Eight weeks of sofosbuvir-velpatasvir cured non-cirrhotic hepatitis C as well as twelve, in an Indian trial of 880 patients

The edition in brief

RESOLVE randomised 880 treatment-naive adults with non-cirrhotic hepatitis C at five Indian public hospitals to 8 or 12 weeks of sofosbuvir-velpatasvir. Per-protocol SVR12 was 98.8% against 99.0% (difference 0.2%, −1.5 to 1.9), and intention-to-treat 93.5% against 91.8%, meeting non-inferiority, with no drug-related serious adverse events. In EPICS-III, 148 patients with primary biliary cholangitis who responded inadequately to or could not take ursodeoxycholic acid received saroglitazar 0.97 mg or placebo for 52 weeks: biochemical response was 56.7% against 9.8%, and ALP normalised in 8.2% against none; itch benefit at 24 weeks was not sustained. A prospective study across 63 transplant centres found one-year mortality of 73% with ACLF-2 and 88% with ACLF-3 among patients declined for transplant, against 10.5% and 21% after transplant; with five or six organ failures, post-transplant mortality reached 42%. EASL, EASD and EASO guidance recommends resmetirom or semaglutide for non-cirrhotic MASH with F2–F3 fibrosis alongside lifestyle care, favouring semaglutide with obesity, diabetes or cardiovascular risk, and advises against either as MASH-targeted therapy in cirrhosis until outcome data exist.