Hepatitis C: The Pace of Progress
The good news is that the guidelines may once again be revised. Preliminary results reported here have documented superior efficacy and tolerability of novel therapeutic strategies based on several new antivirals.
The first is simeprevir, a potent, once-daily oral investigational NS3/4A protease inhibitor that was shown to be effective in treatment of genotype 1 infection both in treatment-naive patients and nonresponders when coadministered with standard therapy (peginterferon and ribavirin).
The second agent is sofosbuvir, a nucleotide analog that inhibits NS5B-directed HCV replication, which was also shown to be highly effective. This drug in combination with standard therapy was associated with SVR rates of 90% at 12 weeks post-treatment compared with 58% in placebo-treated patients.
Most reported adverse effects were associated with peginterferon and ribavirin and not with new agents. Thus, these drugs represent an advance in management capable of inducing high sustained response rates with a shorter duration of therapy, better tolerability, and no resistance development, but they still require the addition of interferon to the regimen.
Next-in-Line Antivirals: Simeprevir and Sofosbuvir
The good news is that the guidelines may once again be revised. Preliminary results reported here have documented superior efficacy and tolerability of novel therapeutic strategies based on several new antivirals.
The first is simeprevir, a potent, once-daily oral investigational NS3/4A protease inhibitor that was shown to be effective in treatment of genotype 1 infection both in treatment-naive patients and nonresponders when coadministered with standard therapy (peginterferon and ribavirin).
The second agent is sofosbuvir, a nucleotide analog that inhibits NS5B-directed HCV replication, which was also shown to be highly effective. This drug in combination with standard therapy was associated with SVR rates of 90% at 12 weeks post-treatment compared with 58% in placebo-treated patients.
Most reported adverse effects were associated with peginterferon and ribavirin and not with new agents. Thus, these drugs represent an advance in management capable of inducing high sustained response rates with a shorter duration of therapy, better tolerability, and no resistance development, but they still require the addition of interferon to the regimen.