New Hepatitis C treatment shows remarkable efficacy

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After 20 years of intense research, the first two antiviral drugs (protease inhibitors) to treat hepatitis C, bocepravir (Victrelis, Merck) and telaprevir (Incivek, Vertex) were approved by the FDA one week apart. Incivek, the more potent of the two, may become the preferred first-line therapy for a disease that affects 4.5 million Americans, and as many as 200 million people worldwide. The infection, if left untreated, causes gradual deterioration of the liver, leading to cirrhosis, cancer, and end-stage liver disease. Hepatitis C, which is primarily spread by exposure to blood via injectable drug use and rarely (since 1989), blood transfusions, for instance is an enormous global health issue, with a prevalence about four times greater than that of AIDS.

When Incivak was added to interferon (the former standard of care), remarkable efficacy was observed. In a pilot study conducted to determine the optimal doses of the Incivek-interferon combination, 93 percent of the patients in the highest dose group had their viral levels drop below the limit of detection within 12 weeks. By 24 weeks, all signs of the virus were gone in every patient. By comparison, the previous standard of care, interferon and ribavirin, was about 40 to 50 percent effective, and the duration of therapy ranged from 6 to 12 months. Unlike AIDS, hepatitis C can be cured, a status defined as having no measurable levels of the virus six months after discontinuation of treatment.

It would seem, says ACSH's Dr. Josh Bloom, that one more deadly infectious disease is on the path to being conquered by the concerted efforts of molecular biology and medicinal chemistry within the pharmaceutical industry.