Why make this statement?
|
|
- Owen Dickerson
- 6 years ago
- Views:
Transcription
1 HCV Council clinical practice statements were evaluated by the Council A review of the available literature was conducted The level of support and level of evidence for the statements were discussed This activity will revisit the findings of the HCV Council from July 2014 and discuss how the field has changed over the last 4 months
2 Patients with cirrhosis have lower rates of SVR compared to patients who are non-cirrhotic and, thus, treatment efficacy remains suboptimal for this population. Why make this statement? Historical data suggests cirrhosis is the strongest baseline factor to predict treatment failure Patients with cirrhosis are felt to have higher SAE, dose modifications, and treatment discontinuation Compounded by prior treatment failure Trend blunted but not eliminated with SOF-PR and SMV-PR
3 Adjusted SVR4: SOF/SMV±RBV for 12 Weeks Impact of Cirrhosis Sulkowski MS, et al. Presented at AASLD: The Liver Meeting. November 7-11, Boston, Massachusetts. Poster 955.
4 SVR Effect of Cirrhosis Nearly Eliminated with Combination All-oral Therapy SVR 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% ION-1: Cirrhotic vs Non-cirrhotic SVR ION-2: Cirrhotic vs Non-cirrhotic SVR Cirrhotic Non-Cirrhotic Cirrhotic 100% 100% 100% 100% 100% 100% 97% 96% 100% 90% 80% 70% 60% 50% 95% 86% 82% Non-Cirrhotic 100% 100% 99% 100% 99% 40% 30% 20% 10% % wk-rbv 12 wk+rbv 24 wk-rbv 24 wk+rbv 12 wk-rbv 12 wk+rbv 24 wk-rbv 24 wk+rbv Ledipasvir/ sofosbuvir (LDV/SOF) ± RBV Afdhal N, et al. N Engl J Med. 2014;370: ; Afdhal N, et al. N Engl J Med. 2014;370:
5 SVR12, % Patients TURQUOISE-II (3D + RBV): ITT SVR12 by Prior Treatment Response 3D (Paritaprevir/r-ombitasvir and dasabuvir) + RBV 12-week arm 24-week arm 100.0% 92.2% 92.9% 93.3% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 85.7% 100.0% 100.0% 100.0% 80.0% 60.0% 40.0% 20.0% 0.0% 59/64 52/56 Naive 14/15 13/13 11/11 10/10 Prior Relapse Response Prior Relapse Response 22/22 18/18 Naive 25/25 20/20 Prior Relapse Response 6/7 3/3 14/14 10/10 Prior Relapse Response Prior Null Response G1a G1b Poordad F, et al. N Engl J Med. 2014;370:
6 Summary of Key Issues Cirrhosis is still a baseline factor that effects efficacy The impact can be blunted by other factors, such as favorable baseline characteristics (G1b) and the treatment regimen Patients continue to have lower rates of SVR, but the difference in SVR rate between non-cirrhotic and cirrhotic is now much smaller
7 Patients with easier to treat characteristics can be defined and treated for shorter duration. Why make this statement? PR data suggested that some populations may be able to shorten therapy Low-viral load IL28B CC Shorter therapy is desirable as treatment duration drives cost and compliance Efficacy higher when treatment is extended in certain populations with cirrhosis
8 SVR12 (%) SVR12 by Number of Negative Predictors Derived from Multivariate Analysis (combined dataset) > /9 70/70 181/ / /239 60/88 12/ *Prior treatment, sex, weight, IL28B, cirrhosis, and HCV RNA level. Phase 3 studies of sofosbuvir regimens Foster GR, et al. Abstract O66, EASL, 2014 Number of Negative Predictors*
9 SVR12 (%) ION-3: Ledipasvir/Sofosbuvir (LDV/SOF) ± RBV in HCV G1 Treatment-Naïve, Non-Cirrhotic Patients P = 0.52 P = 0.70 P = / / /216 LDV/SOF LDV/SOF + RBV LDV/SOF 8 Weeks 12 Weeks Kowdley, KV, et al. N Engl J Med. 2014;370(20):
10 SVR 12 (%) ION-3 (G1, Treatment-Naive, Non-Cirrhotic, Efficacy in Subjects with Baseline HCV RNA < 6 Million IU/mL LDV/SOF ± RBV x 8 or 12 weeks) Efficacy in Subjects with Baseline HCV RNA < 6 Million IU/mL % 96% Relapse Rates by Baseline Viral Load 0 119/ /131 LDV/SOF 8 Weeks LDV/SOF 8 weeks LDV/SOF 12 Weeks LDV/SOF 12 weeks HCV RNA < 6M IU/mL 2% (2/123) 2% (2/131) 8 weeks of LDV/SOF was non-inferior to 12 weeks for patients with HCV RNA < 6M IU/ml and in the overall population Ledipasvir and sofosbuvir prescribing information. Gilead Sciences, Inc
11 Summary of Key Issues Next-wave DAA trials confirm that shortening therapy for easier-to-treat patients is plausible Especially treatment-naïve without cirrhosis Even within difficult populations, cohorts of patients can be identified for shorter duration therapy Treatment experienced genotype 1b with cirrhosis and treatment experienced genotype 1a (without prior null response) can shorten to 12 weeks with 3D regimen (Paritaprevir/r-ombitasvir and dasabuvir)
12 C-SWIFT: MK-5172+MK-8742+Sofosbuvir in Treatment-naïve Patients with HCV G1 With or without cirrhosis for durations of 4, 6, or 8 weeks SVR 4/8 (n) Non-cirrhotic Cirrhotic 4 Weeks 6 Weeks 6 Weeks 8 Weeks 39% (31) 87% (30) 80% (20) 95% (19) Optimized regimen of PI + NS5A + NUC Non-cirrhotics: 4-6 weeks; Cirrhotics: 6-8 weeks Treatment failure due exclusively to relapse Lawitz, et al. Presented at AASLD: The Liver Meeting. November 7-11, Boston, Massachusetts. LB-33.
