Monday, May 18, 2015

SVR durability using new interferon-free DAAs in comparison to SVR with interferon-based regimens

SVR durability using new interferon-free DAAs in comparison to SVR with interferon-based regimens

In this month's issue of HCV Next, Michael S. Saag, MD., writes about SVR durability using new all-oral, interferon-free DAAs in comparison to SVR with interferon-based regimens, noting some experts suggest there may be a difference.

Here is the editorial;The Unintended Consequences of Conservatism

Each issue of "HCV Next" offers information on a range of topics which include hepatitis C therapies, side effects, drug/drug interaction, guidelines, fatty liver disease and more.

Check out the following articles that appeared in the May 2015 print edition of HCV Next published online at Healio.

Table of Contents

Why should we doubt that SVR due to DAA therapy is any different than an SVR obtained with interferon-based therapy?

A Conversation with Andrea L. Cox, MD, PhD
Many organizations, including the CDC, have endorsed expanding widespread screening for hepatitis C virus, but experts writing in The BMJ warn that physicians should resist screening until more evidence on the risk-benefit ratio and long-term clinical improvements with antiviral therapy becomes available.

A number of recent studies demonstrated that, when treated with direct-acting antivirals, there were comparable response rates in patients with hepatitis C virus genotype 4 as those reported for other genotypes. That is, upward of 95%. However, experts remain confounded by a host of obstacles that stand in the way of marginalizing — or eradicating — hepatitis C virus genotype 4.

Model Accurately Predicts Rapid Response in HCV at 4 Weeks
Multiple variables, including IL28B genotype with viral load, HCV genotype, Forns’ Index and HIV coinfection were used to construct a model that accurately predicted virological response at 4 weeks in patients with hepatitis C virus infection treated with pegylated interferon alfa-2a and ribavirin, according to study data.

PAD Risk Higher for Patients with HCV
Hepatitis C virus infection was associated with a greater risk for peripheral arterial disease, or PAD, in Taiwanese patients, with a nearly 12-fold increased risk in patients older than 65 years, according to study data published in theJournal of Hepatology.
In a prospective cohort study, patients who experienced hepatitis C virus infection clearance after treatment with pegylated interferon and ribavirin also had improved mixed cryoglobulinemia, according to data published in Hepatology.
HCV and Metabolic Syndrome
Studies have shown that HCV may directly influence glucose metabolism, increase the risk for diabetes and predispose patients to obesity. Beyond the metabolic factors, patients with chronic HCV and insulin resistance may have higher viral loads based on retrospective studies.

FDA Warns of Hepatic Failure, Bradycardia with Simeprevir
The FDA has approved changes to the warnings and precautions label for simeprevir for the treatment of hepatitis C virus infection, indicating that it can cause hepatic decompensation and failure, and serious symptomatic bradycardia when co-administered with sofosbuvir and amiodarone, according to a news release from the FDA.

Rapid HCV Test gets European Approval

FDA Grants New Breakthrough Therapy Designations for Grazoprevir/Elbasvir
The FDA originally granted breakthrough therapy designation for the drug combination in October 2013. However, in February, Merck announced the FDA’s intent to rescind that designation due to the availability of other new drugs for HCV. The new breakthrough designations for grazoprevir and elbasvir (MK-5172, MK-8742; Merck) are geared towards treating patients with chronic HCV genotype 1 with end-stage renal disease on hemodialysis and patients with chronic HCV genotype 4, according to the release.
The Japanese Ministry of Health, Labour and Welfare has approved sofosbuvir to suppress viremia in patients with chronic hepatitis C virus genotype 2 infection, with or without compensated cirrhosis, according to a press release from the drug maker.

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