Is This a New Tx?

[Lukey]

It was sent to me today. After I relapsed on 8 wks of Harvoni last Winter, this has me wondering if this might be my next step : 

http://www.sciencedaily.com/releases/2015/11/151116181750.htm

[Lynn K]

Hi Lukey

Here is some more info for you. I don't think they tested it as of yet anyway with Harvoni relapse patients

http://www.gilead.com/news/press-releases/2015/9/gilead-announces-svr12-rates-from-four-phase-3-studies-evaluating-a-oncedaily-fixeddose-combination-of-sofosbuvir-sof-and-velpatasvir-vel-gs5816-for-the-treatment-of-all-six-hepatitis-c-genotypes

http://www.nejm.org/doi/full/10.1056/NEJMoa1512614?af=R&rss=currentIssue&

have you done any resistance testing?

http://www.hcvguidelines.org/full-report/retreatment-persons-whom-prior-therapy-has-failed



Recommended regimen for patients in whom previous treatment with any HCV nonstructural protein 5A (NS5A) inhibitors has failed (including daclatasvir plus sofosbuvir, ledipasvir/sofosbuvir, or paritaprevir/ritonavir/ombitasvir plus dasabuvir).

For patients with minimal liver disease, deferral of treatment is recommended, pending availability of data.

Rating: Class IIb, Level C

 

For patients with cirrhosis or other patients who require retreatment urgently, testing for resistance-associated variants that confer decreased susceptibility to NS3 protease inhibitors and to NS5A inhibitors is recommended. The specific drugs used in the retreatment regimen should be tailored to the results of this testing as described below. Treatment duration of 24 weeks is recommended and, unless contraindicated, weight-based RBV should be added.

For patients with cirrhosis or other patients who require retreatment urgently, testing for RAVs that confer decreased susceptibility to NS3 protease inhibitors (eg, Q80K) and to NS5A inhibitors should be performed using commercially available assays prior to selecting the next HCV treatment regimen. For patients with no NS5A inhibitor RAVs detected, retreatment with ledipasvir/sofosbuvir and RBV for 24 weeks is recommended. For patients who have NS5A inhibitor RAVs detected and who do not have NS3 inhibitor RAVs detected, treatment with simeprevir, sofosbuvir, and RBV for 24 weeks is recommended. For patients who have both NS3 and NS5A inhibitor RAVs detected, retreatment should be conducted in a clinical trial setting, as an appropriate treatment regimen cannot be recommended at this time.


good luck to you