January 20, 2012
A combination of antiviral drugs boosted treatment results for hepatitis C virus (HCV) patients who had been unresponsive to previous therapy, according to a preliminary study.
The open-label, Phase 2a trial involved 21 patients with chronic HCV who were randomly assigned to receive two antivirals, the NS5A replication complex inhibitor daclatasvir (60 mg once daily) and the NS3 protease inhibitor asunaprevir (600 mg twice daily), either alone or in combination with peginterferon alfa-2a and ribavirin.
Among those receiving only the two antivirals, 36 percent had a sustained virologic response (SVR) over 24 weeks of treatment. All but one of the patients on the four-drug combination achieved SVR after 24 weeks. Patients with HCV genotype 1b had a particularly strong response to the antivirals. Studies are ongoing to further evaluate combinations of antivirals against HCV.
"Overall, these results suggest that further research with combinations of direct-acting antiviral agents, with or without [interferon] and ribavirin, is warranted," wrote lead study author Dr. Anna S. Lok, of the University of Michigan Medical Center, and colleagues.
"We are on the threshold of a treatment revolution that will greatly improve the effectiveness of [HCV] therapy by dramatically increasing the number of persons treated," Dr. Raymond T. Chung, director of hepatology at Massachusetts General Hospital, wrote in an accompanying editorial.
The report, "Preliminary Study of Two Antiviral Agents for Hepatitis C Genotype 1," and the editorial, "A Watershed Moment in the Treatment of Hepatitis C," were published in the New England Journal of Medicine (2012;366:216-224 and 273-275, respectively).