What is Hepatitis C and Why Should You Care?



How Hepatitis C Is Treated

Direct-Acting Antiviral Medicines

In the last decade, the Food and Drug Administration (FDA) has approved a number of new oral drugs to help treat hepatitis C, called direct-acting antiviral medicines.

Which medication you’re prescribed and the length of your treatment will depend on:

  • Which hepatitis C genotype you have
  • How much liver damage you have
  • Whether you have been treated for hepatitis C in the past (6)

These medications include the following:

Simeprevir (Olysio) is part of a class of drugs called protease inhibitors, which block a specific protein that HCV needs to replicate. Approved to treat HCV genotype 1, simeprevir is a once-a-day pill. Taken for 12 weeks along with the drug sofosbuvir (Sovaldi), it has had cure rates greater than 90 percent. It may also be used with interferon and ribavirin for hepatitis C genotype 4. (7)

Sofosbuvir (Sovaldi) is part of a class of drugs called polymerase inhibitors, which block another protein that HCV produces. It's approved to treat genotypes 1, 2, 3, and 4. In clinical trials, regimens containing sofosbuvir had cure rates ranging from 56 percent to over 90 percent. A study published in November 2019 in theWorld Journal of Virologyfound comparable real-world cure rates for these regimens. (8) Depending on the needs of the patient, sofosbuvir is taken in combination with pegylated interferon and ribavirin, ribavirin alone, or, increasingly, in combination with other antiviral drugs (9).

Harvoni was approved by the FDA in 2014. It’s a combination drug for hepatitis C genotype 1, 4, 5, or 6 that includes sofosbuvir and ledipasvir. Most patients take a 12-week course of pills, but some may be prescribed in 8-week or 24-week courses. In clinical studies, cure rates ranged from 93 to 100 percent. (10)

Viekira Pak(ombitasvir/paritaprevir/ritonavir and dasabuvir), an interferon-free cure for hepatitis C genotype 1, was approved by the FDA in December 2014. This combination drug includes ombitasvir, paritaprevir, and ritonavir tablets, combined with dasabuvir tablets. Viekira Pak, taken for 12 to 24 weeks, was shown to be more than 95 percent effective against HCV genotype 1, according to a report in theNew England Journal of Medicine. (11)

Daklinza(daclatasvir) was FDA-approved in 2015 for use in combination with sofosbuvir or sofosbuvir and ribavirin to treat HCV genotype 3 infections. Daklinza is the first drug that was shown to be safe and effective in treating genotype 3 without needing to be administered with interferon or ribavirin. In patients without cirrhosis, clinical trials demonstrated that 98 percent of patients who hadn’t been treated before achieved SVR. It has since been approved to treat genotype 1 as well. (12)

Technivie(ombitasvir/paritaprevir/ritonavir) is a combination drug approved in 2015. It consists of drugs similar to those in Viekira Pak but approved to treat genotype 4. It was the first treatment option for genotype 4 that didn’t require co-administration of interferon. (12)

Zepatier(elbasvir/grazoprevir) is a once-daily pill to treat genotypes 1 and 4 that was approved by the FDA in 2019. It may be given in combination with ribavirin. (12) In studies, patients with genotype 1 chronic hepatitis C, 94 percent to 97 percent were cured and 97 percent to 100 percent of patients with genotype 4 chronic hepatitis C infection were cured. (13)

Epclusa(sofosbuvir/velpatasvir) is a once-daily, fixed-dose combination tablet that was approved in 2019 for treatment of all genotypes, 1 through 6. A 12-week treatment was approved in patients without cirrhosis or with compensated cirrhosis, and in combination with ribavirin for patients with advanced cirrhosis. In clinical trials of patients without cirrhosis or compensated cirrhosis, 98 percent were considered cured after treatment with Epclusa. In patients with decompensated cirrhosis, those that received 12 weeks of Epclusa with ribavirin had a cure rate of 94 percent, compared with 83 percent for those who received Epclusa alone for 12 weeks. Those who received Epclusa alone for 24 weeks had an 86 percent cure rate. (12)

Vosevi(sofosbuvir/velpatasvir/voxilaprevir) is a combination drug that was approved by the FDA in 2019. It contains sofosbuvir and velpatasvir, as well as a new drug, voxilaprevir, to treat adults with chronic HCV genotypes 1 through 6 without cirrhosis or with mild cirrhosis. Vosevi is the first treatment approved for patients who have been previously treated with sofosbuvir or other drugs for HCV that inhibit a protein called NS5A. Clinical trials demonstrated that 96 percent to 97 percent of patients had no virus detected in the blood 12 weeks after finishing treatment. (14)

Mavyret(glecaprevir and pibrentasvir) was approved by the FDA in 2019 as the first treatment of eight weeks' duration for all HCV genotypes 1 through 6 in adults without cirrhosis who have not been previously treated. Before then, standard treatment length was 12 weeks or more. In clinical trials, 92 percent to 100 percent of patients who received Mavyret for 8, 12 or 16 weeks had no virus detected in the blood 12 weeks after finishing treatment.






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Date: 01.12.2018, 08:17 / Views: 64375