Theme: Clinical Research Year: 2019
Background: Data on treatment outcomes with Glecaprevir/Pibrentasvir (G/P) amongst people who use drugs are lacking, with few enrolled in registration trials. We sought to evaluate the impact of baseline drug use on SVR rates in a real world cohort. Methods: Patients commencing G/P prior to 01/05/2018 were identified from the Scottish HCV database. For patients on ORT, review of drug service notes identified (where available) self reported intravenous drug use (IVDU), and non-IVDU in the 3/12 pre-treatment. Anonymous linkage with the needle exchange database (NEO) identified Injecting equipment provision (IEP) uptake in the same 3/12. Results: 354 people commenced treatment (250 (70.6%) male, mean age 45.2 (±9.3), 33 (9.3%) with cirrhosis, 187 (52.8% GT3)). Self reported drug use, NEO registration and IEP uptake are summarised below. IEP uptake was highest amongst those in specialist care, though 1:4 in non specialist care (shared care with general practice) accessed IEP. Premature discontinuation was infrequent irrespective of baseline drug use (4 (3.0%) with vs 2 (2.6%) without). Intention to treat (ITT) and modified ITT (mITT) rates were high for the cohort (91.5 and 97.5%) respectively. Non SVR was predominantly due to non attendance (15), relapse (6) and death (4). ITT and mITT rates were similar according to presence/absence of baseline drug use (90.4% vs 89.6% (p 0.86), 96.8% vs 97.2% (p 0.87)). Addictions Care Self reported IVDU (%) Self reported Non-IVDU (%) Any evidence DU (%) NEO registered (%) Needle transactions (%) Specialist care 16/160 10.0) 79/160 (49.4) 107/160(66.9) 97 (67.4) 46 (31.9) Shared care 1/37 (2.7) 18 /36 (50.0) 26/37 (70.3) 36 (50.0) 16 (25.8) Not in care n/a n/a n/a 35 (23.6) 9 (6.1) Total 17 (8.6) 97 (49.5) 133 (67.5) 168 (47.5) 71 (20.0) Conclusion: We demonstrate that SVR rates in a real world cohort treated with G/P are high, irrespective of drug use. Disclosure of Interest Statement: This work was sponsored by Abbvie. Dr S Barclay has received speakers fees, advisory board fees and grants from Abbvie and Gilead. Miss F Marra has received speakers fees, advisory board fees and grants from Abbvie, Gilead and Merck. Miss Boyle has received speakers fees and grants from Abbvie and Gilead.
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