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Alan Franciscus

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HCV Advocate



Friday, January 16, 2015

European Commission Grants Marketing Authorizations for AbbVie's VIEKIRAX® (ombitasvir/paritaprevir/ritonavir tablets) + EXVIERA® (dasabuvir tablets) for the Treatment of Chronic Hepatitis C

- In Phase 3 clinical trials, VIEKIRAX + EXVIERA cured 95-100 percent of genotype 1 chronic hepatitis C patients, with less than 2 percent of patients experiencing virologic failure[1],[2]

- Tolerability profile shows more than 98 percent of patients completed a full course of therapy[3]

- All-oral, interferon-free regimen also approved for HCV/HIV-1 co-infection, patients on opioid substitution therapy and patients who have undergone a liver transplant[1],[2]

- VIEKIRAX + EXVIERA are the first products to be approved as a combination treatment of three direct-acting antivirals with distinct mechanisms of action targeting hepatitis C at multiple steps in the viral lifecycle[1],[2]

Jan 16, 2015
NORTH CHICAGO, Ill., Jan. 16, 2015 /PRNewswire/ -- AbbVie (NYSE: ABBV) announced that the European Commission has granted marketing authorizations for its all-oral, short-course, interferon-free treatment of VIEKIRAX® (ombitasvir/paritaprevir/ritonavir tablets) + EXVIERA® (dasabuvir tablets).1,2 The treatment has been approved with or without ribavirin (RBV) for patients with genotype 1 (GT1) chronic hepatitis C virus (HCV) infection, including those with compensated liver cirrhosis, HIV-1 co-infection, patients on opioid substitution therapy and liver transplant recipients.1,2 Additionally, VIEKIRAX has been approved for use with RBV in genotype 4 (GT4) chronic hepatitis C patients.1

"The approval of AbbVie's hepatitis C treatment in the European Union, following the recent approvals in the U.S. and Canada, offers patients across Europe a new and effective treatment to cure this serious disease," said Richard Gonzalez, chairman of the board and chief executive officer, AbbVie. "We are committed to working with local governments and healthcare systems to support broad access to VIEKIRAX + EXVIERA." 

The approvals follow a review under accelerated assessment by the European Medicines Agency, designated to new medicines of major public health interest. Approximately nine million people in Europe are infected with chronic hepatitis C, a major cause of liver cancer and liver transplantation.Genotype 1 is the most prevalent form of hepatitis C in Europe, accounting for 60 percent of cases worldwide.5 In Europe, the most prevalent sub-genotype is 1b (47 percent).6 Genotype 4, most common in the Middle East, sub-Saharan Africa and Egypt, is becoming increasingly prevalent in several European countries, including Italy, France, Greece and Spain.7 AbbVie's treatment is now licensed for use in all 28 member countries of the European Union, as well as in the U.S., Canada, Switzerland, Iceland, Liechtenstein and Norway.

"Hepatitis C is a complex disease, with multiple genotypes and special patient populations that need to be considered when determining the right treatment for an individual patient," said Stefan Zeuzem, M.D., professor of medicine and chief of the department of medicine I, J.W. Goethe University Hospital, Frankfurt, Germany. "In clinical trials, AbbVie's treatment achieved high cure rates with low rates of discontinuation across a variety of patient populations, making it an important addition to the class of therapies that is changing the way hepatitis C is being treated."

Treating hepatitis C is complex because the virus mutates and replicates rapidly. VIEKIRAX + EXVIERA are the first products to be approved as a combination treatment of three direct-acting antivirals with distinct mechanisms of action and non-overlapping resistance profiles to target hepatitis C at multiple steps in the viral lifecycle.1,2

"With the approval of VIEKIRAX + EXVIERA in the European Union, we are offering a treatment that achieved high cure rates for people living with GT1 and GT4 chronic hepatitis C," said Michael Severino, M.D., executive vice president, research and development and chief scientific officer, AbbVie. "This is an important part of our ongoing commitment to advancing public health by applying innovative science to the development of promising medicines."

Robust Clinical Development ProgramThe approval of VIEKIRAX + EXVIERA is supported by a robust clinical development program designed to study the safety and efficacy of the regimen in more than 2,300 enrolled patients across 25 countries.1,2 The program consisted of six pivotal Phase 3 studies, which demonstrated that VIEKIRAX + EXVIERA cured 95-100 percent of hepatitis C patients with GT1 HCV infection who received the recommended regimen, with less than 2 percent of patients experiencing virologic failure.1,2 Additionally, more than 98 percent (n=2,011/2,053) of patients in clinical trials completed a full course of therapy.3 Most common (>20 percent) adverse reactions for VIEKIRAX + EXVIERA with RBV were fatigue and nausea.1,2

The approval of VIEKIRAX + EXVIERA is also based on the results from Phase 2 clinical trials in GT1 chronic HCV infected patients, which showed that VIEKIRAX + EXVIERA cured 97 percent (n=33/34) of liver transplant recipients, 92 percent (n=58/63) of patients co-infected with HIV-1 and 97 percent (n=37/38) of patients on opioid substitution therapy.1,2 Patients who achieve a sustained virologic response (SVR12) are considered cured of hepatitis C.