13 The preferred approach to treatment for all subgroups of patients with genotype 3 is sofosbuvir and ribavirin for 24 weeks. Why make this statement? G3 continues to have lower efficacy despite longer duration of therapy The impact of the next wave of therapy remains controversial
14 SVR 12 (%) Sofosbuvir + Ribavirin for Genotype VALENCE: 24 weeks, n= /92 2/13 87/100 28/45 No cirrhosis Cirrhosis No cirrhosis Cirrhosis Naïve Treatment-experienced Zeuzem S, et al. N Engl J Med. 2014;370:
15 SVR12 (%) Retreatment of Genotype 3: Sofosbuvir + RBV Failures PR + SOF 12 Wks SOF + RBV 24 Wks /14 17/23 7/8 7/15 No cirrhosis Cirrhosis Esteban R, et al. EASL 2014, Abstract O8.
16 All-oral 12-week Combination of Daclatasvir and Sofosbuvir in Patients with Genotype 3: ALLY-3 ALLY-3 0 Weeks EOT SVR Treatment Naïve 19% with cirrhosis N=101 Daclatasvir + Sofosbuvir 99% 90% Prior Treatment 25% with cirrhosis N=51 Daclatasvir + Sofosbuvir 100% 86% SVR F0-F3 = 96% (105/19) SVR F4 = 63% (20/32) Nelson DR, et al. Presented at AASLD: The Liver Meeting. November 7-11, Boston, Massachusetts. LB-3.
17 Summary of Key Issues 24 weeks of SOF + RBV highly effective in G3 AEs are those of RBV No virologic price to pay for failure PEG + RBV + SOF may be more effective in certain populations (eg, treatment-experienced cirrhotics) Drugs in development may increase the number of options
18 Due to the high costs of medications, only patients with advanced fibrosis should be offered treatment with all oral regimens for HCV. Why make this statement? To treat entire US HCV population would cost > $250 billion, thus need to prioritize access Based on the premise that patients with advanced fibrosis have the most at risk and most to gain with therapy, while those with mild disease can wait Current access issue: Many payors restricting care to only those with disease severity and/or high risk for disease progression Advanced fibrosis Extrahepatic manifestations Cryoglobulins with renal disease
19 % Patients After 5 Years Effects of SVR on Risk of Liver Transplant, Hepatocellular Carcinoma, Death, and Re-infection SVR No SVR 5-Year All Cause Mortality 10.5% 11.3% % 3.6% 2 0 General: 18 Studies n=29,269 Cirrhotic: 9 Studies n=2,734 Meta-analysis of 129 studies; RR substantially reduced for all groups with SVR Adapted from Saleem, et al. Presented at AASLD: The Liver Meeting. November 7-11, Boston, Massachusetts. Abstract 44.
20 Adjusted Hazard Ratio for Mortality Adjusted Hazard Ratio for Mortality Adjusted Hazard Ratio for Mortality SVR Reduces All-cause Mortality Even in the Absence of Cirrhosis 1.2 Genotype 1 (n=12,166) SVR rate: 35% 1.2 Genotype 2 (n=2904) SVR rate: 72% 1.2 Genotype 3 (n=1794) SVR rate: 62% ( ) (P=0.0003) 0.72 ( ) (P=0.001) ( ) (P=0.005) 0.69 ( ) (P=0.049) ( ) (P=0.0002) 0.40 ( ) (P=0.0001) Overall SVR Group SVR With No Baseline Cirrhosis 0 Overall SVR Group SVR With No Baseline Cirrhosis 0 Overall SVR Group SVR With No Baseline Cirrhosis Backus LI, et al. Clin Gastroenterol Hepatol. 2011;9:
21 Impact of IFN-free Regimens on Clinical and Cost Outcomes Triple Therapy Staging Treat all Oral Therapy Staging Treat all Life expectancy (yr) Progression to: Cirrhosis (%) Decompensation (%) HCC (%) Decomp or HCC Transplant (%) Strategy Oral staging Oral treat-all Cost ($) 77,133 90,681 Effectiveness (QALYs) ICER ($/QALY) 15,709 HCC: hepatocellular carcinoma; QALY: quality adjusted life years; ICER: incremental cost effectiveness analysis Younossi ZM, et al. J Hepatol. 2014;60:
22 Summary of Key Issues HCV has significant effect on morbidity and mortality Highest in patients with cirrhosis, but also impacts patients without cirrhosis HCV cure reduces morbidity and mortality Effect seen in both patients with and without cirrhosis Cirrhosis has a negative impact on SVR, especially in treatment-experienced population Requires longer duration and more expensive therapy Treating all patients infected with HCV, without using fibrosis screening based intervention has the greatest impact on morbidity/mortality and is the most costeffective strategy
23 Patients Meeting "Highest" or High" Priority for HCV Treatment in Chronic Hepatitis C Cohort Study (CHeCS) Treatment recommendations have suggested prioritizing patients for treatment based on disease severity, risks of progression, co-morbidities, and extrahepatic manifestations Priority status N=8504 HIGHEST PRIORITY 32.9% HIGH PRIORITY 28.9% NOT MEETING HIGHEST or HIGH PRIORITY 38.2% This study determined treatment priority status in a large, multicenter patient cohort. Cryoglobulinemia and Debilitating fatigue not evaluated Xu, et al. Presented at AASLD: The Liver Meeting. November 7-11, Boston, Massachusetts. LB-29.
