Daclatasvir + Sofosbuvir Better for HCV/HIV Coinfection

The combination of daclatasvir (Daklinza, Bristol-Myers Squibb) and sofosbuvir (Sovaldi, Gilead Sciences) more effectively cures hepatitis C virus (HCV) among those coinfected with HIV than does sofosbuvir and ribavirin, according to a new systematic literature review from Monthly Prescribing Reference

Researchers conducted a systematic literature review of all Phase III trials of coinfected individuals, including ALLY-2, which tested daclatasvir and sofosbuvir, and PHOTON-1 and PHOTON-2, which tested sofosbuvir and ribavirin. The combined data showed a 99.99% sustained virologic response (SVR) for the daclatasvir-sofosbuvir combination 12 weeks after completing treatment, compared with 84.6% for sofosbuvir and ribavirin. Therapy discontinuation rates due to adverse events, such as cough, diarrhea and insomnia, also were lower with the daclatasvir-sofosbuvir combination.

To adjust for baseline differences among the trials, ALLY-2 patients were statistically weighted “to match all available summary baseline characteristics reported in both the ALLY-2 and PHOTON trials,” reported lead study author Elyse Swallow, MA, of health economics and outcomes research at Analysis Group Inc., and a team from Bristol-Myers Squibb in a presentation at the Liver Meeting 2015, held in November in San Francisco. “These factors included patient age, sex, body mass index, race and ethnicity, treatment-naive status, viral genotypes, HCV RNA level, IL28B genotype, cirrhosis status, CD4 T-cell count and combination antiretroviral therapy regimens

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