Approval of VIEKIRAX in GT4 chronic hepatitis C was based on a Phase 2 study in which patients treated with VIEKIRAX with RBV achieved 100 percent SVR12.1

About VIEKIRAX® + EXVIERA®VIEKIRAX + EXVIERA is approved for the treatment of genotype 1 chronic hepatitis C virus infection, including patients with compensated cirrhosis. VIEKIRAX consists of the fixed-dose combination of paritaprevir 150mg (NS3/4A protease inhibitor) and ritonavir 100mg with ombitasvir 25mg (NS5A inhibitor), dosed once daily, and EXVIERA consists of dasabuvir 250mg (non-nucleoside NS5B polymerase inhibitor) dosed twice daily taken with or without ribavirin, dosed twice daily. VIEKIRAX + EXVIERA is taken for 12 weeks with or without RBV, except in GT1a patients with cirrhosis, who should take it for 24 weeks.

For the treatment of genotype 4 chronic hepatitis C patients, AbbVie's treatment consists of VIEKIRAX dosed once daily taken with RBV, dosed twice daily.

Paritaprevir was discovered during the ongoing collaboration between AbbVie and Enanta Pharmaceuticals (NASDAQ: ENTA) for hepatitis C protease inhibitors and regimens that include protease inhibitors. Paritaprevir has been developed by AbbVie for use in combination with AbbVie's other investigational medicines for the treatment of chronic hepatitis C.

Additional information about AbbVie's hepatitis C development program can be found on www.clinicaltrials.gov.

EU IndicationVIEKIRAX is indicated in combination with other medicinal products for the treatment of chronic hepatitis C (CHC) in adults. EXVIERA is indicated in combination with other medicinal products for the treatment of chronic hepatitis C (CHC) in adults.

Important EU Safety Information 
Contraindications:
VIEKIRAX + EXVIERA are contraindicated in patients with severe hepatic impairment (Child-Pugh C). Patients taking ethinyl estradiol-containing medicinal products must discontinue them and switch to an alternative method of contraception prior to initiating VIEKIRAX + EXVIERA. Do not give VIEKIRAX with certain drugs that are sensitive CYP3A substrates or strong inhibitors of CYP3A. Do not give VIEKIRAX and EXVIERA with strong or moderate enzyme inducers. Do not give EXVIERA with certain drugs that are strong inhibitors of CYP2C8.

Special warnings and precautions for use:
VIEKIRAX and EXVIERA are not recommended as monotherapy and should be used in combination with other medicinal products for the treatment of hepatitis C infection.

Pregnancy and concomitant use with ribavirinWhen VIEKIRAX + EXVIERA are used in combination with ribavirin, women of childbearing potential or their male partners must use an effective form of contraception during the treatment and 6 months after the treatment. Refer to the Summary of Product Characteristics for ribavirin for additional information.

ALT elevationsTransient elevations of ALT to >5x ULN without concomitant elevations of bilirubin occurred in clinical trials with VIEKIRAX + EXVIERA and were more frequent in a subgroup who were using ethinyl estradiol-containing contraceptives.

Use with concomitant medicinal productsUse caution when administering VIEKIRAX with fluticasone or other glucocorticoids that are metabolized by CYP3A4. A reduction in colchicine dosage or interruption in colchicine is recommended in patients with normal renal or hepatic function. VIEKIRAX with or without EXVIERA is expected to increase exposure of statins so certain statins need to be discontinued or dosages reduced. Low dose ritonavir, which is part of VIEKIRAX, may select for PI resistance in HIV co-infected patients without ongoing antiretroviral therapy. HIV co-infected patients without suppressive antiretroviral therapy should not be treated with VIEKIRAX.

Adverse ReactionsMost common (>20 percent) adverse reactions for VIEKIRAX + EXVIERA with RBV were fatigue and nausea.

Full summary of product characteristics is available at www.ema.europa.eu

Globally, prescribing information varies; refer to the individual country product label for complete information.

About AbbVieAbbVie is a global, research-based biopharmaceutical company formed in 2013 following separation from Abbott Laboratories. The company's mission is to use its expertise, dedicated people and unique approach to innovation to develop and market advanced therapies that address some of the world's most complex and serious diseases. AbbVie employs approximately 25,000 people worldwide and markets medicines in more than 170 countries. For further information on the company and its people, portfolio and commitments, please visit www.abbvie.com. Follow @abbvie on Twitter or view careers on our Facebook or LinkedIn page.

