New and Noteworthy:
Telaprevir discontinued in Canada
Telaprevir (Incivek) has been discontinued in Canada as of January 1, 2015. Telaprevir is a first generation direct-acting anti-viral medication that is used in combination with peg-interferon and ribavirin to treat hepatitis C. The availability of new treatments for hepatitis C has resulted in a decreased demand for telaprevir.
The manufacturer has requested that doctors and nurses do not start any new patients on telaprevir. They have said they will make available enough medication for people who are already being treated with telaprevir.
Study shows one-third of people with cirrhosis progress to liver failure within five years
Almost one-third of people with severe liver damage (cirrhosis) progressed to liver failure (decompensation) within 5 years, reported researchers at the American Association for the Study of Liver Diseases (AASLD) Meeting in Boston.
This study included a large number of participants (2839 people) from the Chronic Hepatitis Cohort Study (CHeCS), which is an ongoing study of hepatitis C patients in four U.S. states. The researchers analyzed the number of cases of liver failure, liver cancer and other markers over an average of 5 and one half years.
The majority of participants were male, white and over the age of 50. The majority had mild (F0–F1) or moderate (F2) fibrosis when tested by liver biopsy. Cirrhosis (F4 fibrosis) occurred in 364 participants.
People with cirrhosis were five times more likely to experience liver failure than people with moderate liver damage (F2 fibrosis). People with cirrhosis who had been treated for hepatitis C were significantly less likely to develop liver failure than people who had not been treated (25% versus 50%). They were also less likely to develop liver cancer than people who had never been treated (approximately 7% versus 15%).
“We observed substantial liver disease progression in a population-based observational cohort among patients meeting liver disease stage criteria that now confer ‘high’ or ‘highest’ recommendation for treatment,” the researchers concluded. (HIVandHepatitis.com, December 2014, in English)
Harvoni cures most people with cirrhosis who have previously been treated
Treatment with Harvoni (ledipasvir + sofosbuvir) cured hepatitis C in 97% of people with cirrhosis who had previously been unsuccessfully treated with a first generation direct-acting anti-viral medication, reported researchers at the American Association for the Study of Liver Diseases (AASLD) Meeting in Boston.
All of the 155 participants had genotype 1 hepatitis C virus. The majority of the participants were white, male and over the age of 50. Most of the participants had relapsed when they were treated previously, which means they had an undetectable Hep C viral load while on treatment but the virus came back after the end of treatment. Only four participants had no response to previous treatment.
Participants were treated for 24 weeks with Harvoni or for 12 weeks with Harvoni and ribavirin. The cure rates were very similar between arms, with 97% being cured in the first arm and 96% being cure in the second arm. Both treatments were well tolerated with mostly mild or moderate side effects. The most common side effects were weakness, headache, itching, difficulty sleeping and nausea.