Interferon-Free Treatments Are Imminent for Hep C
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Composing one half or one third of the currently prescribed Hepatitis C therapy regimens, interferon is a fierce drug. Due to an inability to tolerate interferon, many people are deemed “non-responders” to Hepatitis C treatment. Luckily, there are a handful of interferon-free treatment regimens in trials that are showing great promise for previous non-responders.
We are witnessing an exciting time in Hepatitis C treatment progress. Combination therapy with pegylated interferon and ribavirin long stood as the standard of care for chronic Hepatitis C infection. Effective in achieving a cure in about half of those on the treatment, these drugs are associated with extremely challenging side effects.
Administered as an injection, interferon has been used since the late 1980s in the treatment of chronic Hepatitis C. Improving its usability, pegylated interferon rendered the drug long-acting. Adding orally administered ribavirin dramatically increased interferon’s efficacy in clearing Hepatitis C. Although interferon is still standard in the treatment of chronic Hepatitis C, its side effects can be brutal. Common interferon-related side effects include:
- Headache
- Fatigue
- Muscle and joint pain
- Fever
- Nausea
- Low appetite
- Diarrhea
- Depression
- Irritability
- Insomnia
- Skin itching and rash
- Hair loss
- Cough and chest pain
- Shortness of breath
- Anemia (suppression of bone marrow’s production of red blood cells)
- Neutropenia (suppression of bone marrow’s production of leukocytes)
- Thrombocytopenia (suppression of bone marrow’s production of blood platelets)
- Visual changes
- Thyroid problems
In the spring of 2011, Hepatitis C treatment leapt forward with the approval of two new drugs, telaprevir and boceprevir. These direct-acting, antiviral, protease inhibitors increase the effectiveness of interferon and ribavirin in a shorter amount of time. However, interferon’s side effects remain a major reason people either are not candidates for, or delay or refuse treatment. Thus, effective, safe, interferon-free treatment regimens represent the current goal of drug manufacturers, fueling a majority of today’s Hepatitis C research.
Finally, the quest to produce an interferon-free drug protocol appears within Western medicine’s reach. Data from various studies in the first part of 2012 has brought great expectation to the future of Hepatitis C treatment. With heavy investing in this arena, keep an eye out for progress from the following list of hopefuls from seven different pharmaceutical companies:
- Bristol-Myers Squibb – Asunaprevir and Daclatasvir
- Roche – Danoprevir and Mericitabine and Setrobuvir
- Merck – Vaniprevir
- Boehringer Ingelheim – BI 201335 and BI 207127
- Janssen – TMC435
- Gilead – GS7977 and Tegobuvir
- Vertex – VX-222
Although not a comprehensive list, three examples of encouraging preliminary trial results are:
- As reported in April of 2012, an interferon-free combination of BI 201335, BI 207127 and ribavirin given for 12 weeks yielded a 68 percent success rate in those with Hepatitis C genotype 1.
- As reported in early 2012, combination therapy with asunaprevir and daclatasvir for 12 weeks suppressed Hepatitis C virus genotype 1 infection in 90 percent of previous non-responders.
- As reported in April of 2012 at the annual meeting of the European Association for the Study of the Liver, a preliminary study of mericitabine, danoprevir and ribavirin showed over a 70 percent success rate against treatment naïve Hepatitis C genotype 1.
Although experts believe it may be another three to five years for the first interferon-free combinations for Hepatitis C infection to become available, they agree that more effective, easier to tolerate treatment cocktails are undoubtedly on their way.
References:
http://www.aidsmap.com/Full-speed-ahead-to-curing-hep-C/page/2368492/, Full Speed Ahead to CURING Hepatitis C, Liz Highleyman, Retrieved July 1, 2012, NAM Publications, 2012.
http://www.gastroendonews.com/ViewArticle.aspx?d=Breaking+News&d_id=409&i=February+2012&i_id=809&a_id=20098, New Study of Interferon-free HCV Therapy Hailed as ‘Watershed Moment’ in Hep C Research, Christina Frangou, Retrieved July 1, 2012, McMahon Publishing, 2012.
http://www.hepatitis.va.gov/provider/reviews/treatment-side-effects.asp#S1X, Interferon and Ribavirin Treatment Side Effects, Retrieved July 1, 2012, US Department of Veteran Affairs, 2012.
http://www.hepcassoc.org/Hepatitiscnews-2012-feb9.html, Hepatitis C News, William F. Balistreri, MD, Hepatitis C Association, Inc, 2012.
http://www.natap.org/2012/EASL/EASL_52.htm, Interferon-Free Treatment with a Combination of Mericitabine and Danoprevir/R With or Without Ribavirin in Treatment-Naïve HCV Genotype 1-Infected Patients, Jules Levin, Retrieved July 1, 2012, EASL 47th Annual Meeting, 2012.
http://us.boehringer-ingelheim.com/news_events/press_releases/press_release_archive/2012/april_19_2012.html, Phase 2b Study of Boehringer Ingelheim’s Interferon-Free Hepatitis C Treatment Shows Undetectable Virus in HCV Genotype-1 Patients 12 Weeks After Treatment Ended (SVR12), Retrieved July 1, 2012, Boehringer Ingelheim GmbH, 2012.
