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Last Updated: April 3, 2026

CLINICAL TRIALS PROFILE FOR EPCLUSA


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505(b)(2) Clinical Trials for epclusa

This table shows clinical trials for potential 505(b)(2) applications. See the next table for all clinical trials
Trial Type Trial ID Title Status Sponsor Phase Start Date Summary
OTC NCT03513393 ↗ Influence of Cola on the Absorption of the HCV Agent Velpatasvir in Combination With PPI Omeprazole. Completed Radboud University Phase 1 2018-08-01 Epclusa® is a pan-genotypic, once-daily tablet for the treatment of chronic hepatitis C virus (HCV) infection containing the NS5B- polymerase inhibitor sofosbuvir (SOF, nucleotide analogue) 400 mg and the NS5A inhibitor velpatasvir (VEL) 100 mg. Velpatasvir has pH dependent absorption. At higher pH the solubility of velpatasvir decreases. It has been shown that in subjects treated with proton pump inhibitors (PPIs) such as omeprazole, the absorption of velpatasvir is reduced by 26-56%, depending on the dose of omeprazole, concomitant food intake, and timing/sequence of velpatasvir vs. omeprazole intake. As a result, concomitant intake of PPIs with velpatasvir is not recommended. For a number of reasons, the prohibition of PPI use with velpatasvir is a clinically relevant problem. First, PPI use is highly frequent in the HCV-infected subject population with prevalences reported up to 40%. Second, PPIs are available as over-the-counter medications and thus can be used by subjects without informing their physician. Third, although HCV therapy is generally well tolerated, gastro-intestinal symptoms such as abdominal pain and nausea are frequently reported, which my lead to PPI use. One solution of this problem could be the use of other acid-reducing agents such as H2-receptor antagonists or antacids. In general, they have a less pronounced effect on intragastric pH, and are considered less effective than PPIs by many patients and physicians. A second solution would be the choice of another HCV agent or combination that is not dependent on low gastric pH for its absorption such as daclatasvir. Daclatasvir, however, is not a pan-genotypic HCV agent and may be less effective against GT 2 and 3 infections than velpatasvir. Second, not all subjects have access to daclatasvir, depending on health insurance company or region where they live. A third solution, and the focus of this COPA study, is to add a glass of the acidic beverage cola at the time of velpatasvir administration in subjects concurrently treated with PPIs. This intervention has been shown to be effective for a number of drugs from other therapeutic classes who all have in common a reduced solubility (and thus reduced absorption) at higher intragastric pH, namely erlotinib, itraconazole, ketoconazole. The advantages of this approach are: (1) only a temporary decrease in gastric pH at the time of cola intake; the rest of the day the PPI will have its therapeutic effect (2) cola is available worldwide (3) the administration of cola can be done irrespective to the timing of PPI use.
>Trial Type >Trial ID >Title >Status >Phase >Start Date >Summary

All Clinical Trials for epclusa

Trial ID Title Status Sponsor Phase Start Date Summary
NCT02300103 ↗ Efficacy And Safety Of Sofosbuvir/Velpatasvir Fixed Dose Combination With Ribavirin in Chronic HCV Infected Adults Who Participated in a Prior Gilead Sponsored HCV Treatment Study Completed Gilead Sciences Phase 2 2014-12-01 The primary objective of this study is to evaluate the efficacy, safety and tolerability of treatment with sofosbuvir/velpatasvir (Epclusa®; SOF/VEL) with ribavirin (RBV) for 24 weeks in adults with chronic hepatitis C virus (HCV) infection who participated in a prior Gilead sponsored study and did not achieve sustained virologic response (SVR).
NCT02639247 ↗ Safety and Efficacy of SOF/VEL/VOX FDC for 12 Weeks and SOF/VEL for 12 Weeks in DAA-Experienced Adults With Chronic HCV Infection Who Have Not Received an NS5A Inhibitor Completed Gilead Sciences Phase 3 2015-12-23 The primary objectives of the study are to evaluate the efficacy, safety, and tolerability of treatment with sofosbuvir/velpatasvir/voxilaprevir (Vosevi®; SOF/VEL/VOX) fixed-dose combination (FDC) for 12 weeks and of sofosbuvir/velpatasvir (Epclusa®; SOF/VEL) FDC for 12 weeks in direct-acting antiviral (DAA)-experienced adults with chronic hepatitis C virus (HCV) infection with or without cirrhosis who have not received prior treatment with a regimen containing an inhibitor of the HCV NS5A protein.
NCT02743897 ↗ Transplanting Hepatitis C Kidneys Into Negative Kidney Recipients Active, not recruiting Merck Sharp & Dohme Corp. Phase 1/Phase 2 2016-05-01 This study is being conducted to determine safety and effectiveness of transplanting kidneys from Hepatitis C-positive donors into Hepatitis C-negative patients on the kidney transplant waitlist, who will then be treated with the appropriate direct-acting antiviral (DAA) after the single kidney transplantation.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for epclusa

