August 15, 2013
Chronic hepatitis C virus (HCV) infection could cause cirrhosis of the liver or liver cancer. Healthcare providers currently treat HCV infection with interferon, ribavirin, and one of two newer drugs telaprevir and boceprevir. This drug combination cures 6875 percent of HCV genotype 1, the most common strain of the virus. However, interferon causes many adverse reactions, leading researchers to search for a new drug that could eliminate interferon's use. Researchers led by Dr. Stefan Zeuzem of Goethe University Medical Center in Frankfurt, Germany, conducted clinical trials on two experimental drugs -- faldaprevir and deleobuvir -- against HCV genotype 1 (HCV 1).
The researchers randomly distributed 362 chronic HCV patients to one of five groups. Four groups received the two new drugs as well as ribavirin while the fifth group received only the two new drugs. Three months after treatment ended, researchers discovered that 5269 percent of patients who received all three drugs were cured depending on the dose and length of treatment. Only 39 percent of patients who did not receive ribavirin were cured. Virus subtype also affected treatment results; approximately 85 percent of patients with HCV 1b were cured three months after treatment compared to 47 percent of patients with HCV 1a.
The researchers have not determined the ideal treatment duration; study participants received drugs for 16 to 40 weeks. Zeuzem believed that 16 weeks of treatment might be enough for patients with HCV 1b. Current treatment lasts 48 weeks. Study participants experienced side effects, including rash, nausea, vomiting and diarrhea, but most considered them mild. Zeuzem acknowledged that questions remained and the drugs required additional trials.
The pharmaceutical company Boehringer Ingelheim funded the study.
The full report, "Faldaprevir and Deleobuvir for HCV Genotype 1 Infection," was published in the New England Journal of Medicine (2013; 369: (630-639), doi: 10.1056/NEJMoa1213557).