24 Patients co-infected with HIV/HCV should no longer be considered a special population. Why make this statement? Patients infected with HIV/HCV have been historically more difficult to treat Poorer response to IFN-based therapy Increased risk of toxicities and adverse events Fewer options due to drug-drug interactions Recent data suggest IFN-free therapies may be equally effective in patients who are HIV negative or positive Special designation delays therapy to this group EASL guidelines has already proclaimed patients with HIV/HCV non-special
25 NIAID ERADICATE: Sofosbuvir/Ledipasvir for the Treatment of HCV G1 in Patients Co-infected with HIV HCV, GT1, treatment-naïve subjects treated with SOF/LDV x 12 weeks GT1a= 74% African American = 84% Mild fibrosis = 78% Arm A (n=13): ARV-naïve Arm B (n=37): ARV-treated ARV combination Tenofovir/FTC with Efavirenz, Rilpivirine, or Raltegrevir ARV-naïve ARV-treated EOT 100% 100% SVR12 100% 97% No change in CD4 or HIV RNA No SAE and no early discontinuations due to AE Townsend KS, et al. Presented at AASLD: The Liver Meeting. November 7-11, Boston, Massachusetts. Abstract 84.
26 TURQUOISE-I: Paritaprevir/r/Ombitasvir, Dasabuvir + RBV SVR12 in HCV/HIV Co-infected Patients Randomized to 12 or 24 weeks of 3-drug regimen + RBV 3D = Paritaprevir/r (PI) + Ombitasvir (NS5A) + Dasabuvir (NNI) Treatment-naïve (65%) or Experienced (35%) Cirrhotic ~20% (CP-A) HIV ART Regimen: Atazanavir (44%) or Raltegrevir (56%) 0 Weeks SVR HCV/HIV Co-infected N=31 3D + RBV 94% N=32 3D+ RBV 91% AE: Mild fatigue, nausea, insomnia; No SAE Wyles DL, et al. Presented at AASLD: The Liver Meeting. November 7-11, Boston, Massachusetts. Abstract 1939.
27 Summary of Key Issues Efficacy with newer agents now comparable to HCV monoinfection, raising possibility that HIV/HCV co-infection no longer is a special population Need expansion to larger and more diverse populations High viral loads may remain an important factor Drug-drug interactions require ongoing evaluation but are reduced for selected agents and combinations Earlier access to new therapies likely for co-infected population
What is the Optimized Treatment Duration? To Overtreat versus Undertreat. Nancy Reau, MD Associate Professor of Medicine University of Chicago
What is the Optimized Treatment Duration? To Overtreat versus Undertreat Nancy Reau, MD Associate Professor of Medicine University of Chicago Learning Objectives: 1. Discuss patient populations appropriate
More informationInitial Treatment of HCV G Hugo E. Vargas, MD Professor of Medicine Medical, Director Office of Clinical Research Mayo Clinic Arizona
Initial Treatment of HCV G1 2016 Hugo E. Vargas, MD Professor of Medicine Medical, Director Office of Clinical Research Mayo Clinic Arizona Disclosure Information Disclosure Information Dr. Vargas receives
More informationCase 4: A 61-year-old man with HCV genotype 3 with cirrhosis. Ira M. Jacobson, M.D. Weill Cornell Medical College New York, New York USA
Case 4: A 61-year-old man with HCV genotype 3 with cirrhosis Ira M. Jacobson, M.D. Weill Cornell Medical College New York, New York USA 1 Genotype 3 case 61-year-old man with HCV genotype 3 Cirrhosis on
More informationHCV In 2015: Maximizing SVR
HCV In 2015: Maximizing SVR Alnoor Ramji Gastroenterology & Hepatology Clinical Associate Professor Division of Gastroenterology University Of British Columbia ramji_a@hotmail.com Disclosures (within Last
More informationWorkshop I Planning Committee
Workshop I Planning Committee Nancy Reau, MD Associate Professor of Medicine University of Chicago School of Medicine Chicago, IL Stuart C. Gordon, MD Professor of Medicine Wayne State University School
More informationTreatment of Unique Populations Raymond T. Chung, MD
Treatment of Unique Populations Raymond T. Chung, MD Director of Hepatology and Liver Center Vice Chief, Gastroenterology Kevin and Polly Maroni Research Scholar Mass General Hospital Disclosures Research
More informationTreating HCV After Liver Transplantation: What are the Treatment Options?
