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Last Updated: December 19, 2025

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.
NCT02743897 ↗ Transplanting Hepatitis C Kidneys Into Negative Kidney Recipients Active, not recruiting University of Pennsylvania 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
HCV 2
Chronic Hepatitis C 2
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Condition MeSH

Condition MeSH for epclusa
Intervention Trials
Hepatitis C 38
Hepatitis 29
Hepatitis A 19
Hepatitis C, Chronic 12
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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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Clinical Trials Update, Market Analysis, and Projection for Epclusa

Last updated: October 29, 2025

Introduction

Epclusa (sofosbuvir and velpatasvir) stands as a prominent oral antiviral therapy developed by Gilead Sciences for chronic hepatitis C virus (HCV) infection. Approved in 2016, Epclusa represented a significant advancement, offering a pan-genotypic regimen that simplifies treatment across all HCV genotypes. This article provides a comprehensive update on ongoing and recent clinical trials, analyzes current market dynamics, and projects future growth of Epclusa within the global hepatitis C therapeutics landscape.


Clinical Trials Landscape for Epclusa

Recent and Ongoing Clinical Trials

Since its initial approval, Epclusa has been extensively evaluated through post-market studies aimed at expanding its indications, assessing long-term efficacy, and exploring combination therapies:

  • Real-world Effectiveness and Safety Studies
    Multiple observational studies have reinforced Epclusa’s high sustained virologic response (SVR) rates exceeding 95% across diverse populations, including those with comorbidities such as HIV co-infection, varying degrees of liver fibrosis, and treatment-experienced patients [1].

  • Special Population Trials
    Recent trials have focused on populations traditionally challenging to treat:

    • Decompensated Cirrhosis: Trials indicate improved safety profile with comparable SVR rates, emphasizing the potential for Epclusa as first-line therapy in advanced liver disease [2].
    • Pediatric Populations: Ongoing studies are evaluating dosage and safety in children aged 6 to 17, aiming to expand treatment access [3].
  • Combination and Adjunctive Studies
    Current research explores Epclusa in combination with other antiviral agents for potentially accelerated cure rates or reduced treatment duration, especially in cases of resistant viral variants [4].

Innovational Breakthroughs & Projected Trials

Emerging studies are investigating:

  • Epclusa’s role in eliminating HCV in co-infected HIV patients, aiming for integrated treatment regimens.
  • Comparisons with newer pan-genotypic agents to establish comparative efficacy and cost-effectiveness.

Regulatory Status and Approvals

Besides its initial EU and US approval, Gilead is pursuing expanded labels, including for pediatric use and in special populations, with supplementary NDAs under review or approved in multiple markets.


Market Analysis of Epclusa

Global Market Overview

The global hepatitis C therapeutics market was valued at approximately $19.4 billion in 2022 and is projected to reach $33.1 billion by 2030, with a compound annual growth rate (CAGR) of 6.7% [5]. Epclusa accounts for a significant share of this market owing to its broad efficacy, convenience, and safety profile.

Key Market Segments

  • Geographical Distribution: North America dominates due to high diagnosis and treatment rates, supplemented by significant growth in Europe, Asia-Pacific, and Latin America.
  • Patient Demographics: The treatment landscape is driven by:
    • High prevalence in baby boomers and intravenous drug users.
    • Increased screening initiatives, especially in developed nations.
    • Rising awareness and expanding access to treatment.

Competitive Position

Epclusa’s pan-genotypic formulation gives it a competitive advantage over historically genotype-specific regimens like Harvoni (ledipasvir with sofosbuvir). Its duration (12 weeks), high accuracy, and favorable side-effect profile distinguish it in a crowded market with alternatives including Mavyret (glecaprevir/pibrentasvir) and Vosevi (sofosbuvir/velpatasvir/voxilaprevir).

Pricing and Reimbursement

Pricing strategies significantly influence market penetration. Gilead has maintained a premium pricing model, but competition has prompted price reductions and increased generic availability in some regions, notably India. Reimbursement policies and healthcare infrastructure heavily impact access, especially in emerging markets.

Market Challenges

  • Patent Expirations & Generics: Patent expiry in key markets could erode market share unless existing patents are extended or new formulations are developed.
  • Residual Unmet Needs: Populations with advanced liver disease or co-morbidities require tailored approaches, potentially limiting universal coverage.

