As noted in numerous blog entries (see below), there has been increasing availability of new and more effective treatments for Hepatitis C virus (HCV). Two more drugs have promising results:
- NEJM 2013; 368: 34-44
- NEJM 2013; 368; 45-53
The first study provides encouragement with regard to sofosbuvir (previously known as GS-7977) which is a direct-acting nucleotide polymerase inhibitor targeting the NS5B polymerase.
In this open-label study, there were eight groups of patients. Of 40 previously untreated patients (genotype 2 or 3), all patients received sofosbuvir (400 mg daily) for 12 weeks. All 10 who received the study drug with ribavirin (& without interferon) and all 30 who received the study drug with ribavirin and peginterferon had a sustained virologic response (SVR) at 24 weeks. Among patients with sofosbuvir monotherapy, 6 of 10 had a SVR. Among HCV genotype 1 patients, 21 of 25 (84%) previously untreated patients had a SVR. The most common adverse effects were headache, fatigue, insomnia, rash and anemia.
The second study also was a phase 2a, open-label study for HCV genotype 1 non-cirrhotic patients using ABT-333 and ribavirin. ABT-333 is a nonnucleoside NS5B polymerase inhibitor. Results: 17 of 19 (89%) patients in group 1 (Rx with ABT-333, ribavrin, ABT-450, and ritonavir), 11 of 14 (79%) patients in group 2 (Rx with same drugs at lower doses of latter two drugs) had extended rapid virologic response. SVR was achieved in 95% and 93% respectively. Groups 1 and 2 were previously untreated. Group 3 were patients who had either a null or partial response to previous treatment achieved a 47% SVR. The most common adverse effects were abnormalities in liver function tests, headache, fatigue, insomnia, pruritus, nausea and rash.
These preliminary results suggest that Sofosbuvir is effective in all genotypes and may allow a short duration all-oral regimen. ABT-333 similarly is effective in an all oral regimen in genotype 1 patients.
Related blog posts:
- Pediatric HCV Guidelines | gutsandgrowth
- The cost of progress in treating Hepatitis C | gutsandgrowth
- Vaniprevir for HCV | gutsandgrowth
- Missing “C” | gutsandgrowth
- Case finding for hepatitis C | gutsandgrowth
- Unknown unknowns for Hepatitis C | gutsandgrowth
- Looking ‘Sily‘ taking this herb? | gutsandgrowth