Investigational drugs for hepatitis C

Flisiak, Robert; Parfieniuk, Anna

doi:10.1517/13543780903431034

Cited by 41 publications

(12 citation statements)

References 37 publications

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“…Studies are mostly directed at patients infected by HCV genotype 1 [158]. Phase III clinical trials combining pegylated IFN-a, ribavirin, and a direct acting antiviral of the HCV protease inhibitor family (telaprevir or boceprevir) have been completed.…”

Section: Perspective Of Triple Therapy With Peg-interferon Ribavirinmentioning

confidence: 99%

EASL Clinical Practice Guidelines: Management of hepatitis C virus infection

2011

Journal of Hepatology

966

306

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Section: Perspective Of Triple Therapy With Peg-interferon Ribavirinmentioning

confidence: 99%

EASL Clinical Practice Guidelines: Management of hepatitis C virus infection

2011

Journal of Hepatology

966

306

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“…Although Peg-interferon and ribavirin probably remain a cornerstone of therapeutic regimens in the short-term, combinations of antiviral drugs of different classes, possibly associated with new agents that target host factors or increase antiviral defenses, will create future treatment options. 94,95 Recommendations for treatment of thalassemia patients with chronic HCV hepatitis 18. Combination therapy with Peg-interferon plus ribavirin should be suggested to patients with HCV chronic hepatitis or compensated cirrhosis (moderate quality of evidence in thalassemia patients).…”

Section: Recommendations For Virologic and Clinical Evaluation Of Thamentioning

confidence: 99%

Management of chronic viral hepatitis in patients with thalassemia: recommendations from an international panel

Marco

Capra²,

Angelucci³

et al. 2010

Blood

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IntroductionIn the last 4 decades, regular blood transfusions and chelation therapy have improved the survival of patients with thalassemia major. 1-3 Despite the progress on chelation therapy, cardiac complications remain the main cause of death among transfusiondependent thalassemia patients related to the susceptibility of cardiac cells to iron overload toxicity. 4,5 The interest in the clinical management of chronic liver diseases has been increasing, however, because of the high prevalence of viral infections in adult transfusion-dependent thalassemia patients and the central role of the liver in regulating the iron metabolism. 5,6 The assessment of heart and liver iron overload is required to tailor iron chelation therapy. Furthermore, the diagnosis of hepatitis B virus (HBV)-or hepatitis C virus (HCV)-related chronic hepatitis is required to identify patients who have a high risk of developing liver complications and who may obtain a benefit by antiviral therapy.The goals of this paper are to summarize the epidemiology and the risks of transmission of viral infections, to analyze invasive and noninvasive methods for the diagnosis of chronic liver disease, to report the knowledge on clinical course of chronic viral hepatitis, and to suggest the management of antiviral therapy. For personal use only. on May 12, 2018. by guest www.bloodjournal.org From An expert hepatologist prepared an initial draft based on systematic review of published literature by Medline search on viral hepatitis in thalassemia patients, examined recently published guidelines on the diagnosis, management, and treatment of chronic hepatitis B and chronic hepatitis C edited by the American Association for the Study of Liver Diseases, the European Association for the Study of the Liver, and the Asian-Pacific Association for the Study of the Liver 7-10 and the Consensus Development Conference sponsored by the National Institutes of Health. 11 Recommendations of the panel of experts were based insofar as possible on evidence from publications that reported data on thalassemia patients. If evidence from thalassemia patients was unavailable, the panel selected recommendations from published guidelines that were suitable for thalassemia patients. Recommendations were evaluated according to the Grading of Recommendations Assessment Development and Evaluation system and classified into 3 levels: high, moderate, or low 12 (Table 1). For each recommendation, the level of evidence (high, moderate, or low) and population studied (general population of patients with viral chronic hepatitis or thalassemia patients) was specified. The panel of experts discussed the draft issue by issue, and 3 experts on blood transfusion, iron metabolism, and viral hepatitis management reviewed the recommendations. Finally, 8 international external experts in pediatrics, hematology, and viral hepatitis reviewed and criticized the recommendations. Methods Results What proportion of thalassemia patients have chronic viral infections?Worldwide, from 0.3% to 5.7% of thala...

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“…Very recently, several progresses have been made in the development of new treatments, such as new specific inhibitors or direct antiviral agents that are active against hepatitis C virus. Many studies, mostly conducted in patients infected by HCV genotype 1 who were naïve to the treatment, showed an increase in the SVR rate of 27-31% [38]. Previous relapse patients show very high SVR rates of 75%-86%, while response rates are lower for partial responders (>2 log decline in HCV RNA at 12 weeks of prior therapy) [50-60%) and previous nonresponder patients (33%, data only for telaprevir) [38][39][40].…”

Section: Individualised Therapy For Chronic Hepatitis C and Future Pementioning

confidence: 99%

“…Many studies, mostly conducted in patients infected by HCV genotype 1 who were naïve to the treatment, showed an increase in the SVR rate of 27-31% [38]. Previous relapse patients show very high SVR rates of 75%-86%, while response rates are lower for partial responders (>2 log decline in HCV RNA at 12 weeks of prior therapy) [50-60%) and previous nonresponder patients (33%, data only for telaprevir) [38][39][40]. Even though there are no data demonstrating the efficacy and toxicity of such drugs in elderly population, avoid antiviral therapy due to the advanced age is far from the good practice that should inspire clinicians.…”

Section: Individualised Therapy For Chronic Hepatitis C and Future Pementioning

confidence: 99%

Management of HCV Infection in the Elderly

Romano¹,

Vendemiale²

2013

Practical Management of Chronic Viral Hepatitis

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Among younger people HCV infection declines [1]. HCV infections are common worldwide. It is estimated that about 3% of the world's population have HCV. There are about 4 million carriers in Europe alone. The prevalence of HCV in the general population varies widely across European countries, with ranges from 0.4% in Sweden, Germany and the Netherlands to over 20% in one region of Italy. According to an American National Health survey, the prevalence of HCV infection in elderly population varies from 0,9 % to 1.0% in subjects who were, respectively, in the age groups of 60-69 years and 70 years and more [2]. In general, countries in the southern part of Europe have a higher HCV prevalence compared to countries in the north or west of the EU. Italy in particular has a high general population prevalence of HCV, much higher than the country's estimated HBV prevalence [3]. In a large Italian study conducted among 1646 subjects, seroprevalence of HCV antibodies were found between 5% and 2% in patient ranging respectively, 58 to 67 years and 68 to 77 years [4].

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Investigational drugs for hepatitis C

Abstract: In coming years, we can expect that triple therapy becomes a standard medication, and treatment without interferon and/or ribavirin becomes a new studied therapeutic scenario.

Cited by 41 publications

References 37 publications

EASL Clinical Practice Guidelines: Management of hepatitis C virus infection

EASL Clinical Practice Guidelines: Management of hepatitis C virus infection

Management of chronic viral hepatitis in patients with thalassemia: recommendations from an international panel

Management of HCV Infection in the Elderly

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