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HCV treatment adherence improved with shorter therapies
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Patients with hepatitis C virus who were assigned fewer direct-acting antivirals with shorter therapeutic courses displayed high adherence rates than those taking more pills for a longer duration, according to data.
Researchers enrolled 60 patients (88% black, 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/90 mg 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.”
Petersen T. #667.
Disclosure: Petersen reports no relevant financial disclosures.