Most With Hepatitis C May Soon Find Hope in New Treatments
Two studies suggest pill cocktails may one day replace injections altogether
Sulkowski said 98 percent of the 126 previously untreated patients and 98 percent of 41 patients whose infections had not cleared despite treatment with standard hepatitis C therapy, were considered cured. "There was no detectable virus in their blood three months after the treatment stopped," he noted.
The U.S. Food and Drug Administration approved sofosbuvir in combination with peginterferon and ribavirin this past December for one form of hepatitis C, and daclatasvir is still in the approval process, Sulkowski said.
According to the U.S. Centers for Disease Control and Prevention, 3.2 million people in the United States have chronic hepatitis C infection. The virus is silent early on, but over two or three decades it can lead to severe liver damage, sometimes requiring a liver transplant. It's the leading cause of liver transplants in the United States.
Up until now, injectable interferon has been the key form of treatment, usually combined with antiviral medications, said Sulkowski, but many patients can't tolerate the side effects of the interferon, which can include flu-like symptoms, nausea, fatigue, anxiety and depression.
The second study, headed up by researchers at Virginia Mason Medical Center in Seattle, involved more than eight medical centers in the United States and internationally. It included 571 patients with hepatitis C, some of whom had not received treatment previously and others who had previously received standard treatments with interferon injections and ribavirin -- an antiviral drug that when given reduces relapses -- but had not responded to them.
The participants were randomly assigned to take any of three combinations of antiviral pills -- medications called ABT-450, ABT-267, and ABT-333 -- for eight, 12 or 24 weeks.
Almost all of the patients (more than 93 percent in both groups) saw the virus cleared from their systems within 24 weeks, said lead author Dr. Kris Kowdley, director of the liver center of excellence in the Digestive Disease Institute at Virginia Mason.
"Even in patients with prior no-response, a difficult-to-treat population with interferon, this all-oral regimen for 12 weeks can achieve a cure in the vast majority of patients. It is safe and well-tolerated," said Kowdley. "It really changes the paradigm for treatments."