New Treatments Coming for Hepatitis C

Horizons in Hemophilia, December 2009

By Jeff Cornett RN MSN, Director of Training, Research and Advocacy

Research findings presented at meetings of the National Hemophilia Foundation and the American Association for the Study of Liver Disease are good news for people with bleeding disorders and hepatitis C. That is because the research focuses on the success of new drugs, protease inhibitors against the hepatitis C virus (HCV), in overcoming infection with the subtype 1 form of HCV. People with bleeding disorders and hepatitis are most likely to have subtype 1. Subtype 1 is also the type least likely to respond to the current treatment of interferon and ribavirin.

One of the new drugs, the protease inhibitor telaprevir (also known as VX-950), is being developed and tested by Tibotec and Vertex Pharmaceuticals. They announced that a phase II clinical trial resulted in over 80% of those with HCV subtype 1 clearing the virus from their bodies after taking telaprevir in combination with interferon and ribavirin. The patients enrolled in this clinical trial had not previously tried any treatment for their hepatitis C infection.

Another clinical trial of telaprevir studied patients who had tried treatment with interferon and ribavirin but who had failed to clear the virus. In this trial, 40% of the patients who had failed to clear the virus before were able to do so after adding telaprevir to the treatment. In addition, 76% of "relapsed" patients - those who had previously had a drop in the amount of virus when taking interferon/ribavirin only to see the virus rebound - were able to overcome the virus with telaprevir.

Similar results were obtained in clinical trials of a hepatitis C protease inhibitor being developed by Schering-Plough. It is called boceprevir.

Dilip Moonka, a liver specialist and the Medical Director of Liver Transplantation at the Henry Ford Hospital in Detroit, spoke about hepatitis C at the National Hemophilia Foundation Annual Meeting in October in San Francisco. He said there are about 20 different hepatitis C protease inhibitors in development and predicted that the first one will be approved by the FDA in 2011. While patients are waiting for the new drugs, he encouraged them to lower their risk for developing cirrhosis (damage to the liver) by losing weight and limiting their consumption of alcohol. Infected people who are obese - who have a high body mass index - are less likely to respond to treatment and their hepatitis C follows a more aggressive course. Infected people should not drink more than 50 grams of alcohol a day. This is about four beers or four glasses of wine or three drinks of liquor a day.

Hepatitis C is a virus that infects the liver. Many people who used factor concentrate before 1990 became infected with the virus. Some people who get the hepatitis C virus are able to overcome the infection but others become chronically infected. Over time, the hepatitis C virus can damage the liver.

Now factor products made from human plasma are treated so that they don't transmit hepatitis C. Recombinant factor products are not made from human plasma and don't carry any risk for hepatitis C.