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More Drugs Show Promise in Fighting Hepatitis C

Faldaprevir and deleobuvir are part of effort to develop treatments that avoid harsh side effects
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In the new study, funded by drugmaker Boehringer Ingelheim, German researchers tested two experimental drugs called faldaprevir and deleobuvir against hepatitis C genotype 1.

The investigators randomly assigned 362 patients to one of five groups. Each group received the two new drugs. Four groups also took ribavirin, while the fifth did not.

In the end, the ribavirin proved necessary, Saag pointed out. Three months after their treatment ended, anywhere from 52 percent to 69 percent of patients on all three drugs were hepatitis free, depending on the dose and how long they took the medications.

In contrast, only 39 percent of patients who did not take ribavirin were free of the virus.

The benefits also depended on which virus subtype patients had. Of those with genotype 1b, up to 85 percent were hepatitis free three months after treatment. That compared with no better than 47 percent of patients with type 1a.

"That's to be expected," Saag said. "Type 1b is just easier to treat in general."

There are still questions, and later-stage trials of the new drugs are continuing, said study leader Dr. Stefan Zeuzem, of Goethe University Medical Center, in Frankfurt.

The ideal treatment time, for example, is not clear. The study patients took the drugs for 16 to 40 weeks. But for patients with type 1b, 16 weeks might be enough, according to Zeuzem.

That compares with up to 48 weeks with standard treatment.

As for side effects, nearly all of the study patients had some, including rash, nausea, vomiting and diarrhea. But for most, those problems were mild, Zeuzem's team noted.

"Interferon side effects are certainly worse than side effects observed with faldaprevir and deleoprevir," Zeuzem said.

"It looks like severe side effects were not common," Saag agreed. But, he said, "the main problem with these drugs is that you still have to use ribavirin."

Ribavirin is more tolerable than interferon, but it destroys red blood cells and can cause serious fatigue and other problems.

"Ideally, you'd like drug regimens without ribavirin," Saag said. The good news, he added, is that those are on the way.

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