EASL 2014 – European Liver Meeting in London

EASL 2014 logo for i-Base.info website

Early reports

Reports from EASL 2014 for the next edition of HIV Treatment Bulletin are linked below.

This year the European Liver Meeting was held from 9-13 April at the ExCel Centre in London.

This was a full meeting – from Wednesday to Sunday (when the London Marathon is being run). The programme included 170 oral abstract presentations and over 1320 poster presentations.

Although this is primarily a liver conference, the programme has some sessions on HIV/HCV coinfection. This includes an overview lecture about HIV/HCV coinfection on Sunday by Dr Sanjay Bhagani from the Royal Free Hospital.

Most of the news focused on new oral drugs for hepatitis C (called Directly Active Agents or DAAs) – and there are a lot of new drugs. Some companies have several compounds that are only being studied together as in-house combinations (including Gilead, Abbott and Merck).

The news is dramatic in terms of the efficacy and safety of these drugs – with cure rates approaching 100% for treatment naive patients. This is perhaps comparable to the first years of combination therapy for HIV in 1996. The meeting also includes promising results in advanced and difficult to treat patients including people with cirrhosis and who did not respond to previous HCV treatment.

Although most of the DAA studies are in HCV mono infection, some HIV/HCV coinfection studies are included. Importantly though, DAAs appear to have similar success rates irrespective of HIV status, so the monoinfection studies are highly relevant. Regulatory decisions on approving new DAAs are likely to recommend broad use, irrespective of HIV status.

Highlights of the DAAs with new data at EASL 2014 will include:

  • ABT-450/r/ABT-267, ABT-333 (AbbVie combination)
  • sofosbuvir – already approved in Europe and the US – but with new data in different genotype and populations
  • sofosbuvir plus ledipasvir (Gilead combination)
  • sofosbuvir plus GS-5816 (another Gilead combination)
  • MK-5172 and MK-8742 (Merck combination) – including in HIV positive people with genotype 1.
  • daclatasvir (from BMS) – including with sofosbuvir (in research not supported by Gilead)
  • simeprevir (Janssen) – already licensed in the US and available on early access in the EU.

The details are as important as the headline news. Some studies, especially in sub-groups, have small study numbers,  A surprising number of abstracts promise “SVR results will be presented” which is a convention that HIV conferences restricted years ago. If the data is not in the abstract when submitted, it doesn’t get in…

This excitement is also tempered by issues of cost and access – both in developed countries based on the launch price of sofosbuvir – and in middle and low income countries where most HCV positive people live – and where dramatically reduced pricing will be needed.

The programme, abstract books and related Apps are already available as open access online from the conference website.

The meeting doesn’t seem to webcast sessions, but a series of 26 press conferences and interviews are available on YouTube: