FDA OKs Merck’s Zepatier for Hep C

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FDA has approved a Merck NDA for Zepatier (elbasvir and grazoprevir) with or without ribavirin for treating chronic hepatitis C virus (HCV) genotypes 1 and 4 infections in adult patients. Approval is based on clinical trial data from 1,373 participants with chronic HCV genotype 1 or 4 infections with and without cirrhosis. Participants received Zepatier with or without ribavirin once daily for 12 or 16 weeks, according to an agency release. The overall sustained virologic response (SVR) rates ranged from 94-97% in genotype 1-infected subjects and from 97-100% in genotype 4-infected subjects across trials for the approved treatment regimens, it says.

The most common side effects of Zepatier without ribavirin were fatigue, headache and nausea; and with ribavirin they were anemia and headache. The therapy’s labeling carries a warning alerting patients and health care providers that elevations of liver enzymes to greater than five times the upper limit of normal occurred in approximately 1% of clinical trial participants, generally at or after treatment week eight, FDA says. “Liver-related blood tests should be performed prior to starting therapy and at certain times during treatment,” it adds. Additionally, it says Zepatier should not be given to patients with moderate or severe liver impairment.

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