Daclatasvir as a hepatitis C infection treatment option: an up-to-date evaluation

ABSTRACT

Introduction

Globally, it is estimated that 290,000 patients infected with hepatitis C virus (HCV) died from hepatitis C consequences, including cirrhosis and hepatocellular carcinoma in 2019. Although daclatasvir (DCV), combined with sofosbuvir (SOF), is effective in HCV patients, the new pan-genotypic combinations are considered by many as more cost-effective and successful in eradicating HCV infection.

Areas covered

This review discusses the safety, efficacy, and cost-effectiveness of DCV as an HCV treatment option based on real-world studies and pharmacoeconomic evaluations.

Expert opinion

Real-life studies suggest that SOF/DCV has acceptable sustained virological response and can be used successfully to manage HCV. Nonetheless, the use of SOF/DCV is limited by the longer treatment duration in genotype (GT)-3 patients and the need for ribavirin (RBV) in treatment-experienced patients which increases the likelihood of adverse effects. DCV is likely to remain as a therapeutic option for the management of GT-1, GT-2, and GT-4 patients in resource limited settings, while GT-3 patients are more likely to benefit from RBV-free direct-acting antiviral combinations such as SOF/velpatasvir for 12 weeks or glecaprevir/pibrentasvir for 8 weeks. The introduction of generics for these new pan-genotypic drugs would likely eliminate the need for SOF/DCV in the near future.

KEYWORDS:

• DCV
• daclatasvir
• efficacy
• HCV
• review
• economic evaluation

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

A reviewer on this manuscript has disclosed they are a consultant for AbbVie. Peer reviewers on this manuscript have no other relevant financial or other relationships to disclose.

List of abbreviations

AASLD: American Association for the Study of Liver Diseases

ASV: Asunaprevir

BCRP: Breast cancer resistance protein

BCV: Beclabuvir

BMS: Bristol Myers Squibb

CYP450: Cytochrome P450

DAA: Direct-acting antivirals

DCV: Daclatasvir

DDI: Drug-drug interaction

EASL: European Association for the Study of Liver Diseases

EMA: European Medicines Agency

ESRD: End stage renal disease

FDA: Food and Drug Administration

GT: Genotype

HCV: Hepatitis C virus

HIV: Human immune deficiency virus

IDSA: Infectious Diseases Society of America

LPV: Ledipasvir

OATP: Organic anion-transporting polypeptide

PE: Pharmacoeconomic

PR: Pegylated interferon/ribavirin

RBV: Ribavirin

RNA: Ribonucleic acid

SMV: Simeprevir

SOF: Sofosbuvir

SR: Sofosbuvir/ribavirin

SVR: Sustained virologic response

VEL: Velpatasvir

Additional information

Funding

This paper was not funded.