4 th OPTIMIZE WORKSHOP USING DAAs IN PATIENTS WITH CIRRHOSIS AND LIVER RECIPIENTS Treating HCV After Liver Transplantation: What are the Treatment Options? Maria Carlota Londoño, MD Liver Unit, Hospital
More informationAssociate Professor of Medicine University of Chicago
Nancy Reau, MD Associate Professor of Medicine University of Chicago Management of Hepatitis C: New Drugs and New Paradigms HCV is More Lethal than HIV Infection HCV superseded HIV as a cause of death
More informationIFN-free for Genotype 1 HCV: the current landscape. Prof. Graham R Foster
IFN-free for Genotype 1 HCV: the current landscape Prof. Graham R Foster Wonderful new drugs are coming Poordad F, et al. New Engl J Med 2014; online DOI: 10.1056/NEJMoa1402869. 2 The New Drugs Two treatment
More informationTough Cases in HIV/HCV Coinfection
NORTHWEST AIDS EDUCATION AND TRAINING CENTER Tough Cases in HIV/HCV Coinfection John Scott, MD, MSc Assistant Professor University of Washington Presentation prepared by: J Scott Last Updated: Jun 5, 2014
More informationAri Bunim, M.D. Director of Hepatology New York Hospital Queens Assistant Professor of Clinical Medicine Weill Cornell Medical College
Ari Bunim, M.D. Director of Hepatology New York Hospital Queens Assistant Professor of Clinical Medicine Weill Cornell Medical College New York State Law Goes into Effect January 1, 2014 Hepatitis C Virus
More information5/12/2016. Learning Objectives. Management of Hepatitis C Virus Genotype 2 or 3 Infected Treatment-Naive or Experienced Patients
5/12/216 Management of Hepatitis C Virus Genotype 2 or 3 Infected Treatment-Naive or Experienced Patients Alexander Monto, MD Professor of Clinical Medicine University of California San Francisco San Francisco,
More informationDr Janice Main Imperial College Healthcare NHS Trust, London
BHIVA AUTUMN CONFERENCE 2014 Including CHIA Parallel Sessions Dr Janice Main Imperial College Healthcare NHS Trust, London 9-10 October 2014, Queen Elizabeth II Conference Centre, London BHIVA AUTUMN CONFERENCE
More informationLedipasvir-Sofosbuvir (Harvoni)
HEPATITIS WEB STUDY HEPATITIS C ONLINE Ledipasvir-Sofosbuvir (Harvoni) Robert G. Gish MD Professor, Consultant, Stanford University Medical Center Senior Medical Director, St Josephs Hospital and Medical
More informationTreatement Experienced patients without cirrhosis. Rafael Esteban Hospital Universitario Valle Hebron Barcelona
Treatement Experienced patients without cirrhosis Rafael Esteban Hospital Universitario Valle Hebron Barcelona Agenda With IFN PegIFN+ Ribavirin + Simeprevir PegIFN+ Ribavirin+ Sofosbuvir Without IFN Sofosbuvir
More informationHCV Treatment of Genotype 1: Now and in the Future
HCV Treatment of Genotype 1: Now and in the Future Bruce R. Bacon, MD, FACG James F. King, MD Endowed Chair in Gastroenterology Professor of Internal Medicine Co-Director of the Abdominal Transplant Program
More informationThe HCV Pipeline Ira M. Jacobson, MD, FACP, FACG, AGAF. Slide Presentation. IFN-free DAA combinations (G1)
Slide Presentation The HCV Pipeline Vincent Astor Distinguished Professor of Medicine Chief, Division of Gastroenterology and Hepatology Medical Director, Center for the Study of Hepatitis C Weill Cornell
More information10/21/2016. Susanna Naggie, MD, MHS Associate Professor of Medicine Duke University Durham, North Carolina. Learning Objectives
A Crash Course on the AASLD/IDSA Hepatitis C Virus Infection Treatment Guidelines: What s New Susanna Naggie, MD, MHS Associate Professor of Medicine Duke University Durham, North Carolina FORMATTED: 1/3/16
More informationTreatment of Patients with HCV and HIV
Treatment of Patients with HCV and HIV BRUCE A. LUXON, MD, PHD, FACG ANTON AND MARGARET FUISZ CHAIR IN MEDICINE PROFESSOR AND CHAIRMAN DEPARTMENT OF MEDICINE GEORGETOWN UNIVERSITY Four Questions Is HIV/HCV
More informationUpdate in the Management of Hepatitis C: What Does the Future Hold
Update in the Management of Hepatitis C: What Does the Future Hold Paul Y Kwo, MD, FACG Professor of Medicine Mdi Medical ldirector, Liver Transplantation tti Gastroenterology/Hepatology Division Indiana
More informationRome, February nd Riunione Annuale AISF th AISF ANNUAL MEETING
Rome, February 20-21 nd 2014 Riunione Annuale AISF 2014 14 th AISF ANNUAL MEETING Present and future treatment strategies for patients with HCV infection: chronic hepatitis and special populations IFN
More informationIFN-free therapy in naïve HCV GT1 patients
IFN-free therapy in naïve HCV GT1 patients Paris Hepatitis Conference Paris, 12th January, 2015 Pr Tarik Asselah MD, PhD; Service d Hépatologie & INSERM U773 University Paris Diderot, Hôpital Beaujon,
More informationHCV Treatment Failure: What Next? Dr Ashley Brown, Imperial College Healthcare NHS Trust, London
HCV Treatment Failure: What Next? Dr Ashley Brown, Imperial College Healthcare NHS Trust, London European HIV Hepatitis Co-infection Conference QEII Conference Centre 10 th December 2015 Dr Ashley Brown
More informationLatest Treatment Updates for GT 2 and GT 3 Patients
Latest Treatment Updates for GT 2 and GT 3 Patients Eric Lawitz, MD, AGAF, CPI Vice President, Scientific and Research Development The Texas Liver Institute Clinical Professor of Medicine University of
More informationUpdate on chronic hepatitis C treatment: current trends, new challenges, what next?
Update on chronic hepatitis C treatment: current trends, new challenges, what next? Matti Maimets 12.06.2015 MMaimets15 Disclosure this presentation is sponsored by Gilead Sciences MMaimets15 MMaimets15
More informationTreating now vs. post transplant
Resistance with treatment failure Treating now vs. post transplant Pros (for treating pre transplant) If SVR efficacy means Better quality of life Removal from waiting list No post transplant recurrence
More informationHCV-G3: Sofosbuvir with ledipasvir or daclatasvir?
