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The Committee for Medicinal Products for Human Use ( CHMP ), the scientific committee of the European Medicines Agency ( EMA ), has adopted a positive opinion on Vosevi, an investigational, once-daily, single tablet regimen of Sofosbuvir 400 mg, Velpatasvir 100 mg, and Voxilaprevir 100 mg ( SOF/VEL/VOX ) for the treatment of chronic hepatitis C virus (HCV)-infected patients.

The data included in the application support the use of SOF/VEL/VOX in patients with and without compensated cirrhosis, with all genotypes ( GT1-6 ) of HCV infection regardless of prior therapy, including 8 weeks of treatment for HCV direct-acting antiviral (DAA)-naïve patients without cirrhosis, as well as 12 weeks of treatment for patients who have previously failed therapy with a DAA-containing regimen.

The CHMP positive opinion was adopted following an accelerated assessment procedure, reserved for medicinal products expected to be of major public health interest.

The MAA ( Marketing Authorization Application ) for Vosevi is supported by data from four phase 3 studies.

Two studies ( POLARIS-1 and POLARIS-4 ), have evaluated 12 weeks of the single tablet regimen in patients with genotypes 1-6 HCV infection previously treated unsuccessfully with DAA-containing regimens, including NS5A inhibitors.
Two other studies ( POLARIS-2 and POLARIS-3 ) evaluated 8 weeks of Vosevi in DAA-naïve patients with genotypes 1-6 HCV infection.

Across POLARIS-1 and POLARIS-4, 97% of patients treated with Vosevi ( n=431/445 ) achieved the primary efficacy endpoint of SVR12.
In POLARIS-2, 95% of patients with genotypes 1-6 HCV infection with and without cirrhosis treated with Vosevi ( n=477/501 ) achieved the primary efficacy endpoint of SVR12.
In POLARIS-3, 96% of patients with genotype 3 infection and cirrhosis treated with Vosevi ( n=106/110 ) achieved the primary efficacy endpoint of SVR12.

The most common adverse events among patients who received Vosevi in the POLARIS studies were headache, fatigue, diarrhea and nausea.

Sofosbuvir as a single agent was granted marketing authorization in the European Union on January 16, 2014, under the trade name Sovaldi, for use in combination with other agents.
The single tablet regimen of Sofosbuvir ( 400 mg ) and Ledipasvir ( 90 mg ) received marketing authorization in the European Union on November 18, 2014, under the trade name Harvoni.
The single tablet regimen of Sofosbuvir ( 400 mg ) and Velpatasvir ( 100 mg ) received marketing authorization in the European Union on July 8, 2016, under the trade name Epclusa. ( Xagena )

Source: Gilead, 2017

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