Can Hep C Be Cured in Just Six Weeks?
Only five years ago, the medications prescribed to treat Hepatitis C were analogous to spinning the roulette wheel. The odds of eliminating the Hepatitis C virus used to hover around 50 percent; however, new drug combinations have dramatically increased the likelihood of viral elimination. Every fiscal period, the pharmaceutical industry is determined to one-up their competitor’s Hepatitis C offerings – and the length of time required for successful treatment might help determine the victor.
The evolution of Hepatitis C treatment is moving forward quickly, in several different realms. Thanks to new, antiviral drug combinations:
- the percentage of people able to eliminate the Hepatitis C virus from their body has skyrocketed from about 50 percent to 90 percent or more.
- Hepatitis C therapy’s side effects are less of an issue, as the newer drugs are associated with far less severe adverse effects.
- oral formulations have reduced the need for drug injections.
- regimens can be completed faster.
As evidenced by the protocol in the newest Hepatitis C cocktails, and confirmed by a poster presentation at the most recent European Association of the Study of the Liver (EASL) meeting, the amount of time needed to complete a successful drug regimen keeps getting shorter.
- For over a decade, the Hepatitis C standard of care consisted of treatment with pegylated interferon and ribavirin. Although not its only drawback, the duration of this treatment was considered grueling – lasting from six months to a year or more.
- Approved in 2011, Incivek and Victrelis were the next generation of Hepatitis C antiviral medications. While adding one of these drugs improved the treatment success rate, their duration of treatment also spanned between six months and a year.
- In 2013 and 2014, another generation of direct-acting antiviral medications were approved. Changing the odds of Hepatitis C treatment success to the 90th percentile, these drugs are today’s favorites and include Olysio, Sovaldi, Harvoni and Viekira Pak. Besides increasing the Hepatitis C cure rate, the new drug regimens are much shorter – spanning an average of just three months.
Although very expensive, the new, interferon-free direct-acting antiviral regimens taken for three months can cure a majority of people with Hepatitis C genotype 1 (the most common type in the U.S.). Nonetheless, researchers are working to develop new drugs requiring a shorter duration of treatment. The shorter duration is favorable because it is more convenient, will improve treatment adherence and can potentially lower treatment cost.
According to research by Edward Gane from Auckland Clinical Studies in New Zealand and colleagues, a Gilead triple drug combination appears to have cut the treatment duration in half.
Presented in April 2015 at the EASL 50th International Liver Congress in Vienna, a six-week regimen of Sovaldi plus two of Gilead’s experimental direct-acting antivirals cured more than 90 percent of a specific subset of Hepatitis C patients. Although six weeks was insufficient for some individuals, it was plenty of time to get a favorable treatment outcome for those:
- With Hepatitis C genotype 1
- Without liver cirrhosis
- Who have never tried Hepatitis C treatment before (treatment-naïve)
By combining medications that attack the Hepatitis C virus at three different points in its lifecycle, the researchers surmised that shorter treatment durations might be possible. Combined with Sovaldi, Gilead’s experimental NS5A inhibitor GS-5816 and HCV protease inhibitor GS-9857 posted the following results:
- In six weeks, 93 percent of treatment-naive participants without cirrhosis achieved sustained virological response (SVR) – no genetic particles of Hepatitis C detected in the blood 12 weeks after therapy’s completion.
- In six weeks, 87 percent of treatment-naïve participants with cirrhosis achieved SVR 12 weeks after therapy’s completion.
Adding to the excitement over these study results, treatment with this particular triple regimen was reported as generally safe and well tolerated.
Gilead’s two direct-acting antiviral drugs used in this trial (GS-5816 and GS-9857) are not FDA approved yet, but the preliminary data for this drug cocktail is encouraging. Hopefully, repeated studies will confirm the efficacy, safety and short duration requirement for this combination of medications. If so, Gilead will be changing the face of Hepatitis C treatment again – this time by providing an effective drug regimen in half the amount of time as is currently required.
http://www.biospace.com/news_story.aspx?StoryID=373700&full=1, Gilead (GILD)’s Hepatitis C Combo Shows Cure Rate of 93% At Six Weeks, Fails at Four, Retrieved May 10, 2015, biospace.com, 2015.
http://www.hivandhepatitis.com/hepatitis-c/hepatitis-c-topics/hcv-treatment/5207-easl-2015-gilead-triple-combination-cures-easy-to-treat-hepatitis-c-patients-in-6-weeks, EASL 2015: Gilead Triple Combination Cures Easy-to-Treat Hepatitis C Patients in 6 Weeks, Liz Highleyman, Retrieved May 10, 2015.