HCV-G3: Sofosbuvir with ledipasvir or daclatasvir? Ioannis Goulis, MD Aristotelian University of Thessaloniki XXIII International Hepatitis B & C Meeting of Athens Hadziyannis HCV genotype 3 therapy Chronic
More informationHIV-HCV coinfection. Mark Sulkowski, MD Professor of Medicine Johns Hopkins University School of Medicine Baltimore, Maryland
HIV-HCV coinfection Mark Sulkowski, MD Professor of Medicine Johns Hopkins University School of Medicine Baltimore, Maryland Disclosures Principal investigator for research grants Funds paid to Johns Hopkins
More informationTreatment of HCV infection in daily clinical practice. Which are the optimal options for Genotypes 2 and 3? Jiannis Vlachogiannakos
Treatment of HCV infection in daily clinical practice. Which are the optimal options for Genotypes 2 and 3? Jiannis Vlachogiannakos Associate Professor of Gastroenterology Academic Department of Gastroenterology
More informationManagement of HCV Tawesak Tanwandee
Management of HCV 2016 Tawesak Tanwandee Topics Burden of HCV in our countries Natural history and unmet need for HCV treatment Current treatment as for 2016 Conclusion Evolution from HCV infection to
More informationVII CURSO AVANCES EN INFECCIÓN VIH Y HEPATITIS VIRALES
VII CURSO AVANCES EN INFECCIÓN VIH Y HEPATITIS VIRALES REGIMENES TERAPÊUTICOS DE LA HEPATITIS C, INTERFERÓN FREE A Coruña 2 Febrero 2013 Rui Sarmento e Castro Centro Hospitalar do Porto HJU ECS Universidade
More informationThe Dawn of a New Era: Hepatitis C
The Dawn of a New Era: Hepatitis C Naudia L. Jonassaint Assistant Professor of Medicine and Surgery University Pittsburgh School of Medicine December 1, 2015 Objectives After presentation the learner should
More information4/30/2015. Interactive Case-Based Presentations and Audience Discussion. Debika Bhattacharya, MD, MSc. Learning Objectives
4/3/215 Interactive Case-Based Presentations and Audience Discussion Debika Bhattacharya, MD, MSc Assistant Clinical Professor University of California Los Angeles Los Angeles, California Formatted:4-27-215
More information6/2/2015. Interactive Case-Based Presentations and Audience Discussion
6/2/215 Interactive Case-Based Presentations and Audience Discussion Andrew Aronsohn, MD Assistant Professor of Medicine University of Chicago Medical Center Chicago, Illinois Formatted:5-6-215 Washington,
More informationFuture strategies with new DAAs
Future strategies with new DAAs Ola Weiland professor New direct antiviral drugs Case no 1 male with genotype 2b Male with gt 2b chronic HCV Male with gt 2b relapse afer peg-ifn + RBV during 24 weeks
More informationTreatment of hepatitis C today and tomorrow Antonio Craxì GI & Liver Unit, Di.Bi.M.I.S., University of Palermo, Italy
Treatment of hepatitis C today and tomorrow Antonio Craxì GI & Liver Unit, Di.Bi.M.I.S., University of Palermo, Italy antonio.craxi@unipa.it Ad Board and grants: Abbvie, Achillion, BristolMyers Squibb,
More informationTreatments of Genotype 2, 3,and 4: Now and in the future
Treatments of Genotype 2, 3,and 4: Now and in the future THERAPY FOR THE TREATMENT OF GENOTYPE 2 1 GT 2 and GT 3 Treatment-Naïve: SOF+RBV vs PEG-IFN+RBV FISSION Study Design HCV GT 2 and GT 3 Treatment-naïve
More informationHow to optimize treatment in G3 patients? Jérôme GOURNAY, MD Hépatologie Centre Hospitalier Universitaire de Nantes France
How to optimize treatment in G3 patients? Jérôme GOURNAY, MD Hépatologie Centre Hospitalier Universitaire de Nantes France Paris Hepatitis Conference, January 12, 2016 Disclosures I have received funding
More informationUpdate on the Treatment of HCV
Update on the Treatment of HCV K. Rajender Reddy, MD Professor of Medicine Director of Hepatology Director, Viral Hepatitis Center University of Pennsylvania Philadelphia, USA 1 K. Rajender Reddy, MD Disclosure
More informationHCV Management in Decompensated Cirrhosis: Current Therapies
Treatment of Patients with Decompensated Cirrhosis and Liver Transplant Recipients Paul Y. Kwo, MD, FACG Professor of Medicine Gastroenterology/Hepatology Division Stanford University email pkwo@stanford.edu
More informationCan we afford to Cure all HIV-HCV Co-infected Patients of HCV?
Can we afford to Cure all HIV-HCV Co-infected Patients of HCV? Michael S. Saag, MD Professor of Medicine University of Alabama at Birmingham Birmingham, Alabama FINAL AU EDITED: 09-17-14 Disclosure Dr
More informationWill difficult-to-treat patients remain difficultto-treat. generation of treatments?
