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New HCV treatments increase patient adherence through shorter therapy, low pill count

BOSTON — In a clinical trial that compared direct-acting antiviral therapies for patients with hepatitis C, treatment adherence was highest among patients treated for shorter duration with fewer pills, according to data presented at the 2014 Conference on Retroviruses and Opportunistic Infections.

Researchers enrolled 60 patients (88% African-American, 72% men) infected with HCV in three arms of a phase 2 clinical trial. Patients were assigned direct-acting antivirals (DAA) sofosbuvir and ledipasvir (400 mg/90mg one pill once daily in a fixed dose combination [FDC]) for 12 weeks; FDC and GS-9451 (80 mg daily), two pills, once daily for 6 weeks; or FDC and GS-9669 (500 mg daily), three pills, once daily for 6 weeks.

Using medication event monitoring system caps, pill counts and patient reports, researchers noted adherence dropped with increasing pill count and duration.

Patients taking the most pills had the worst adherence rate (99.3 ± 1.6% vs. 97.2 ± 3.6% vs. 94.8 ± 7.4%, one, two and three pills daily, respectively, P=.02), and patients on the 12-week course declined during treatment (98.1 ± 0.9% vs. 95 ± 1.2% weeks 0 through 4 vs. weeks 8 through 12, P=.04)

The biggest risk factors for patients failing to maintain therapy were feeling inconvenienced (P=.03) and having children living with them at home (P=.01). Among patients who failed to adhere to therapy, 39% said they felt the drugs were working, 35% said they forgot, and 32% said they had been away from home.

“Adherence to short courses of DAA therapy with one to three pills once a day was excellent,” the researchers wrote. “Increased pill burden and duration of treatment decreased adherence.”

For more information:

Petersen T. Abstract #667. Presented at CROI 2014; March 3-6, 2014; Boston.

Disclosure: Tess Petersen reports no relevant financial disclosures.