As early as next month, remaining excuses to not treat HCV will take a big hit when two powerful new antiviral medications arrive on the scene. While scientists aren’t exactly sure how peg-riba works, telaprevir and boceprevir, which come in pill form, specifically target enzymes HCV needs to replicate and survive. When either new drug is administered along with peg-riba, the regimen cures 75 percent of patients with the stubborn Genotype 1 strain of HCV—in only six months.
“When we’ve talked to [Genotype 1] patients in the past and we told them that they had around a 40 percent change of cure, that just doesn’t sound very good to many people, the way it does if you tell them you have a 75 percent chance of cure,” Dr. Andrew Muir of Duke University School of Medical says. Muir is the director of gastrointestinal research at Duke and co-authored research papers on telaprevir.
“From a public health standpoint, this is a major step forward for this disease in our field. This is the first change in treatment in a decade, and it really bumps up the response rate for most Americans with hepatitis C. This is huge.”
Southwest CARE Center in Santa Fe wrapped up a six-patient telaprevir trial April 25, and is testing other new antiviral treatment drugs this summer that could obviate the need for peginterferon, and injection-based HCV treatments in general.
“The stated goal of some [pharmaceutical] companies is to have what we have with HIV, a combination of three drugs in one pill, basically one pill a day, with success rates in the 80 percent range and [fewer side effects],” Dr. Trevor Hawkins, medical director of Southwest CARE Center, says. Hawkins is the principal investigator in the clinical trials.
Questions remain about how private insurance will deal with the drug—some may require that patients fail on the old drugs before getting authorization to use telaprevir or boceprevir, Thornton warns.
Nevertheless, health practitioners and treatment advocates involved with HCV issues say the new drugs “could change everything,” in the words of Levin.
“In theory, we could cure everybody in the United States over the course of the next 10 years,” Levin says, “If we had the right commitment to do it.” SFR