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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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.
Between 50 and 60 new hepatitis C drugs are currently in the pipeline, Saag said, and a couple are already under review by the FDA. One is sofosbuvir: In a recent trial, researchers found that sofosbuvir, along with ribavirin, cured about three-quarters of patients with genotype 2 or 3 hepatitis C.
But Saag predicted that in the next year or two, there will be oral drug regimens that bypass interferon and ribavirin altogether.
"There should be a lot of new options for hepatitis C patients in the next couple years," he said. These new findings, Saag added, "are an important step. But they are not the final step."
In the United States, an estimated 3.2 million people are living with chronic hepatitis C -- most of whom do not know it. Because of that, the U.S. Centers for Disease Control and Prevention recommends that baby boomers (people born between 1945 and 1965) be tested for the virus.
Injection drug abuse is now the top risk factor. But people who had a blood transfusion before 1992 are also at risk, because that predated widespread hepatitis C screening. In a small number of cases, the virus is transmitted during sex.