Treatment Outcomes of Sofosbuvir/Velpatasvir/Voxilaprevir in Direct-Acting Antiviral-Experienced Hepatitis C Virus Patients: A Systematic Review and Meta-Analysis
About 5% of chronic hepatitis C (CHC) patients experienced treatment failure with direct-acting antiviral (DAA) treatment. The global data on the practice and treatment outcomes of Sofosbuvir/Velpatasvir/Voxilaprevir (SOF/VEL/VOX) in DAA-experienced CHC patients remains sparse. We performed a system...
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MDPI AG
2023-06-01
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| Series: | Viruses |
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| Online Access: | https://www.mdpi.com/1999-4915/15/7/1489 |
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| author | Pooja Devan Kai Le Ashley Tiong Jean Ee Neo Babu P. Mohan Karn Wijarnpreecha Yew Chong Steve Tam Nicola Coppola Carmen Monica Preda Yu Jun Wong |
| author_facet | Pooja Devan Kai Le Ashley Tiong Jean Ee Neo Babu P. Mohan Karn Wijarnpreecha Yew Chong Steve Tam Nicola Coppola Carmen Monica Preda Yu Jun Wong |
| author_sort | Pooja Devan |
| collection | DOAJ |
| description | About 5% of chronic hepatitis C (CHC) patients experienced treatment failure with direct-acting antiviral (DAA) treatment. The global data on the practice and treatment outcomes of Sofosbuvir/Velpatasvir/Voxilaprevir (SOF/VEL/VOX) in DAA-experienced CHC patients remains sparse. We performed a systematic review and meta-analysis to evaluate the efficacy and safety of SOF/VEL/VOX as a salvage treatment in DAA-experienced CHC patients. We searched five electronic databases from inception to 31 January 2023. The study outcomes were SVR12 and treatment-related adverse effects, with subgroup analysis performed based on genotype, cirrhosis, HCC, prior SOF/VEL exposure, and region. We identified and analyzed data from 24 studies (2877 DAA-experienced CHC patients); 17.2% had prior SOF/VEL exposure, 25% received ribavirin with SOF/VEL/VOX, and 42% had pre-treatment resistance-associated substitution (RAS) testing performed. Eastern Mediterranean had a higher pooled SVR12 than the America and Europe regions (<i>p</i> < 0.05). Predictors of SOF/VEL/VOX failure were genotype 3, active HCC, baseline cirrhosis, and prior SOF/VEL. Baseline RAS mutation and ribavirin supplementation were not associated with higher SVR12. Treatment discontinuation because of drug-related adverse events was uncommon (10 studies, 0.2%). In summary, SOF/VEL/VOX is efficacious and safe for retreatment in DAA-experienced CHC patients, even with RAS mutation. Our findings support SOF/VEL/VOX as a first-line rescue treatment for DAA-experienced CHC patients. |
| first_indexed | 2024-03-11T00:34:23Z |
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| id | doaj.art-9861a3c10d5e48a4819e41f53385edac |
| institution | Directory Open Access Journal |
| issn | 1999-4915 |
| language | English |
| last_indexed | 2024-03-11T00:34:23Z |
| publishDate | 2023-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Viruses |
| spelling | doaj.art-9861a3c10d5e48a4819e41f53385edac2023-11-18T21:44:25ZengMDPI AGViruses1999-49152023-06-01157148910.3390/v15071489Treatment Outcomes of Sofosbuvir/Velpatasvir/Voxilaprevir in Direct-Acting Antiviral-Experienced Hepatitis C Virus Patients: A Systematic Review and Meta-AnalysisPooja Devan0Kai Le Ashley Tiong1Jean Ee Neo2Babu P. Mohan3Karn Wijarnpreecha4Yew Chong Steve Tam5Nicola Coppola6Carmen Monica Preda7Yu Jun Wong8Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, SingaporeYong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, SingaporeYong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, SingaporeDivision of Gastroenterology & Hepatology, University of Utah Health, Salt Lake City, UT 84112, USADivision of Gastroenterology and Hepatology, Department