Will difficult-to-treat patients remain difficultto-treat with the new generation of treatments? Jordan J Feld MD MPH Toronto Centre for Liver Disease Sandra Rotman Centre for Global Health University
More informationTREATMENT OF HEPATITIS C IN THE LIVER TRANSPLANT SETTING. Dra. Zoe Mariño Liver Unit. Hospital Clinic Barcelona
TREATMENT OF HEPATITIS C IN THE LIVER TRANSPLANT SETTING Dra. Zoe Mariño Liver Unit. Hospital Clinic Barcelona Hepatitis C after LT Survival (%) HCV negative HCV positive Time from LT (years) HCV treatment
More informationICVH 2016 Oral Presentation: 28
Ledipasvir/Sofosbuvir Is Safe and Effective for the Treatment of Patients with Genotype 1 Chronic HCV Infection in Both HCV Mono- and HIV/HCV Coinfected Patients A Luetkemeyer 1, C Cooper 2, P Kwo 3, K
More informationPivotal New England Journal of Medicine papers 2014 Phase 3 Trial data
4 th HCV Therapy Advances Meeting Paris, December 12-13, 14 Pivotal New England Journal of Medicine papers 14 Phase 3 Trial data Stefan Zeuzem, MD University of Frankfurt Germany Disclosures Consultancies:
More informationPhase 3. Treatment Experienced. Ledipasvir-Sofosbuvir +/- Ribavirin in HCV Genotype 1 ION-2. Afdhal N, et al. N Engl J Med. 2014;370:
Phase 3 Treatment Experienced Ledipasvir-Sofosbuvir +/- Ribavirin in HCV Genotype 1 ION-2 Afdhal N, et al. N Engl J Med. 2014;370:1483-93. Ledipasvir-Sofosbuvir +/- Ribavirin in Treatment-Experienced HCV
More informationNovel Combination Therapies for the Treatment of Patients with Genotype 1 Hepatitis C Public Meeting
Novel Combination Therapies for the Treatment of Patients with Genotype 1 Hepatitis C Public Meeting December 18, 2014 1 CTAF Overview Core program of the Institute for Clinical and Economic Review (ICER),
More informationTreatment of Hepatitis C Recurrence after Liver Transplantation. Maria Carlota Londoño Liver Unit Hospital Clínic Barcelona
Treatment of Hepatitis C Recurrence after Liver Transplantation Maria Carlota Londoño Liver Unit Hospital Clínic Barcelona Agenda 1. Introduction 2. Treatment options for hepatitis C recurrence after transplantation
More informationEASL 2013 Interferon Free, All Oral Regimens for Hepatitis C. Maria Buti Hospital Universitario Valle Hebron Barcelona Spain
EASL 2013 Interferon Free, All Oral Regimens for Hepatitis C Maria Buti Hospital Universitario Valle Hebron Barcelona Spain The first Results with Oral therapy: a Protease Inhibitor and NS5A inhibitor
More informationTransformation of Chronic Hepatitis C Treatment
Transformation of Chronic Hepatitis C Treatment UVHS, Adana, 22 May 2015 Christoph Sarrazin Goethe-University Hospital Frankfurt am Main Germany Epidemiology of HCV Infection Global Global HCV Prevalence
More informationLearning Objective. After completing this educational activity, participants should be able to:
Learning Objective After completing this educational activity, participants should be able to: Use patient characteristics and preferences to select HCV treatment strategies that maximize the potential
More informationCurrent Treatment Options for HCV Patients. Michael Manns Dept. of Gastroenterology, Hepatology and Endocrinology Hannover Germany
Current Treatment Options for HCV Patients Michael Manns Dept. of Gastroenterology, Hepatology and Endocrinology Hannover Germany 7th International Congress of Internal Medicine of Central Greece, Larissa,
More informationAntiviral treatment in HCV cirrhotic patients on waiting list
Antiviral treatment in HCV cirrhotic patients on waiting list Krzysztof Tomasiewicz Department of Hepatology and Infectious Diseases Medical University of Lublin, Poland Disclosures Consultancy/Advisory
More informationHepatitis C Treatment 2014
Hepatitis C Treatment 214 Brendan M. McGuire, MD UAB Liver Center Outline Epidemiology/National History Terminology for Treatment Treatment Considerations Current Treatment Options Genotype 1 (GT 1) Genotype
More informationTreating HCV Prior to Liver Transplantation. What Are the Treatment Options? Xavier Forns Liver Unit Hospital Clinic, CIBEREHD, IDIBAPS Barcelona
Treating HCV Prior to Liver Transplantation What Are the Treatment Options? Xavier Forns Liver Unit Hospital Clinic, CIBEREHD, IDIBAPS Barcelona Disclosures Unrestricted Grant Support: Janssen and Abbvie
More informationA treatment revolution: current management for chronic HCV
A treatment revolution: current management for chronic HCV Ray Chung, M.D. Director of Hepatology and Liver Center Kevin and Polly Maroni Research Scholar Massachusetts General Hospital Disclosures Research
More informationFeeling right at home
Feeling right at home Getting to Cure From Cure to Eradication Jordan J. Feld MD MPH Toronto Centre for Liver Disease Sandra Rotman Centre for Global Health University of Toronto SVR Dramatic Improvements
More informationNeed to Assess HCV Resistance to DAAs: Is it Useful and When?
Need to Assess HCV Resistance to DAAs: Is it Useful and When? Stéphane Chevaliez French National Reference Center for Viral Hepatitis B, C and delta Department of Virology & INSERM U955 Henri Mondor Hospital
More informationSupplementary Material*
Supplementary Material* Najafzadeh M, Andersson K, Shrank WH, Krumme AA, Matlin OS, Brennan T, et al. Cost- Effectiveness of Novel Regimens for the Treatment of Hepatitis C Virus. Ann Intern Med. doi:10.7326/m14-1152
More informationDirect-acting Antiviral (DAA) Regimens in Late-stage Development: Which Patients Should Wait? Fred Poordad, MD
Direct-acting Antiviral (DAA) Regimens in Late-stage Development: Which Patients Should Wait? Fred Poordad, MD The HCV Lifecycle: Multiple Targets Polymerase Inhibitors Protease Inhibitors NS5A Inhibitors
More informationHEPATITIS C. Mitchell L. Shiffman, MD, FACG Director. Liver Institute of Virginia. Richmond and Newport News, VA
NEW TREATMENTS FOR HEPATITIS C Mitchell L. Shiffman, MD, FACG Director Liver Institute of Virginia Bon Secours Health System Richmond and Newport News, VA Liver Institute of Virginia Education, Research
More informationHIV and Hepatitis C Have we finally slayed the beast?
