Daily Highlights from EASL 2017 - 
Sunday, April 23, 2017
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  "Reporting on EASL 2017 - Advances in Chronic Hepatitis C Management and Treatment: Comprehensive Expert Review and Discussion of Key Presentations"

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Sunday, April 23, 2017
MAGELLAN-1, Part 2: Glecaprevir and pibrentasvir for 12 or 16 weeks in patients with chronic hepatitis C virus genotype 1 or 4 and prior direct-acting antiviral treatment failure (PS-156):

Glecaprevir and pibrentasvir are second generation NS3 and NS5a inhibitors and have been shown to lead to high SVR rates when given for 8 -12 weeks in na├»ve and interferon non-responders. Magellan-1 examined this combination in DAA failures for 12 and 16 week durations.  The overall SVR rate for the 12 week arm was 100% in PI failures and 88% and 79% respectively in NS5a and NS3/NS5a RAS patients respectively. 16 week duration SVRs were higher in NS5a and NS3/NS5a RAS patients with SVR rates of 94% and 81% respectively.  In patients with key substitutions in  NS3 positions: (155, 156, 168)  a nd key NS5A positions: 24, 28, 30, 31, 58, 92, 93, only 5/9 achieved SVR.  I n DAA failures, resistance testing is essential. Those with RASs at key positions in NS3 and NS5 will need alternative therapies to glecaprevir/pibrentasvir regardless of duration. The presence of NS3 RASs does not affect SVR rates with this combination
Efficacy and safety of sofosbuvir/velpatasvir in people with chronic hepatitis C virus infection and recent injecting drug use: the SIMPLIFY study (FRI-234):
This was an international open-label study that recruited participants with recent injecting drug use (previous six months) and chronic HCV genotype (G) 1-6 infection between March and October, 2016 in seven countries (19 sites). Participants received sofosbuvir/velpatasvir daily administered in a one-week electronic blister pack (records the time and date of each dose) for 12 weeks. Overall SVR rate was 96% with SVR rate of 94% in those with recent IV drug use. There were 3 lost to F/U, 1 death, and 1 re-infection. This study compliments the recent Co-Star study with grazoprevir/elbasvir which also showed high SVR rates. If patients can comply with therapy with DAAs, high SVR rates can be achieved.
MAGELLAN-2: safety and efficacy of glecaprevir/pibrentasvir in liver or renal transplant adults with chronic hepatitis C genotype 1-6 infection (LBO-03):

The combination of glecaprevir/pibrentasvir for 12 weeks without ribavirin was studied in non-cirrhotic liver or renal transplant patients in those with GT 1, 2, 3, 4 and 6. Only relapse was noted, a GT 3a subject. The treatment was well tolerated. This regimen appears to be highly effective across all genotypes without cirrhosis, was well tolerated and is ribavirin free.