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Olysio-based therapy shows promise in recurrent HCV after liver transplant

In a pilot study, 12 weeks of Olysio-based triple therapy was safe and effective in live donor liver transplant recipients with hepatitis C virus infection recurrence.

“We prospectively investigated the efficacy and safety of simeprevir in combination with pegylated interferon and ribavirin in five patients undergoing living donor liver transplantation with recurrent hepatitis due to hepatitis C virus [infection] genotype 1b,” the study researchers wrote.

The five live donor liver transplant recipients underwent adult-to-adult transplantation at the University of Tokyo Hospital in Japan and began a treatment regimen of 100 mg Olysio (simeprevir, Janssen Pharmaceuticals) in combination with a low dose of pegylated interferon alfa-2b and up to 400 mg ribavirin per day for 12 weeks. In addition, each patient was scheduled to undergo 36 weeks of dual treatment after 12 weeks of therapy. The treatment began in March 2014 and follow-up was until June 2014.

Overall, all five patients completed the 12-week treatment regimen, followed by dual therapy with PEG-IFN and ribavirin. Three of five patients achieved undetectable HCV viral load at 4, 8 and 12 weeks.  HCV viral load for the other two patients were at the lower level of quantification. Only one patient experienced a significant adverse event, grade 2 diarrhea, which was resolved after a reduction of mycophenolate mofetil. None of the patients required a lower dose of PEG-IFN or ribavirin. 

“This combination therapy produced fewer side-effects and drug interactions with [calcineurin inhibitors] than prior [direct-acting antivirals],” the researchers concluded. “Recipients who were tolerant to dual therapy but could not achieve a satisfactory viral response should be considered candidates for [simeprevir].”

The researchers further stated: “Future studies including a larger number of liver transplant recipients in diverse situations, such as those undergoing first-line treatment for established recurrence of HCV post-liver transplantation, are crucial.” – by Melinda Stevens

Disclosure:  The researchers report no relevant financial disclosures.