Opioid-agonist therapy: no longer a barrier to hepatitis C treatment?

Takeaway

• Results support removal of illicit drug use and opioid-agonist therapy as barriers to receiving interferon-free direct-acting antiviral hepatitis C therapy.

Study design

• C-EDGE CO-STAR.
• Randomized, placebo-controlled, multisite, double-blind trial.
• Adults with chronic hepatitis C infection (GT1, GT4, or GT6) receiving opioid-agonist therapy (OAT) with:

        — Methadone;
        — Buprenorphine;
        — Buprenorphine–naloxone.

• People who inject drugs (PWID) while receiving OAT not excluded.
• Randomized 2:1 to 12-wk treatment with:

        — Elbasvir–grazoprevir (ITG);
        — Placebo, followed by deferred elbasvir–grazoprevir treatment (DTG).

• Urine drug screening (UDS) conducted at each visit for potential drugs of abuse.
• Funding: Merck.

Key results

• 301 patients.
• Primary outcome, sustained virologic response after 12 weeks of active treatment (SVR12):

        — 91.5% ITG vs 89.5% DTG.

• 50% of patients in each group t...