P free regimen with combination of 2 DAA achieves SVR above 95%. Addition of R to LY2157299 clinical trial 2 DAA increases SAE and DDR without increase in efficacy. Cost of treatment to achieve an SVR with DAA based regimen was lower for NR compared to P+R regimen. However,
the cost per SVR remains higher for treatment naïve patients. Conclusion: Second generation and emerging DAA are promising in HCV treatment with a very high safety and efficacy. An important drawback is their high cost. However, the present meta-analysis shows that the cost per SVR for NR’s (but not for naïve patients) was lower compared to P+R. This finding together with the superior safety profile and better compliance makes these drugs highly attractive. this website It is possible that further
reduction in treatment duration may make them even more cost effective. Table: Efficacy, safety, and cost comparing HCV treatment regimens Disclosures: Mohamed G. Shoreibah – Advisory Committees or Review Panels: Gilead ; Stock Shareholder: Gilead Brendan M. McGuire – Grant/Research Support: bayer healthcare, vital therapies, salix, vertex pharmaceuticals The following people have nothing to disclose: Siddharth Bansal, Ashwani K. Singal, Bhupinderjit S. Anand Background: The COMSOS phase 2 trial showed high cure rates and favorable side effect profile of a 12-wk regimen of Sofosbuvir (SOF) and Simeprevir (SIM) in patients with genotype (GT) 1 Hepatitis C. Given the small number of Baricitinib patients in the COSMOS trial, there is uncertainty in efficacy
and safety of this combination therapy. We now report our experience with COSMOS regimen in the multiethnic population of Hawaii including East Asians and patients with decompensated cirrhosis. Methods: Retrospective review of 85 patients treated with a fixed dose regimen of SIM 150 mg and SOF 400 mg daily, beginning 1/2014 at a single referral center. We collected data on demographics, side effects, laboratory values and SVR (sustained virological response). Statistical analysis was performed with Stata v8.2 software. Intention to treat data will be presented. Results: Baseline characteristics of 85 patients: 69% cirrhotic (19% of those Child Pugh Class B/C), 35% Asian, 16% Pacific Islander, 65% male, mean age 60.9±7.6, mean BMI 28.9±6.9, 26% diabetic, 63% genotype 1a, 21/41 IL28B non-CC GT, 8/33 positive for Q80K. Interim analysis data are presented. Viral load was negative in 100% of patients who reached end of treatment (EOT). Viral kinetics did not differ significantly in cirrhotics vs non-cirrhotics. Main side effects: headache 12%, fatigue 18 %, rash/photosensitivity 7.8%, nausea 7.8%. None were > grade 2 severity. Fatigue: 25% cirrhotics vs 4% non-cirrhotics. Differences in headache and skin reactions in Asians vs Caucasians did not reach statistical significance (17 vs 6% and 14 vs 6%). None of the patients experienced hepatic decompensation, renal dysfunction or worsening hematologic profile.