Safety and efficacy of sofosbuvir plus velpatasvir with or without ribavirin for chronic hepatitis C virus infection: A systematic review and meta-analysis
2017
Abstract
Velpatasviris a newly FDA-approved inhibitor of hepatitis C virus (HCV)
NS5Aprotein. We performed this systematic review and meta-analysis to investigate the safety and efficacy of
velpatasvirplus
sofosbuvirin the treatment of chronic HCV infection. A computerized literature search of PubMed, SCOPUS, EMBASE, EBSCO, Web of science, and Cochrane CENTRAL was conducted using relevant keywords. Data from eligible studies were pooled in a fixed effect meta-analysis model, using OpenMeta[Analyst] software. Pooled data from six randomized trials (n = 1427 patients) showed that
velpatasvirplus
sofosbuvirachieved sustained virological response (SVR12) rates of 98.2% in
genotype-1, 99.4% in
genotype-2, 94.7% in
genotype-3, 99.6% in
genotype-4, 97.1% in
genotype-5, and 98.8% in
genotype-6 patients. The addition of
ribavirindid not significantly increase the SVR12 (RR = 0.95, 95%CI [0.88, 1.02]) or decrease relapse rates (RR = 2.52, 95% CI [0.49, 12.87]) in
HCV genotype-1 patients. However, adding
ribavirinsignificantly increased SVR12 (RR = 89.5, 95% CI [80.4, 99.5]) in
genotype-3 patients. In conclusion, the 12-week regimen of
sofosbuvirplus
velpatasvirwas highly effective in HCV patients, including those with cirrhosis and former treatment experience. Except for
genotype-3, adding
ribavirinwas not associated with significant improvements in SVR12 rates. Further studies should investigate the effect of adding
ribavirinto this regimen, especially in
HCV genotype-3 patients.
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