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Strategic Treatment Optimizationon for HCV (STOPHCV-1): an open-label
factorial randomised controlled trial of short duration therapy for
chronic hepatitis C
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AASLD 2019 Nov 8-11 Boston
Reported by Jules Levin
Graham S. Cooke1,2, Sarah Pe>3,4,5, Leanne McCabe3, Chris Jones1,2, Richard Gilson4,5, Sumita Verma6, Stephen D Ryder7, Jane D Collier8,
Stephen T. Barclay9, A]ab Ala10, Sanjay Bhagani11, Mark Nelson12, Chinlye Ch'Ng13, Ben Stone14, Mar,n Wiselka15, Daniel Forton16, Stuart
McPherson17, Rachel Halford18, Emily Dennis3, Fleur Hudson3, Eleanor J Barnes19, Ann Sarah Walker3, on behalf of the STOP-HCV trial team
1 Department of Infectious Disease, Imperial College London; 2 Imperial College NHS Trust, London; 3 MRC Clinical Trials Unit, UCL; 4 Mortimer Market Clinic, Central and North West London NHS Foundation Trust ; 5 Institute of Globasl Health, UCL 6 Hepatology, Brighton and Sussex Medical School; 7 Nottingham University Hospitals; 8 John Radcliffe Hospital, Headley Way, Headington, Oxford; 9 Gastroenterology, Glasgow Royal Infirmary; 10 Department of Clinical and Experimental Medicine, University of Surrey; 11 Infectious Diseases, Royal Free NHS Foundation Trust; 12 Chelsea and Westminster Hospital; 13 Swansea Bay University Health Board; 14 Infectious Diseases, Sheffield Teaching Hospitals NHS Trust; 15 Leicester University Hospitals NHS Trust; 16 Hepatology, St George's NHS Foundation Trust; 17 Hepatology, Newcastle upon Tyne Hospitals NHS Foundation Trust; 18 Hepatitis C Trust 19 Translational Gastroenterology Unit, University of Oxford.
in the UK and many other places G/P is not widely available and, more, importantly, patients engaged with care are almost all cured. So they are largely now trying to treat more marginalized populations (e.g. severe dependency issues, street homeless). The common clinical question is whether to start treatment at all in patients who might not finish and what are the risk/benefits of doing so. Part of the answer needs a better understanding the likelihood of cure with shortened courses which the VUS1/2 data in this study helps with that. Also of immediate relevance they also saw in this study (a) 100% SVR12 with harvoni/rbv when used as retreatment (a far more accessible option than SOF/VEL/VOX or SOF/G/P.) which suggests the risks to failure here are minimal and (b) the first evidence that early treatment responses predict cure with short treatments (all patients who were undetectable at Day 3 went on to cure regardless of how much treatment they were given).
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