Extended hepatitis C treatment after liver transplant beneficial for patients

May 3, 2010 By Leave a Comment

Washington, May 3 (ANI): A new study has shown that extending hepatitis C treatment for liver transplant patients beyond current standards results in high clearance rates of the hepatitis C virus from the blood, and a low relapse rate.

“We found that patients who achieved a sustained virological response were more likely to have had extended treatment after transplant,” said Matthew Moeller, gastroenterology fellow at Henry Ford Hospital and lead author of the study.

“In the study, we saw a trend toward decreased mortality as sustained virological response was found to be associated with a 100 percent five-year survival rate vs. 86 percent for those without,” Moeller added.

Although, statistically insignificant, the trend could show significance with longer follow-up and a larger sample size, said Moeller.

As part of the study, the researchers looked at 241 consecutive liver transplant patients from 1999-2006. Patients were offered treatment if they tested positive for hepatitis C, had recurrent hepatitis C with at least Stage I fibrosis on biopsy, and stable immunosuppression for a minimum of three months.

Patients received either non-pegylated interferon tiw or pegylated interferon weekly in combination with ribavirin.

Of the study patients with hepatitis C, 66 were eligible for treatment, and 22 achieved sustained virological response. Only two patients (8 percent) relapsed.

This is in contrast to typical relapse rates of 30-35 percent in non-transplant patients treated with standard therapy. Genotype 1 patients failed more than genotype 2 or 3 patients in achieving sustained virological response (27 percent vs. 70 percent).

Dr. Moeller noted that 35 percent of patients who went on to achieve sustained virological response first became virus-negative at or following week 24.

“Our results suggest that even if patients are positive at week 24, there is still a 35 percent chance that they can achieve sustained viral clearance with extended treatment,” said Dr. Moeller.

The results of the study were presented at the Digestive Diseases Week conference in New Orleans. (ANI)

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Added anti-viral boosts response, shortens hepatitis C treatment duration

May 2, 2009 By Leave a Comment

London, April 30 (ANI): A new study, conducted by researchers at the Duke Clinical Research Institute (DCRI), has found that adding the anti-viral drug telaprevir to a standard treatment for hepatitis C can shorten the duration of therapy and increase the number of patients who can be cured of their disease.

“Standard treatment for the most common type of hepatitis C is 48 weeks of a combination of two drugs, peginterferon alfa-2a and ribavirin, which cures less than half of patients and has significant side effects that make it very difficult for some patients to continue their treatment,” said John McHutchison, M.D., a hepatologist and gastroenterologist and researcher at the DCRI, and lead investigator on this study.

“Our study found that by combining the standard therapy with the direct anti-viral drug telaprevir, we could reduce the duration of treatment by 50 percent, to 24 weeks, and, at the same time, improve the cure rate by 50 percent,” he added.

Telaprevir is a protease inhibitor that works by blocking an enzyme that the hepatitis C virus needs in order to replicate itself.

In a randomized, Phase IIb, double-blinded, 37-center study of telaprevir in combination with peginterferon alfa-2a and ribavirin, the researchers examined the responses of 250 patients on four trial arms.

The researchers measured rates of sustained viral response – or SVR – defined as 24 weeks during which the hepatitis C virus remains undetectable in the body after the completion of therapy.

“We observed that 67 percent of patients who received standard therapy for 48 weeks in conjunction with 12 weeks of telaprevir were cured of their hepatitis C,” McHutchison said.

“The rate was 61 percent in the group that took the standard therapy for only 24 weeks in combination with 12 weeks of telaprevir, suggesting that many patients may respond to treatment in only six months as compared to about eleven months, which is significant for this patient population, because the side effects of treatment can be so intense,” McHutchison added.

McHutchison said that the group, which received standard therapy for up to 48 weeks had a sustained viral response rate of 41 percent.

He said that the most frequently reported adverse side effect associated with telaprevir was a rash that was manageable in some patients, but caused others to discontinue the treatment.

The findings have been published in the April 30, 2009 issue of the New England Journal of Medicine. (ANI)

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