WEDNESDAY, March 30 (HealthDay News) -- Adding the new drug
boceprevir to the current two-drug treatment for hepatitis C
appears significantly more effective than the standard therapy,
according to two new studies.
The drugs now used to treat hepatitis C, a chronic liver
disease, are the antivirals peginterferon and ribavirin (Copegus,
Rebetol, RibaTab and Ribasphere). Combining them with the not-yet
approved drug boceprevir increased the response rate, researchers
say.
Merck, the manufacturer of boceprevir, funded both studies,
which are published in the March 31 issue of the
New England Journal of Medicine.
"Boceprevir, a protease inhibitor, along with peginterferon and ribavirin increases response rates in previously untreated patients," said Dr. Raj Reddy, co-researcher of one of the studies and director of hepatology and medical director of liver transplantation at the University of Pennsylvania in Philadelphia.
"Also, with this new strategy you have the potential of reducing the duration of therapy, from 48 weeks to 28 weeks," he added.
"We have turned the corner, a bit, and we have a combination treatment that is likely to be more effective in more people," he said.
For his study, 1,097 people, 159 of whom were black, who had not
been treated for hepatitis C were randomly assigned to one of three
groups. All groups were treated with peginterferon and ribavirin.
After four weeks, one group also received a placebo for 44 weeks;
another group had boceprevir added to their treatment for 24 weeks.
The third group was given the three drugs for 44 weeks.
Among non-black patients, 40 percent achieved a sustained
response to standard care. But as many as 68 percent of those also
receiving boceprevir achieved sustained response at 28 weeks, the
researchers found.
For black patients, the response rate was 23 percent for those
receiving standard care and up to 53 percent with the addition of
boceprevir.
The most severe side effect was anemia, which was seen in 13
percent of those receiving standard care and in 21 percent of those
receiving all three drugs, Reddy's team noted.
In the other study, a group led by Dr. Bruce R. Bacon, director
of the gastroenterology and hepatology division at St. Louis
University Health Sciences Center, tested boceprevir on 403
patients with chronic hepatitis C. These patients had been
previously treated with peginterferon and ribavirin.
Again, patients were divided into three groups similar to those
in the other study. For those receiving boceprevir, the response
rate was as high as 66 percent, compared with 21 percent for those
receiving only peginterferon and ribavirin, the researchers
found.
For patients who had no detectable hepatitis C RNA, the response
rate to boceprevir was as high as 88 percent, the researchers
noted.
As in the other study, anemia was the most serious side effect,
affecting up to 46 percent of those taking boceprevir and 21
percent of those on standard care.
"The addition of boceprevir to peginterferon-ribavirin resulted in significantly higher rates of sustained virologic response in previously treated patients with chronic HCV (hepatitis C) genotype 1 infection, as compared with peginterferon-ribavirin alone," the authors concluded.
Commenting on the studies, Dr. Donald M. Jensen, a professor of
medicine at the University of Chicago Medical Center and author of
an accompanying journal editorial, said "there is a significant
improvement in sustained response [with boceprevir], which really
relates to cure of hepatitis C."
Jensen noted that a similar drug is also being tested. "These
drugs will offer patients a significant advantage over current
therapy," Jensen said.
Hepatitis C affects at least 3.2 million Americans, according to
the U.S. Centers for Disease Control and Prevention. More than
12,000 people die each year from liver disease and cancer caused by
hepatitis C. There is no vaccine for hepatitis C, the researchers
note.
Many people with hepatitis C are symptom-free and don't know
they are infected, Jensen said. When symptoms do appear, it can be
too late to treat the disease effectively, and the only option then
is a liver transplant, he added.
More information
For more information on hepatitis C, visit the
U.S. National Library of Medicine.