Market Projection and Future Outlook

Factors Influencing Growth

  • Increased Screening & Diagnosis: Global initiatives to identify asymptomatic carriers, especially in high-burden regions.
  • Treatment Expansion in Underserved Populations: Pediatric, co-infection, and decompensated cirrhosis cohorts bolster increasing demand.
  • Technological Advancements: Novel biomarkers and non-invasive diagnostics enhance treatment monitoring.
  • Competitive Dynamics: Entry of next-generation therapies aims to challenge Epclusa's market dominance, but its safety and efficacy keep it competitive.

Forecasted Revenue and Adoption Trends

By 2030, the Epclosua segment is expected to maintain a CAGR of approximately 5-6%, driven largely by expanding indications and market penetration in underserved regions. The global sales are projected to reach $4 billion annually, with North America constituting over 50% of the market share.

Emergent Opportunities

  • Combination Regimens: Incorporation of Epclusa with other antiviral agents for resistant strains.
  • HCV Elimination Programs: Strategic deployment in national health policies aiming for elimination goals, especially in conjunction with screening initiatives.
  • Therapeutic Optimization: Shortened treatment durations and fewer side effects could further increase compliance and cure rates.

Key Takeaways

  • Clinical Success & Ongoing Trials: Epclusa’s real-world data continually demonstrate superior efficacy across genotype and patient profiles. Ongoing trials focus on extending its application to special populations, including children, co-infected, and decompensated cirrhosis patients.
  • Market Leadership & Challenges: While Epclusa remains a market leader owing to its pan-genotypic efficacy, price competition, patent expirations, and emerging therapies threaten its dominance.
  • Growth Opportunities: Accelerated global screening programs, expanded indications, and strategic combination therapies represent avenues for sustained growth.
  • Impact of Regulatory Developments: Favorable regulatory decisions, especially approvals for pediatric use and in developing countries, will be instrumental in capturing new markets.
  • Competitive Landscape: The advent of newer agents with shortened regimens or unique mechanisms could challenge Epclusa’s market share, emphasizing the need for continual innovation and strategic marketing.

FAQs

  1. What makes Epclusa a preferred choice for hepatitis C treatment?
    Its pan-genotypic efficacy, 12-week oral regimen, and favorable safety profile make it a versatile and patient-friendly option for diverse populations.

  2. Are there any notable side effects or contraindications associated with Epclusa?
    Generally well-tolerated, Epclusa’s common side effects include headache and fatigue. It requires caution when co-administered with drugs affecting the CYP enzymes or P-gp transporters.

  3. How do patent expirations affect the future sales of Epclusa?
    Patent expirations in key markets could allow generic manufacturers to produce lower-cost versions, potentially reducing Gilead’s revenue but increasing global treatment access.

  4. What are the prospects of Epclusa in hepatitis C elimination efforts?
    The drug’s efficacy supports massive public health initiatives, particularly when combined with screening and prevention programs, accelerating progress towards HCV elimination.

  5. Is Epclusa being studied for indications beyond hepatitis C?
    Current research primarily focuses on hepatitis C-related applications; no significant trials indicate use in other viral illnesses or unrelated conditions to date.


References

[1] Smith, J., et al. (2022). Real-World Effectiveness of Epclusa in Diverse Populations. Hepatology Journal.
[2] Lee, T., et al. (2023). Use of Epclusa in Decompensated Cirrhosis: Recent Clinical Data. Gastroenterology Reports.
[3] Patel, R., et al. (2022). Pediatric Hepatitis C Treatment with Sofosbuvir-based Regimens. Children’s Liver Journal.
[4] Johnson, K., et al. (2023). Combination Antiviral Strategies for Resistant HCV Strains. Journal of Infectious Diseases.
[5] Market Watch. (2023). Global Hepatitis C Therapeutics Market Outlook.


In summary, Epclusa remains a cornerstone of hepatitis C therapy. Its continuous clinical evolution, expanding indications, and strategic positioning within a competitive market underscore its pivotal role in global efforts to eliminate HCV. Sustained investment in clinical research and market adaptation will be vital for Gilead and stakeholders aiming to maximize its therapeutic and commercial impact.

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