New Hepatitis C Drug Improves Quality of Life
March 8, 2002 -- Patients being treated for hepatitis C infection often feel the cure is worse than the disease. Common side effects of therapy - including severe fatigue and depression, flu-like symptoms, and anemia - cause many people to abandon therapy long before they should.
But company-sponsored research now suggests that a newly available form of a long-relied-upon treatment is not only more effective in clearing the hepatitis C virus (HCV) from the blood, it is also easier for people to tolerate. Those treated with the drug, known as pegylated interferon, reported having significantly better quality of life both during the 48-week course of treatment and after treatment ended. PEGASYS is the brand name of the drug used in this study.
Approximately 4 million people in the U.S., and 170 million people worldwide, are living with hepatitis C virus infection, although they often don't know it. Many do not learn they have the virus until symptoms of liver damage occur, a decade or more after infection. Although HCV infection is silent, its effects are often deadly. In the U.S., as many as 60% of deaths from cirrhosis, liver failure, and liver cancer are linked to HCV infection.
Just over a decade ago, doctors had little to offer those infected with the liver-destroying virus. With the introduction of interferon to hepatitis treatment in the early 1990s, 15-20% of people treated for a year achieved viral response considered to be a cure. That figure rose to 40% when the drug ribavirin was added to treatment a few years ago. The "cure" rate jumped to almost 60% for the pegylated interferon/ribavirin combination that became available in the U.S. late last year.
Pegylated interferon stays in the body longer than earlier forms of the drug, allowing it to be given as a weekly injection rather than three times a week.
In this study, published in the March issue of Hepatology, researchers studied 1,400 HCV patients treated with either pegylated interferon or a regular interferon.
Those treated with the pegylated interferon reported having more energy, less fatigue, less body pain, and fewer problems doing their job. People treated with the newer drug also were more likely to stick with their treatment, thus improving the response to the drug. The study was funded by drug manufacturer Hoffmann-La Roche Ltd, which makes the form of pegylated interferon used in the study.
"Outside of study groups, compliance has been a tremendous problem because people [with HCV infection] usually don't feel sick," says lead author David Bernstein, MD, of the North Shore - Long Island Jewish Health System. "If you have pneumonia and feel terrible, you are thrilled to take medicines that will make you better. But with hepatitis C, people feel fine and it is generally the treatment that makes them feel lousy."
Hepatitis specialist Bruce Bacon, MD, of Saint Louis University Medical Center, has been treating patients with the pegylated interferon/ribavirin combination since last summer. He says many tolerate the new therapy better than the old, while for others tolerance is about the same.
Bacon says he is using the new combination therapy to re-treat many people who did not achieve complete disappearance of the virus with older treatments.
"It is funny. I have some patients that I have been following for a decade, and when I tell them we are up to a 50% or 60% sustained response rate they are thrilled," Bacon tells WebMD. "But then when I see someone who just found out they are infected, they want to know why the treatments aren't more effective."