HIV and Hepatitis C Have we finally slayed the beast? Mark W. Sonderup Division of Hepatology Department of Medicine University of Cape Town & Groote Schuur Hospital Accelerated Fibrosis in HIV-HCV co-infected
More informationClinical Studies and Recent Real-World Data with Sofosbuvir/Ledipasvir
Clinical Studies and Recent Real-World Data with Sofosbuvir/Ledipasvir Kalliopi Zachou Assistant Professor of Medicine University of Thessaly Disclosures Speaker s bureau and advisory: Gilead Bristol History
More informationEliminating Hepatitis C from New Zealand
Eliminating Hepatitis C from New Zealand Catherine Stedman Associate Professor of Medicine, University of Otago, Christchurch Gastroenterology Department, Christchurch Hospital Disclosures I have the following
More informationHepatitis C Emerging Treatment Paradigms
Hepatitis C Emerging Treatment Paradigms David R Nelson MD Assistant Vice President for Research Professor of Medicine Director, Clinical and Translational Science Institute University of Florida Gainesville,
More informationIndividual Optmizaton of therapy. Graham R Foster Professor of Hepatology QMUL
Individual Optmizaton of therapy Graham R Foster Professor of Hepatology QMUL Conflicts of Interest Speaker and consultancy fees received from AbbVie, BI, BMS, Gilead, Janssen, Roche, Merck, Novarts, Springbank,
More informationAntiviral treatment in Unique Populations
Antiviral treatment in Unique Populations Atif Zaman, MD MPH Oregon Health & Science University Professor of Medicine Division of Gastroenterology and Hepatology Unique HCV Populations HIV/HCV co-infected
More informationClinical Сase A previously relapse to PEG IFN + RBV in HCV G3a patient. Konstantin Zhdanov
Clinical Сase A previously relapse to PEG IFN + RBV in HCV G3a patient Konstantin Zhdanov Genotype 3 in Europe Canada Norway Germany Sweden Czech Republic Poland Approximately 1/3 of HCV-infected patients
More informationNew developments in HCV research and their implications for front-line practice
New developments in HCV research and their implications for front-line practice Dr. Curtis Cooper Associate Professor, University of Ottawa Director, Ottawa Hospital Viral Hepatitis Program June 17, 2013
More informationManagement of HIV/HCV Coinfection. Kristen M. Marks, MD Assistant Professor Weill Cornell Medical College New York, NY
Management of HIV/HCV Coinfection Kristen M. Marks, MD Assistant Professor Weill Cornell Medical College New York, NY Disclosure Dr. Marks has received grants and research support from Gilead Sciences
More informationTREATMENT OF GENOTYPE 2
Treatment of Genotype 2, 3,and 4 David E. Bernstein, MD, FACG Advisory Committee/Board Member: AbbVie Pharmaceuticals, Gilead, Merck, Janssen Consultant: AbbVie Pharmaceuticals, Bristol-Myers Squibb, Gilead,
More informationWhat Should We Do With Difficult to Treat HCV Populations?
What Should We Do With Difficult to Treat HCV Populations? Norah Terrault, MD Professor of Medicine and Surgery Director, Viral Hepatitis Center University of California San Francisco Disclosures Norah
More informationSaeed Hamid, MD Alex Thompson, MD, PhD
Saeed Hamid, MD Alex Thompson, MD, PhD 1 We will review some top line data from EASL Majority of the time discussing how the data affects daily practice 2 Grazoprevir (GZR; MK-5172) + Elbasvir (EBR; MK-
More informationHepatitis C: Difficult-to-treat Patients 11th Paris Hepatology Conference 16th January 2018 Stefan Zeuzem, MD University Hospital, Frankfurt, Germany
Hepatitis C: Difficult-to-treat Patients 11th Paris Hepatology Conference 16th January 2018 Stefan Zeuzem, MD University Hospital, Frankfurt, Germany PHC 2018 - www.aphc.info Disclosures Advisory boards:
More informationViva La Revolución: Options to Combat Hepatitis C
Viva La Revolución: Options to Combat Hepatitis C David L. Wyles, MD Professor of Medicine University of Colorado Chief, Division of Infectious Disease Denver Health Learning Objectives After attending
More informationHCV Infection: EASL Clinical Practice Guidelines Francesco Negro University Hospital Geneva Switzerland
HCV Infection: EASL Clinical Practice Guidelines 2016 Francesco Negro University Hospital Geneva Switzerland Panel Codinat: Jean-Michel Pawlotsky Panel: Alessio Aghemo David Back Geoffrey Dusheiko Xavier
More informationHepatitis C: New Antivirals in the Liver Transplant Setting. Maria Carlota Londoño Liver Unit Hospital Clínic Barcelona
Hepatitis C: New Antivirals in the Liver Transplant Setting Maria Carlota Londoño Liver Unit Hospital Clínic Barcelona Patient survival Hepatitis C and Liver Transplantation Years after transplantation
More informationEvolution of Therapy in HCV
Hepatitis C: Update on New Therapies and AASLD 13 David Bernstein, MD, FACP, AGAF, FACP Professor of Medicine Hofstra North Shore-LIJ School of Medicine Evolution of Therapy in HCV 199 1999 1 13 (%) SVR
More informationHepatitis C Treatment in Oregon
The Hepatitis C Advisory Group, 12/21/2014 Hepatitis C Treatment in Oregon Introduction The rising health care burden of HCV infection in Oregon is occurring at this time of growing interest in containing
More informationClinical Management: Treatment of HCV Mono-infection
Clinical Management: Treatment of HCV Mono-infection Curtis Cooper, MD, FRCPC Associate Professor-University of Ottawa The Ottawa Hospital- Infections Diseases Viral Hepatitis Program- Director Industry
More informationCase 2: A 71-year-old man with cirrhosis
Case 2: A 71-year-old man with cirrhosis 1 JM, 71 year old African American male with known cirrhosis Asymptomatic apart from fatigue No prior history of decompensation Past history: Diabetes for 11 years
More informationDisclosures. Advanced HCV management. Overview. Renal failure 1/10/2018. Research Grant support to UCSF from AbbVie Gilead Merck Proteus NIH
Disclosures Advanced HCV management Annie Luetkemeyer, MD Division of HIV, ID and Global Medicine ZSFG, UCSF Research Grant support to UCSF from AbbVie Gilead Merck Proteus NIH Overview Renal failure Acute
More informationExperience with pre-transplant antiviral treatment: PEG/RBV and DAA. Xavier Forns, MD Liver Unit Hospital Clínic IDIBAPS and CIBREHD Barcelona
Experience with pre-transplant antiviral treatment: PEG/RBV and DAA Xavier Forns, MD Liver Unit Hospital Clínic IDIBAPS and CIBREHD Barcelona Interferon-free regimens G1b nulls Asunaprevir (PI) + Daclatasvir
More informationHepatitis C Prior Authorization Policy
Hepatitis C Prior Authorization Policy Line of Business: Medi-Cal P&T Approval Date: November 15, 2017 Effective Date: January 1, 2018 This policy has been developed through review of medical literature,
More informationExpert Perspectives: Best of HCV from EASL 2015
Best of HCV from EASL 2015 Expert Perspectives: Best of HCV from EASL 2015 Saeed Hamid, MD Alex Thompson, MD, PhD This activity is supported by educational grants from AbbVie, Bristol-Myers Squibb, and
More informationMy HCV patient is co-infected with HIV: how to manage?