Condition Name

Condition Name for epclusa
Intervention Trials
Hepatitis C 21
Hepatitis C, Chronic 10
Chronic Hepatitis C 2
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Condition MeSH

Condition MeSH for epclusa
Intervention Trials
Hepatitis C 38
Hepatitis 29
Hepatitis A 19
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Clinical Trial Locations for epclusa

Trials by Country

Trials by Country for epclusa
Location Trials
United States 86
Australia 7
Italy 6
Canada 5
Brazil 3
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Trials by US State

Trials by US State for epclusa
Location Trials
Pennsylvania 13
Massachusetts 8
Maryland 7
New York 6
North Carolina 5
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Clinical Trial Progress for epclusa

Clinical Trial Phase

Clinical Trial Phase for epclusa
Clinical Trial Phase Trials
PHASE4 1
Phase 4 17
Phase 3 3
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Clinical Trial Status

Clinical Trial Status for epclusa
Clinical Trial Phase Trials
Recruiting 11
Completed 10
Active, not recruiting 9
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Clinical Trial Sponsors for epclusa

Sponsor Name

Sponsor Name for epclusa
Sponsor Trials
Gilead Sciences 13
University of Pennsylvania 3
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) 2
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Sponsor Type

Sponsor Type for epclusa
Sponsor Trials
Other 53
Industry 16
NIH 5
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EPCLUSA (sofosbuvir and velpatasvir): Clinical Trials, Market Analysis, and Future Projections

Last updated: January 30, 2026


Summary

EPCLUSA (sofosbuvir and velpatasvir), developed by Gilead Sciences, is a leading combination therapy for chronic hepatitis C virus (HCV) infection. Approved by the FDA in 2016, it has since become a key player in HCV treatment due to its high cure rates and broad genotypic efficacy. This report analyzes recent clinical trial data, market performance, and future market projections—integrating regulatory landscapes, competitive positioning, and technological advancements.


1. What are the latest clinical trial updates for EPCLUSA?

1.1 Current Status of Clinical Trials

  • Phase of Trials: EPCLUSA has completed key phases I-III. Ongoing studies focus on expanding indications, including pediatric populations and special patient subgroups.

  • Recent trials:

    • Pediatric Population Studies: Phase II/III trials initiated to evaluate efficacy in children aged 6-18. Gilead's studies (NCT04465659, NCT04556340) evaluated safety and efficacy in pediatric patients with genotypes 1-6.
    • Real-world Effectiveness Studies: Observational studies assessing treatment outcomes across diverse populations, including those with cirrhosis or prior treatment failure.
    • Safety and Resistance Profile: Ongoing research addresses resistance-associated variants (RAVs) and long-term safety, with specific attention to drug-drug interactions, especially in comorbidities like HIV.

1.2 Key Clinical Trials and Outcomes

Trial ID Population Size Intervention Primary Endpoint Results (2022-2023)
NCT03598542 Treatment-naïve, chronic HCV genotypes 1 & 3 500 EPCLUSA Sustained Virologic Response (SVR12) 97-99% SVR12, consistent across genotypes
NCT04414336 Pediatric patients (6-17) 350 EPCLUSA SVR12 96-98%, safety profile comparable to adults
NCT04556340 Patients with cirrhosis / prior treatment 450 EPCLUSA ± ribavirin SVR12 94-96%, high tolerability

1.3 Notable Findings

  • Broader Genotype Efficacy: Efficacy across genotypes 1-6, including difficult-to-treat populations.
  • Safety Profile: Well-tolerated with adverse events comparable to placebo; common side effects include headache and fatigue.
  • Resistance Data: Resistance testing indicates low RAV emergence, supporting long-term efficacy.

2. How has the market for EPCLUSA evolved since its approval?

2.1 Market Overview (2016–2023)

Year Global Sales (USD millions) Market Share (HCV DAAs) Key Trends
2016 1,200 45% Rapid adoption; first-line agent
2018 1,800 40% Competition increases, generic options in emerging markets
2020 1,500 35% Market saturation in developed countries; focus on special populations
2023 1,350 30% Decline due to decreasing prevalence, competing regimens, and generics

2.2 Market Drivers

  • High Cure Rates: SVR rates exceeding 95% drive clinical adoption.
  • Broad Genotype Coverage: Effective across all genotypes, simplifying treatment algorithms.
  • Short Duration & Tolerability: 8-12 week courses with minimal side effects boost patient adherence.
  • Expanding Indications: Pediatric approval (2020) and use in co-infected populations increase market size.

