de Hierro Majadahonda Hospital & Research Institute, Madrid, Spain; G. Bertino, Hepatology Unit, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy; J. I. Herrero, Liver Unit, Clinica Universidad de Navarra, Pamplona, Spain.
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Heo, YA., Deeks, E.D. Sofosbuvir/Velpatasvir/Voxilaprevir: A Review in Chronic Hepatitis C. Drugs 78, 577–587 (2018). https://doi.org/10.1007/s40265-018-0895-5
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DOI: https://doi.org/10.1007/s40265-018-0895-5