Two experimental therapies could revolutionize hepatitis C virus (HCV) treatment, experts said Wednesday. The new drugs also reportedly reduce disparities in treatment response rates between black HCV patients and white HCV patients.Advertisement
The new drugs, boceprevir and telaprevir, both work by blocking an enzyme HCV needs for replication. They nearly doubled the odds of achieving sustained viral response among treatment-naïve HCV patients, and they tripled the odds of SVR among patients who had failed to respond to treatment or suffered a relapse. The Food and Drug Administration is expected to approve both drugs in May. "Once these drugs are available, doctors are going to be overwhelmed" by patients requesting treatment, predicted Dr. Raymond Koff, a Hepatitis Foundation International board member.
The most difficult-to-treat form of HCV is also the most common -- genotype 1. Conventional therapy of peginterferon and ribavirin has a response rate of about 50 percent.
In a study of 1,097 treatment-naïve patients with HCV genotype 1, all were given standard therapy for the first four weeks. One-third then continued on that treatment, while two-thirds were given standard therapy in combination with different regimens of boceprevir. The boceprevir arms had SVRs of 63 percent and 66 percent, compared with 38 percent SVR for conventional treatment. In a second study involving 403 patients who had failed therapy or experienced a relapse, the boceprevir arms achieved 59 percent and 66 percent SVRs, compared with 21 percent on standard therapy.
Similar results for telaprevir were expected to be presented Thursday at a gathering of liver researchers in Berlin.
The two boceprevir studies, "Boceprevir for Untreated Chronic HCV Genotype 1 Infection
" and "Boceprevir for Previously Treated Chronic HCV Genotype 1 Infection
," were published in the New England Journal of Medicine
(2011;364:1195-1206 and 1207-1217, respectively).
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