Treatment for hepatitis C has improved greatly over the past few years -- and the future looks even brighter.
Right now treatment consists of a combo of interferon, ribavirin and two new drugs: Olysio (simeprevir) and Sovaldi (sofosbuvir).
But a major concern with this combination is that interferon comes with a lot of side effects. Interferon also must be taken by injection -- much more inconvenient than swallowing a pill.
Experts are hopeful that future drug combos will successfully treat hepatitis C without interferon.
Sovaldi is the first drug approved to treat some types of hepatitis C without interferon. But the types of hepatitis C treated by interferon-free Sovaldi -- genotypes 2 and 3 -- are not that common in the U.S. Most Americans have genotype 1.
Studies are now testing Olysio for use without interferon.
Hopes for More Effective Treatments
A study in the New England Journal of Medicine shows that Sovaldi and another experimental drug, daclatasvir, could wipe out the hepatitis C virus in almost all patients -- even those most difficult to treat.
After 12 weeks of treatment with these two drugs, which have fewer and much milder side effects than previous treatments for hepatitis C, 98% of patients showed no evidence of the virus in their blood.
Even patients who weren't helped by a standard three-drug combination of interferon, ribavirin, and one of the newer antivirals had a 98% cure rate with Sovaldi and daclatasvir.
"This research tells us that we can cure almost all patients with hepatitis C," says Ira Jacobson, MD. He's the chief of gastroenterology and hepatology at the Joan and Sanford I. Weill Medical College of Cornell University. "We're still awaiting study results on another difficult group of patients -- those with cirrhosis. These patients have never responded as well to interferon-based therapy. But early indications are very promising that this combination will be extremely effective for these patients as well."
The Road Ahead
Experts predict that an interferon-free combination treatment for most hepatitis C patients will be approved by the FDA in the next few years.
"This will mean that many patients can go from as many as 18 pills a day, plus one injection a week, plus medications to manage side effects, down to only one or two pills a day and no injections," says Jonathan M. Fenkel, MD. He's the director of the Jefferson Hepatitis C Center at Jefferson University Hospitals.
And that's just the beginning. "We're expecting around 20 more medications for hepatitis C to be approved in the next 4 to 5 years," Fenkel says. There are more than 75 new hepatitis C drugs under development by different companies. "There's a lot of anticipation and expectation."