Comparative Effectiveness of Ledipasvir/Sofosbuvir ± Ribavirinvs. Ombitasvir/Paritaprevir/Ritonavir + Dasabuvir ± Ribavirin in 6961 Genotype 1 Patients Treated in Routine Medical Practice

L. I. Backus; P. S. Belperio; ; T. A. Shahoumian; T. P. Loomis; L. A. Mole


Aliment Pharmacol Ther. 2016;44(4):400-410. 

In This Article


In this large real-world cohort of genotype 1 HCV-infected veterans treated with LDV/SOF-based or OPrD-based therapy, high SVR rates comparable to clinical trials were observed and were consistently high across all subgroups evaluated. Odds of SVR were reduced in African Americans compared to Caucasians, those receiving OPrD + RBV compared to LDV/SOF, those with advanced liver disease and those with BMI ≥30 kg/m2 compared to those with lower BMI. Reduced odds of SVR for African Americans and those receiving OPrD + RBV arose in large part from early discontinuation as these predictors no longer had a significant impact on odds of SVR in those who completed a 12-week course. Advanced liver disease and higher BMI, however, persisted as significant negative predictors of SVR even when considering only those patients who completed a 12-week course. For patients with advanced liver disease and high BMI longer durations of therapy or additional treatment options may still be needed to increase SVR rates. Real-world experience from large diverse cohorts such as this is necessary to better inform and refine HCV management strategies.