New Therapies in the Management of Hepatitis C Virus
New Therapies in the Management of Hepatitis C Virus
Purpose of review The present review discusses recent developments in drug discovery for hepatitis C. We are on the verge of a new era with the introduction of direct acting oral agents that will transform the treatment landscape. Both healthcare providers and patients need to stay abreast of these changes that will influence decisions to treat. This article will discuss the most promising up-to-date hepatitis C virus antiviral therapies in clinical investigation as well as the associated clinical trial results.
Recent findings First generation protease inhibitors will offer higher sustained viral response rates for both naive (70–80%) and treatment-experienced (40–50%) populations when added to standard pegylated interferon and ribavirin. However, these dramatic gains will be partially offset by new challenges with viral resistance and increased adverse events.
Summary There are currently a number of drugs under investigation that target the enzymes involved in hepatitis C virus replication. Year 2011 should bring the approval of the first generation of protease inhibitors that will offer higher cure rates for genotype 1 patients and open the door for the eventual testing of interferon-free regimens.
Hepatitis C virus (HCV) infection is a global problem with an estimated prevalence of 1.6% in the United States. The majority of patients acutely infected with HCV become chronically infected, which increases the risk of developing further complications associated with advanced liver disease. HCV-related end-stage liver disease is a leading cause of hepatocellular carcinoma and the most common indication for liver transplantation in the United States. Current standard therapy for HCV includes pegylated interferon (PEG-IFN) in combination with ribavirin (RBV), and this combination is effective in approximately 40–50% of genotype 1-infected patients and 80% of genotype 2-infected and 3-infected patients. Unfortunately, the majority of HCV patients in the United States are infected with genotype 1. The relatively low response rate in treating genotype 1-infected patients, in combination with the long treatment durations and adverse side effect profile has led to a relatively small minority of patients opting for treatment. However, the introduction of specifically targeted antiviral therapy (STAT-C) is now on the horizon with anticipated higher cure rates and the potential for shorter treatment duration. Approval of the first STAT-C compounds is expected by mid-2011 and many patients are being 'warehoused' in anticipation.
Abstract and Introduction
Abstract
Purpose of review The present review discusses recent developments in drug discovery for hepatitis C. We are on the verge of a new era with the introduction of direct acting oral agents that will transform the treatment landscape. Both healthcare providers and patients need to stay abreast of these changes that will influence decisions to treat. This article will discuss the most promising up-to-date hepatitis C virus antiviral therapies in clinical investigation as well as the associated clinical trial results.
Recent findings First generation protease inhibitors will offer higher sustained viral response rates for both naive (70–80%) and treatment-experienced (40–50%) populations when added to standard pegylated interferon and ribavirin. However, these dramatic gains will be partially offset by new challenges with viral resistance and increased adverse events.
Summary There are currently a number of drugs under investigation that target the enzymes involved in hepatitis C virus replication. Year 2011 should bring the approval of the first generation of protease inhibitors that will offer higher cure rates for genotype 1 patients and open the door for the eventual testing of interferon-free regimens.
Introduction
Hepatitis C virus (HCV) infection is a global problem with an estimated prevalence of 1.6% in the United States. The majority of patients acutely infected with HCV become chronically infected, which increases the risk of developing further complications associated with advanced liver disease. HCV-related end-stage liver disease is a leading cause of hepatocellular carcinoma and the most common indication for liver transplantation in the United States. Current standard therapy for HCV includes pegylated interferon (PEG-IFN) in combination with ribavirin (RBV), and this combination is effective in approximately 40–50% of genotype 1-infected patients and 80% of genotype 2-infected and 3-infected patients. Unfortunately, the majority of HCV patients in the United States are infected with genotype 1. The relatively low response rate in treating genotype 1-infected patients, in combination with the long treatment durations and adverse side effect profile has led to a relatively small minority of patients opting for treatment. However, the introduction of specifically targeted antiviral therapy (STAT-C) is now on the horizon with anticipated higher cure rates and the potential for shorter treatment duration. Approval of the first STAT-C compounds is expected by mid-2011 and many patients are being 'warehoused' in anticipation.
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