New Oral Hepatitis C Drugs: FAQ
Dec. 9, 2013 -- Experts call two new drugs for hepatitis C ''game changers" that they expect will dramatically improve treatment for many of the 3 million Americans with a chronic infection. Hepatitis C can lead to liver failure.
Both new pills -- Olysio (simeprevir) and Sovaldi (sofosbuvir) -- work better than the current treatment for hepatitis C. They cure it more often and in less time. They also have fewer side effects.
In a major advance, the drugs could eliminate the need for some patients to take interferon, which is injected and can have unpleasant, even intolerable side effects.
"Most hepatitis C patients and most physicians would like never to use interferon again,'' says Henry Masur, MD, past president of the Infectious Diseases Society of America.
The FDA approved both new oral drugs in combination with other drugs, he says. "Neither can be taken alone.'' The next question, he says, is "What is the best combination?''
Doctors hope -- and predict -- that the combinations deemed best will often exclude the need for interferon for more and more patients. But the new drugs are expected to be more expensive.
Here, three experts address questions they get from patients about the new options.
How do Olysio and Sovaldi work?
Both Olysio and Sovaldi prevent the virus from copying itself, Masur says.
What is each drug approved for?
Olysio is approved for people with genotype 1 infection (the most common type) in combination with the medicines ribavirin and interferon.
Sovaldi is approved for people with genotypes 1 and 4, in combination with interferon and ribavirin.
In a first, people with genotypes 2 and 3 can use Sovaldi with ribavirin alone. That means they will no longer have to take interferon.
How effective is each drug?
The two newest drugs have never been compared head to head, Masur says.
When they are added to the interferon and ribavirin, though, the success rate is significantly higher than the older regimen.
"Both drugs in general are better than what is available today," says Benedict Maliakkal, MD. He is director of hepatology and medical director of the liver transplantation program at Strong Memorial Hospital of the University of Rochester. He conducted clinical trials of both drugs. He is on the speaker's bureau for Merck, Genentech, and Vertex.
The older regimen -- interferon, ribavirin, and either Incivek or Victrelis – cures hepatitis C about 50% to 70% of the time, Masur says. Adding either of the two newest drugs to ribavirin and interferon instead produces a cure rate of about 80% to 95% or higher, he says.
"They will shorten the treatment time and increase the sustained response rate," Maliakkal says. That means you may not have to take medicine as long, and your chance of curing hepatitis C is greater.