New pills can help cure hepatitis C
Scientists have revealed that new two-pills-only antiviral drug regimens could provide shorter, more effective treatment options with fewer side effects for the majority of patients infected with hepatitis C.
According to researchers, these drugs can place a substantial burden on the patient, with complicated injection and pill regimens, which can involve up to 18 tablets a day and last for up to a year, and can also cause severe side effects including anaemia and depression. Direct-acting antiviral agents (DAAs) provide new opportunities for treatment whilst reducing the need for interferon and ribavirin and their potential side effects.
The scientists randomly assigned 645 patients with HCV genotype 1b from 18 countries to receive a 6-month course of treatment with a pair of oral DAAs asunaprevir and daclatasvir . A further 102 treatment-naive patients were assigned to a placebo control group.
The regimen was highly effective at clearing the virus and well tolerated even in patients who have traditionally been the hardest to treat. 90% of previously untreated patients and 82% who were intolerant of, or who had been treated unsuccessfully using standard regimens, were cured. No differences in response were seen in individuals who had characteristics such as being male, older, African American race, or having advanced liver disease—that are recognised as predictors of poor response to treatment.
Michael Manns from Hannover Medical School in Germany said that the efficacy and safety of 24 weeks of daclatasvir plus asunaprevir represents a huge improvement on the first generation of protease inhibitor based triple therapies for HCV genotype 1b infection (up to 48 weeks of boceprevir or telaprevir in combination with PEG/RBV). This new all-oral interferon and ribavirin-free combination could provide a more effective, safer, shorter, and simpler treatment option for those traditionally hard-to-cure patients with cirrhosis or those who have failed to respond to existing therapies.
The researchers saw a cure rate of about 93% with only 12 weeks of treatment using an all-oral regimen that did not include interferon or ribavirin.
The study was published in Lancet.
(Posted on 28-07-2014)
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