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velpatasvir or daclatasvir (pangenotypic) 6 years 9 months ago #5802

  • emilio
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Hi Everyone

Just wonder what others think. Daclatasvir is no doubt the best pangenotypic NS5A DAA on the market to date, I guess that's my own opinion based on my own investigation.

My concern is that soon Gilead will be flogging velpatasvir as a competing NS5A pangenotypic to daclatasvir. Now given that Gilead own sofosbuvir it would stand to reason to suspect that most people on the planet will be offered sofosbuvir and velpatasvir. More so if indeed velpatasvir is a cheaper option to ledipasvir. My issue is that velpatasvir data doesn't look as good as daclatasvir or ledipasvir regardless of pangenotypic status.

Okay maybe I'm looking too close at this issue but I'm not convinced velpatasvir is an improvement to HCV treatment options. Em

PS I understand there is an NZ trial about to commence in Jan using sof/vel for 8 and 12 weeks and is offering this to F4s, crazy.
Geno 1b F2/3 snce early 80s. Treated in 2008_9 for 63 weeks on INF/Riba. Commence Sof/Dac on 6 October 2015 and completed 18 weeks of tx. UND at 4-6 weeks, UND at EOT, SVR 2, SVR 6 and SVR 12 on 6 May 2016.
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velpatasvir or daclatasvir (pangenotypic) 6 years 9 months ago #5804

Yes the sof/dac looks pretty good by the numbers, sadly compassion and science take a back seat to profit and politics.
Jim
3 years cured, Sof/Dac, thanks Doc Freeman, hepc only a distant memory, go for it ppl

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velpatasvir or daclatasvir (pangenotypic) 6 years 9 months ago #5811

www.gilead.com/news/press-releases/2015/...epatitis-c-genotypes

Treatment emergent serious adverse events occurred in 18 percent of patients and nine patients died.

If you remove the placebo patients the n was 1593 so the death rate was 1 in 177.
YMMV
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velpatasvir or daclatasvir (pangenotypic) 6 years 9 months ago #5866

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The overall cure rate in ASTRAL-1 of 99% looks good but I'd imagine comparable tests of sof/dac and sof/led would be in the same ballpark.

The majority of serious adverse events and deaths were associated with advanced liver disease.

Surely some patients with advanced liver disease would die in 12/24 weeks whether treated or not.
M 61yo HCV+ ~ 30 yrs Gt1a F2 VL 223,000 ALT 54 AST 42 Tx start Sof/Dac 17Dec15.
SVR4 at 7Apr16 ALT 22 AST 22
SVR12 at 9Jun16 ALT 23 AST 25
Melbourne, Australia

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