of Medicine, University of Arizona College of Medicine, Phoenix, AZ 85004, USAEducation Resource Centre, Medical Board, Singapore General Hospital, Singapore 169608, SingaporeDepartment of Mental Health and Preventive Medicine, University of Campania “L. Vanvitelli”, 81100 Napoli, ItalyClinical Institute of Fundeni, Gastroenterology and Hepatology, 022328 Bucharest, RomaniaYong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, SingaporeAbout 5% of chronic hepatitis C (CHC) patients experienced treatment failure with direct-acting antiviral (DAA) treatment. The global data on the practice and treatment outcomes of Sofosbuvir/Velpatasvir/Voxilaprevir (SOF/VEL/VOX) in DAA-experienced CHC patients remains sparse. We performed a systematic review and meta-analysis to evaluate the efficacy and safety of SOF/VEL/VOX as a salvage treatment in DAA-experienced CHC patients. We searched five electronic databases from inception to 31 January 2023. The study outcomes were SVR12 and treatment-related adverse effects, with subgroup analysis performed based on genotype, cirrhosis, HCC, prior SOF/VEL exposure, and region. We identified and analyzed data from 24 studies (2877 DAA-experienced CHC patients); 17.2% had prior SOF/VEL exposure, 25% received ribavirin with SOF/VEL/VOX, and 42% had pre-treatment resistance-associated substitution (RAS) testing performed. Eastern Mediterranean had a higher pooled SVR12 than the America and Europe regions (<i>p</i> < 0.05). Predictors of SOF/VEL/VOX failure were genotype 3, active HCC, baseline cirrhosis, and prior SOF/VEL. Baseline RAS mutation and ribavirin supplementation were not associated with higher SVR12. Treatment discontinuation because of drug-related adverse events was uncommon (10 studies, 0.2%). In summary, SOF/VEL/VOX is efficacious and safe for retreatment in DAA-experienced CHC patients, even with RAS mutation. Our findings support SOF/VEL/VOX as a first-line rescue treatment for DAA-experienced CHC patients.https://www.mdpi.com/1999-4915/15/7/1489direct-acting antiviraltreatmentribavirinsustained virological responseadverse effectsHCV genotype |
| spellingShingle | Pooja Devan Kai Le Ashley Tiong Jean Ee Neo Babu P. Mohan Karn Wijarnpreecha Yew Chong Steve Tam Nicola Coppola Carmen Monica Preda Yu Jun Wong Treatment Outcomes of Sofosbuvir/Velpatasvir/Voxilaprevir in Direct-Acting Antiviral-Experienced Hepatitis C Virus Patients: A Systematic Review and Meta-Analysis Viruses direct-acting antiviral treatment ribavirin sustained virological response adverse effects HCV genotype |
| title | Treatment Outcomes of Sofosbuvir/Velpatasvir/Voxilaprevir in Direct-Acting Antiviral-Experienced Hepatitis C Virus Patients: A Systematic Review and Meta-Analysis |
| title_full | Treatment Outcomes of Sofosbuvir/Velpatasvir/Voxilaprevir in Direct-Acting Antiviral-Experienced Hepatitis C Virus Patients: A Systematic Review and Meta-Analysis |
| title_fullStr | Treatment Outcomes of Sofosbuvir/Velpatasvir/Voxilaprevir in Direct-Acting Antiviral-Experienced Hepatitis C Virus Patients: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Treatment Outcomes of Sofosbuvir/Velpatasvir/Voxilaprevir in Direct-Acting Antiviral-Experienced Hepatitis C Virus Patients: A Systematic Review and Meta-Analysis |
| title_short | Treatment Outcomes of Sofosbuvir/Velpatasvir/Voxilaprevir in Direct-Acting Antiviral-Experienced Hepatitis C Virus Patients: A Systematic Review and Meta-Analysis |
| title_sort | treatment outcomes of sofosbuvir velpatasvir voxilaprevir in direct acting antiviral experienced hepatitis c virus patients a systematic review and meta analysis |
| topic | direct-acting antiviral treatment ribavirin sustained virological response adverse effects HCV genotype |
| url | https://www.mdpi.com/1999-4915/15/7/1489 |
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