The edition · Top Clinical Updates
Eight weeks of sofosbuvir-velpatasvir matched twelve in an Indian hepatitis C trial
A publicly funded Indian trial supports a shorter hepatitis C course; atacicept slows kidney decline in IgA nephropathy; an oral BTK inhibitor beats teriflunomide in multiple sclerosis; and a Sjögren's antibody moves activity scores but not symptoms.
The edition in brief
RESOLVE, an ICMR-funded open-label trial in five Indian public hospitals, randomised 880 treatment-naive adults with non-cirrhotic hepatitis C to 8 or 12 weeks of sofosbuvir-velpatasvir. Cure rates (SVR12) were 98.8% and 99.0% per protocol (risk difference 0.2%, −1.5 to 1.9), and 93.5% vs 91.8% by intention to treat, meeting non-inferiority. In ORIGIN 3, weekly atacicept held eGFR steady over two years in IgA nephropathy while it fell on placebo (slope difference 5.0 mL/min/1.73 m² per year), and composite progression fell from 17.8% to 5.1% (HR 0.24). In two phase 3 trials of 2,007 people with relapsing multiple sclerosis, oral remibrutinib lowered the annualised relapse rate by about a third against teriflunomide (rate ratios 0.65 and 0.69), with fewer discontinuations. In two trials of ianalumab for Sjögren's disease, monthly dosing reduced disease-activity scores by about 1 point more than placebo, at the margin of significance, with no improvement in patient-reported symptoms.
Atacicept held kidney function steady over two years in IgA nephropathy
Refer young adults with haematuria and proteinuria early; IgA nephropathy now has agents that slowed kidney decline in phase 3.
Oral remibrutinib cut relapses by about a third against teriflunomide in multiple sclerosis
Remibrutinib reduced relapses against teriflunomide; whether it slows disability remains open.
Ianalumab lowered Sjögren's activity scores slightly, but patients did not feel better
Ianalumab moved a disease-activity score by about one point but did not improve symptoms; it is not yet a reason to change Sjögren's care.
A positive hepatitis C antibody is a question, not a diagnosis
Confirm current hepatitis C with an RNA test before diagnosing or treating; antibodies stay positive after the virus has gone.
Eight weeks of sofosbuvir-velpatasvir was non-inferior to twelve in non-cirrhotic hepatitis C
For treatment-naive patients without cirrhosis, an 8-week course of sofosbuvir-velpatasvir matched 12 weeks in an Indian trial; watch for programme guidance to follow.
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