1. VIEKIRAX tablets (ombitasvir/paritaprevir/ritonavir) Summary of product characteristics. Maidenhead, UK. AbbVie, Ltd.
2. EXVIERA tablets (dasabuvir) Summary of product characteristics. Maidenhead, UK. AbbVie, Ltd.
3. Data on file
4. Hatzakis A. et al. The state of hepatitis B and C in Europe: report from the hepatitis B and C summit conference. Journal of Viral Hepatitis, 2011; 18 (Suppl. 1): 1-16
5. Global Alert and Response (GAR): Hepatitis C. World Health Organisation Web site. http://www.who.int/csr/disease/hepatitis/whocdscsrlyo2003/en/index2.html#HCV Published 2003. Accessed December 2014
6. O'Leary JG, Davis GL. Hepatitis C. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 9th ed, Vol 1. Philadelphia, PA: Saunders Elsevier. 2010:1313-1335
7. Khattab MA, et al. Management of hepatitis C virus genotype 4: Recommendations of an International Expert Panel. J Hepatol. 2011; 54: 1250-1262


SOURCE AbbVie

For further information: Media, Javier Boix, +1 (847) 937-6113, javier.boix@abbvie.com; Carlos Taveras, +33 1 41 73 92 64, carlos.taveras@abbvie.com; Investor Relations, Liz Shea, +1 (847) 935-2211, liz.shea@abbvie.com

NICE backs new hepatitis C treatments

Two drugs that represent a major advance in hepatitis C are set to be routinely available on the NHS in England and Wales, after NICE issued final draft guidance recommending both Gilead Sciences' Sovaldi (sofosbuvir) and Janssen's Olysio (simeprevir) to treat people with the infection.

Both drugs were approved in Europe in 2014 based on impressive clinical data and have gone on to record substantial sales, helped by the fact that both Olysio and Sovaldi were approved as part of shorter oral regimens that do not require the use of interferon, an injection that needs to be taken over several months.

However, both Gilead and Janssen expressed disappointment with some aspects of the NICE guidance.

Read more...

Thursday, January 15, 2015

UK: Hepatitis C drug delayed by NHS due to high cost

The NHS is to delay the introduction of a highly expensive drug that can save the lives of people infected with the hepatitis C virus. The move by NHS England is unprecedented, because the NHS rationing body, Nice (the National Institute for Health and Care Excellence) has approved the drug. Nice says sofosbuvir is cost-effective, because it is a cure for people who would otherwise run up huge NHS bills.

One in three people infected with hepatitis C will develop liver cirrhosis and some will get cancer. A liver transplant costs more than £50,000.

But NHS England appears to be balking at the bill for the drug, which would hit £1bn for every 20,000 people treated. Approximately 160,000 people in England alone are infected with hepatitis C, although fewer than half are aware of it.

Read more...

Canada: Could a simple blood test combat Saskatchewan’s high rates of hepatitis C?

REGINA – A new study claims that early screening could help save the lives of people infected with what’s considered a silent killer.

Chronic hepatitis C can be treated, or even cured, if diagnosed early. But, detection is difficult because there are often few or no early symptoms.

The research in the Canadian Medical Association Journal states that screening all Canadians for the infection would be cost effective and prevent deaths.

Read more...

Hepatitis C in the Workplace: Should Health Care Professionals Disclose?

by Lucinda K. Porter, RN

About nine months ago, a hepatitis C advocate contacted me and asked if I would be open to having a discussion on hepatitis C among healthcare professionals. Specifically, should we disclose or shouldn’t we? He talked about hepatitis C-positive medical professionals faced with the dilemma of disclosing their hepatitis C status to their employer. Some who divulged their status were terminated. There are also cases of those who were denied a job because pre-employment screening revealed that they had hepatitis C.

Read more...

UK: New Hepatitis C report tackles prevalence of disease in South Asian communities

In the South Asian community hepatitis C is often contracted through medical procedures associated with cultural practices.

Southall MP Virendra Sharma has helped launch a report tackling the high rate of hepatitis C in South Asian communities.

Virendra Sharma, MP for Southall recently chaired the development of the new report called The Challenge of Hepatitis C for the South Asian Community.

Mr Sharma launched the report in Parliament this week (Tuesday January 13) alongside fellow panel members which include like minded MPs healthcare professionals and organisations committed to combating the burden of hepatitis C

Read more....

Humana opts for Gilead in hepatitis C drug battle

Humana acknowledged late Tuesday it has an exclusive deal to offer Gilead Sciences' hepatitis C drugs to its members.

Humana CEO Bruce Broussard told investors in a breakout session that it has a pricing arrangement with Gilead, but he did not disclose what kind of discount the health insurer received for the pricey drugs. High specialty drug costs were part of the reason why Humana's profit was lower in the third quarter.

The company's announcement is the latest in a string of bargaining battles between health insurers and pharmacy benefits managers and pharmaceutical companies. Anthem was the first payer to announce an agreement, saying last week it would use Gilead's drugs for its hepatitis C patients. Gilead makes Sovaldi and Harvoni, which cost $84,000 and $94,500 respectively for the usual 12 weeks of treatment.

Read more...