Authors' objectives: To assess the available evidence on the efficacy, safety and coverage policy related aspect on the use of ombistavir, paritaprevir and ritonaviren regimens for the management of patients with hepatitis C. Chronic hepatitis C virus (HCV) infection is one of the main causes of cirrhosis and hepatocelullar carcinoma. HCV is an RNA virus with six genotypes (1 to 6); genotype 1 being the most frequent in Argentina. The main objective of this therapy is to cure infection, which is called sustained virologic response (SVR) and it is reflected by measuring undetectable HCV RNA in blood once therapy is finished. Treatment with pegylated interferon combined with ribavirin (RBV) has been the main management scheme for many years. New, more efficacious and safer regimens such as sofosbuvir+simeprevir, sofosbuvir+ledipasvir, sofosbuvir+daclatasvir, daclatasvir+asunaprevir, ombitasvir, paritaprevir and ritonavir (OPR)+dasabuvir (DSV) among others have currently appeared; they can be administered even to subjects with decompensated cirrhosis. OPR regimens have been proposed for the treatment of chronic hepatitis C because better SVR rates could be obtained, with less adverse effect and shorter treatment duration. Ombistavir and Paritaprevir are HCV NS3/4a and NS5A protease inhibitors, administered in combination with a paritaprevir metabolism inhibitor (ritonavir) in a single tablet. In general, this regimen is combined with DSV, which is a HCV NS5B protease inhibitor.

Authors' recommendations: There is abundant and good quality evidence. Ombitasvir, paritaprevir and ritonavir regimens with or without dasabuvir have proved to achieve high sustained virologic response rates in the different patient groups, including cirrhotic patients with genotype 1 and 4 HCV, comparable with the efficacy observed with other regimens with new drugs. Although they are no considered in the different Clinical Practice Guidelines and Health Technology Assessment documents identified, their high cost could limit treatment availability.

Project Status: Completed

Year Published: 2015

URL for published report: http://www.iecs.org.ar/publicacion/?id=5497

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Argentina

Organisation Name: Institute for Clinical Effectiveness and Health Policy

Contact Address: Dr. Emilio Ravignani 2024, Buenos Aires - Argentina, C1414 CABA

Contact Name: info@iecs.org.ar

Contact Email: info@iecs.org.ar

Copyright: Institute for Clinical Effectiveness and Health Policy (IECS)