Trio Treatment Showed Promise for Hep C

Hepatitis C treatment with daclatasvir, asunaprevir and beclabuvir appeared effective in patients with and without liver cirrhosis

(RxWiki News) Three may be a crowd when it comes to company, but it might be an ideal number when it comes to medication for treating hepatitis C.

Two new international studies found that a combination of three medications showed success when treating hepatitis C — in patients with and without serious liver scarring (cirrhosis).

"Chronic hepatitis C virus (HCV) infection remains a substantial cause of chronic liver disease, affecting approximately 130 to 150 million individuals worldwide," explained the authors of one of these new studies, led by Andrew J. Muir, MD, of Duke University Medical Center in Durham, NC.

HCV is a chronic infection in the body that can cause disease and serious damage in the liver over time. Both new studies explored a combination treatment for the condition in patients from the US, Canada, France and Australia. One of these studies, led by Fred Poordad, MD, of the University of Texas Health Science Center in San Antonio, involved 312 hepatitis C patients who had never received treatment and 103 who had been treated.

These patients were given a combination of three medications — daclatasvir, asunaprevir and beclabuvir (DCV-TRIO) — twice a day. After 12 weeks, 91.3 percent of these patients had a sustained virologic response (SVR). This means that the level of hepatitis C in their blood was either undetectable or at very low levels.

Dr. Poordad and team recorded an SVR in 92 percent of the patients who had never received treatment before and 89.3 percent of patients who had past treatment.

In the other study, led by Dr. Muir, the 202 patients had cirrhosis. Among these patients, 112 had never received treatment and 90 had received past treatment.

Some of the patients in Dr. Muir's study also received the medication ribavirin (brand names Copegus, Virazole, Rebetol), a common hepatitis C treatment, alongside DCV-TRIO.

Among those who had never been treated before, 93 percent of the patients on DCV-TRIO and 98 percent on DCV-TRIO plus ribavirin achieved an SVR after 12 weeks. For those who had past treatment, 87 percent on DCV-TRIO and 93 percent on DCV-TRIO plus ribavirin achieved an SVR.

In an editorial about these studies, Hari Conjeevaram, MD, of the University of Michigan, said these studies were a part of changing resources for treating hepatitis C.

These treatments have revolutionized management of the condition for patients both with and without significant liver damage, Dr. Conjeevaram said. However, Dr. Conjeevaram stressed that more needs to be done about hepatitis C.

"Despite the progress and the success of viral eradication, numerous questions remain unanswered such as response based on race, still difficult-to-treat situations such as patients with end-stage liver disease or undergoing hemodialysis, access to and affordability of these therapies, improvement in quality of life, and cost-effectiveness," Dr. Conjeevaram wrote. "It is time to reflect on these challenges and find solutions because the influence of HCV infection on global society is an ongoing challenge."

These studies and the editorial were published May 5 in JAMA.

Bristol-Myers Squibb, a pharmaceutical company, funded and co-designed both studies with several overlapping authors. In both cases, study authors reported a variety of professional and monetary ties to Bristol-Myers Squibb and similar companies.

Review Date: 
May 4, 2015