TOPIC: Sof/Dac 2018 guidelines for treatment of G3

Hello All,

I have just read through the new EASL guidelines and found that the Sof/Dac combo is no longer being recommended for G3. In his blog Greg Jeffrys claims that the real world results for this treatment were not as good as the trial results with SVR obtained in 80% of cases after 12 weeks and 90% after 24 weeks.

Well it worked for me so I'm not complaining but would anyone like to comment?

RSF

Hello RSF,

You can read the full version of the guidelines here: www.journal-of-hepatology.eu/article/S0168-8278(18)31968-8/pdf which still contain mention of Daclatasvir.

The practical reality is that with branded Daklinza having a $50,000 list and branded Sovaldi having a $84,000 list that branded Epclusa with a list of $75,000 makes more sense.

In the world of generics it's a different story. Still, it's sad to see the change.

Perhaps a little bit off-topic, but I think it is the first time when we may see a clear message in the Easl journal that generics provide similar results as original compounds:


Licensed generic drugs and drugs agreed with the Medicines Patent Pool have been shown to generate similar results to the original compounds. The presence of the drug at the appropriate dosage must be verified by the provider and guaranteed
to the prescriber and patient. Indeed, effective and safe generics are a crucial resource in resource-limited countries.


Cheers
RHF

Hi RSF,

Sof Dac did not get me over the line first time around though it made me feel better while taking it.

Adding the dreaded Ribavirin second time round made the difference - I hope still SVR as the next blood test is in June. Have to add my liver had seen better days as well.

Jeff

Hi RSF,

I had 12 wks of Sof/Doc for GT3, and it seemed to work: SVR at 16 wks. But about 18 months later I found that I had relapsed, so I was probably in the wrong end of the 90% at 24 wks category. Because I felt absolutely fine after 1 year, I did not bother getting a final VL test. With hindsight, this was a mistake.

With all the success stories here, it now seems like overkill to do a lot of testing while on treatment, but doing 12, 24 and 48 week post-tx tests would still be wise...

Oor Wullie