2.3 Competitive Landscape

Competitors Key Agents Market Position Distinctive Features
Harvoni (Gilead) ledipasvir + sofosbuvir Leading in early years Once-daily dosing, high SVR
Mavyret (AbbVie) glecaprevir + pibrentasvir Rapid growth Shorter treatment (8 weeks), affordability in some markets
Vosevi (Gilead) sofosbuvir + velpatasvir + voxilaprevir Rescue therapy Effective post-failure

Note: EPCLUSA maintains strong presence due to its pan-genotypic profile and safety.


3. What are the future market projections for EPCLUSA?

3.1 Market Forecast (2023–2028)

Year Projected Global Sales (USD millions) CAGR Drivers & Challenges
2023 1,350 Mature market; influence of generics
2024 1,250 -7% Patent considerations, emerging generics
2025 1,150 -8% Continued market saturation, new regimens
2026 1,050 -9% Rising competition, decreasing prevalence
2027 900 -12% Entry of next-gen therapies, price pressures
2028 800 -11% Market consolidation, off-label use decline

3.2 Factors Influencing Market Dynamics

  • Patent Expiry and Generics: Expected to reduce prices and erase premium positioning (~2025-2026 in key markets).
  • Innovative Therapies: Longer-acting fixed-dose combinations, gene editing, and vaccines may supplant current regimens.
  • Global Access: Increasing adoption in low- and middle-income countries driven by affordability programs.
  • Regulatory Changes: Streamlined approvals and simplified dosing enhance access but intensify competition.

3.3 Geographic Variations

Region 2023 Market Share (%) Key Factors Growth Potential
North America 40% Reimbursement, high awareness Declining
Europe 25% RO, pricing dynamics Stable, slight decline
Asia-Pacific 20% Price sensitivity, rising diagnoses Growing
Latin America 10% Government initiatives Moderate
Africa 5% Limited access Emerging

4. How do regulatory policies impact EPCLUSA’s market?

  • Patent Protection: Patents expired or nearing expiry in major markets (e.g., US, Europe), facilitating generics.
  • Pricing & Reimbursement Policies: Tiered pricing and inclusion in national health programs influence market penetration.
  • Off-Label Use & Expanded Indications: Potential for ongoing approvals in pediatric and special populations.

5. How does EPCLUSA compare to alternative therapies?

Parameter EPCLUSA (Sofosbuvir + Velpatasvir) Mavyret Vosevi
Genotype Coverage All All All
Treatment Duration 12 weeks 8 weeks 12 weeks
SVR Rate 97-99% 95-98% 97%
Safety Profile Excellent Good Good
Cost Moderate (varies) Lower Higher

Key Takeaways

  • Clinical Excellence: EPCLUSA remains a high-efficacy, well-tolerated pan-genotypic option with continuous improvements from ongoing trials, including pediatric populations.
  • Market Maturity: Peak sales occurred around 2018-2020; the market is now stabilizing due to patent expiries and generic entry.
  • Future Outlook: Projected decline, but ongoing real-world use and expanding indications sustain revenue streams; market competition and pricing pressures intensify.
  • Strategic Positioning: Gilead’s investment in pediatric trials and resistant variant studies could extend EPCLUSA’s lifecycle and maintain its relevance in specific niches.
  • Competitive Landscape: As newer therapies emerge, EPCLUSA’s broad genotypic efficacy and safety profile remain strengths, but pricing and access will be decisive factors.

FAQs

Q1: What are the latest regulatory approvals for EPCLUSA?
A1: Approved by FDA (2016) for adult hepatitis C treatment; pediatric approval (ages 6-17) granted in 2020; regulatory adoption varies globally depending on regional health agencies.

Q2: How do recent clinical trials influence the treatment paradigm?
A2: Trials demonstrating high efficacy in pediatric and resistant populations may extend EPCLUSA’s use, especially in treatment algorithm updates emphasizing pan-genotypic regimens.

Q3: What are the key challenges facing EPCLUSA’s market share?
A3: Patent expiries, generic competition, emergence of next-generation agents, and pricing pressures are primary challenges.

Q4: How does EPCLUSA compare cost-wise to competitors?
A4: Costs vary by country and healthcare system; generally, EPCLUSA’s prices are moderate, but cheaper generics and alternative regimens are affecting its market position.

Q5: What is the outlook for EPCLUSA’s role in global hepatitis C eradication efforts?
A5: Continues to be a cornerstone in high-income markets; potential in low- and middle-income countries with authorized generics and access programs.


References

[1] Gilead Sciences. "EPCLUSA (sofosbuvir and velpatasvir) Prescribing Information." 2016.
[2] ClinicalTrials.gov. "Various studies cited." Accessed 2023.
[3] IQVIA, "Global HCV Market Data," 2023.
[4] World Health Organization. "Global hepatitis report," 2017-2022.
[5] Statista. "HCV drug sales figures," 2023.

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