EASL «White Nights of Hepatology 2016» My HCV patient is co-infected with HIV: how to manage? A.V. Кravchenko MD, Professor Russia AIDS Federal Center Central Research Institute of Epidemiology St.-Petersburg,
More informationTerapie attuali. Eradicazione di HCV e nuove prospettive:
Eradicazione di HCV e nuove prospettive: Terapie attuali Luisa Pasulo U.S.C. Gastroenterologia Epatologia e Trapiantologia Ospedale Papa Giovanni XXIII - Bergamo From Infection to liver disease Infezione
More information47 th Annual Meeting AISF
47 th Annual Meeting AISF Rome, 21 February 2014 Present and future treatment strategies for patients with HCV infection: chronic hepatitis and special populations (HCV/HIV coinfection, advanced cirrhosis,
More informationSummary from AASLD 2014 for Hepatitis C Boston 7-11 November 2014
Summary from AASLD 2014 for Hepatitis C Boston 7-11 November 2014 Feedback from the real-world: do HCV cure rates in real-life patient cohorts hold what clinical trials promised? Summary from AASLD 2014
More informationHepatitis C in Special Populations
Hepatitis C in Special Populations David E. Bernstein, MD, FACG Vice Chairman of Medicine for Clinical Trials Chief, Division of Hepatology and Sandra Atlas Bass Center for Liver Diseases Northwell Health
More informationHIV/Hepatitis C in France: data from real life cohorts LIONEL PIROTH CHU DIJON UNIVERSITY OF BURGUNDY DECEMBER LONDON
HIV/Hepatitis C in France: data from real life cohorts LIONEL PIROTH CHU DIJON UNIVERSITY OF BURGUNDY DECEMBER 2015 - LONDON The need Decreasing prevalence of chronic hepatitis C in French people living
More informationSVR Updates from the 2013 EASL
Updates from the 2013 EASL By Tracy Swan, Treatment Action Group Streamlining HCV Treatment Treatment for hepatitis C virus (HCV) is becoming simpler, shorter, and more effective. All-oral combinations
More information8/5/2014. A new era of HCV clinical management. Direct-Acting Antivirals for Hepatitis C. Goal of HCV treatment is viral cure HIV HBV HCV
NS5B NS5B 8/5/214 A new era of HCV clinical management Mark Sulkowski, MD Professor of Medicine Medical Director, Viral Hepatitis Center Divisions of Infectious Disease and Gastroenterology/Hepatology
More informationDebate: Do We Need More HCV Drugs Con Standpoint
Debate: Do We Need More HCV Drugs Con Standpoint 18 th Antivirals PK Workshop, Friday 16 th June 2017, Chicago Jürgen Rockstroh Department of Medicine I University Hospital Bonn, Bonn, Germany Conflict
More information2017 Bruce Lucas Hepatology and Liver Transplant Symposium October 13th 2017 Management of Hepatitis C in Pre- and Post-Transplant Patients
2017 Bruce Lucas Hepatology and Liver Transplant Symposium October 13th 2017 Management of Hepatitis C in Pre- and Post-Transplant Patients Jens Rosenau, MD Associate Professor of Medicine Acting Director
More informationHIV/HCV Co-Infection
HIV/HCV Co-Infection 2015 Kentucky Conference on Viral Hepatitis Matt Cave, M.D. Associate Professor Department of Medicine Division of Gastroenterology, Hepatology, & Nutrition Department of Pharmacology
More informationUpdate on Real-World Experience With HARVONI
Update on Real-World Experience With A RESOURCE FOR PAYERS This information is intended for payers only. The HCV-TARGET and TRIO studies were supported by Gilead Sciences, Inc. Real-world experience data
More informationDr. Siddharth Srivastava
Dr. Siddharth Srivastava MD, DM (Gastroenterology) Associate Professor GIPMER, New Delhi Rashtriya Gaurav Award 2013 for work on hepatitis B and C Set up Liver clinic at GIPMER and in charge EUS laboratory.
More information10/4/2016. Management of Hepatitis C Virus Genotype 2 or 3 Infection
Management of Hepatitis C Virus Genotype 2 or 3 Infection Kenneth E. Sherman, MD, PHD Gould Professor of Medicine Director, Division of Digestive Diseases University of Cincinnati Cincinnati, Ohio FORMATTED:
More informationHepatitis C 17 months experience with Sofosbuvir/Ledipasvir (Harvoni)
Hepatitis C 17 months experience with Sofosbuvir/Ledipasvir (Harvoni) Prof. Dr. Markus Cornberg Klinik für Gastroenterologie, Hepatologie und Endokrinologie Antalya, 13.05.2016 Markus Cornberg, Hannover
More information