Interferon Free Hepatitis C Treatment Regimens: The Beginning of Another Era

Poordad, Fred; Chee, Grace M.

doi:10.1007/s11894-011-0229-1

Cited by 8 publications

(6 citation statements)

References 26 publications

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“…Unmitigated GI side effects can decrease medication adherence, and for DAAs this can result in the emergence of drug resistance [7] , a potentially serious complication. Even with the development of interferon-free regimens, RBV and DAAs will independently contribute to side effects and adherence challenges [48, 49] .…”

Section: Discussionmentioning

confidence: 99%

Physical, Social, and Psychological Consequences of Treatment for Hepatitis C

Manos

Murphy

et al. 2013

Patient

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Background Hepatitis C virus (HCV) antiviral therapy entails a long treatment course, as well as significant side effects that can lead to medication non-adherence and premature termination of treatment. Few large studies have comprehensively examined patient perspectives on the treatment experience, particularly the social and personal effects. Objective We sought to understand how a diverse group of patients’ lives were affected during HCV treatment, and to obtain suggestions about how to better support patients during treatment. Methods On average, 13 months after therapy we interviewed by telephone a consecutive sample of 200 patients treated for hepatitis C with ribavirin and pegylated interferon in a comprehensive, integrated health plan in the years 2008–2010. Mixed (quantitative and qualitative) survey methods were used. Results The response rate was 68.9 %. Mean age at treatment was 51 years; 63.0 % were men; and Black, Hispanic, Asian, and White non-Hispanic racial/ethnic groups were similarly represented. Patients whose treatment was managed by nurses or clinical pharmacists (vs. physicians) were more likely to report their providers as being part of their support system (83.5 % vs. 58.9 %; p < 0.001). Most patients reported flu-like symptoms (93.5 %) and psychiatric problems (84.5 %), and 43.0 % reported side effects lasted up to 6 months after treatment. Black patients reported discontinuing treatment prematurely due to side effects more often than non-Blacks (29.4 % vs.12.1 %; p < 0.001). Physical side effects (69.5 % of patients), psychiatric issues (43.5 %), and employment (27.4 %) were ranked among the three most difficult challenges. Patients desired help in anticipating and arranging work modifications during treatment. Most patients rated peer support, nutritional guidance, and weekly provider contact by telephone as potentially helpful resources for future patients undergoing HCV treatment. Conclusions Patient perspectives can help formulate and refine HCV treatment support programs. Effective support programs for diverse populations are crucial as the complexities and costs of HCV treatment increase. The call for greater support from peers, providers, and employers demands new systems such as patient-centered care teams.

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Section: Discussionmentioning

confidence: 99%

Physical, Social, and Psychological Consequences of Treatment for Hepatitis C

Manos

Murphy

et al. 2013

Patient

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“…Achievement of HCV-RNA negativity prior to liver transplantation, while on continued antiviral therapy, reduces the risk of recurrent HCV but does not prevent reinfection in all cases [6,7]. Ultimately, interferon-free regimens are an attractive future treatment strategy for waitlisted patients, as elimination of PEG-IFN would be predicted to substantially improve tolerability and applicability of therapy [8,9]. Ultimately, interferon-free regimens are an attractive future treatment strategy for waitlisted patients, as elimination of PEG-IFN would be predicted to substantially improve tolerability and applicability of therapy [8,9].…”

Section: Pretransplant Antiviral Therapymentioning

confidence: 99%

Hepatitis C virus treatment and liver transplantation in the era of new antiviral therapies

Saxena

Terrault²

2012

Current Opinion in Organ Transplantation

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Given the complexities of treatment, it is best undertaken by experienced clinicians and only after a detailed discussion of risks-benefits with the patient. To maximize the benefit while minimizing risk, only Child-Turcott-Pugh A (CPT-A) cirrhotics should be considered for pretransplant protease inhibitor-triple therapy. For transplant recipients, very close monitoring and adjustment of CNI levels is critical during protease inhibitor-triple therapy. Cytopenias, especially anemia, will require aggressive management.

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“…These two drugs are first-generation inhibitors of the NS3/4A protease of HCV. They have both demonstrated excellent efficacy in the management of treatment-naïve patients with HCV genotype 1 as well as relapser-responders, improving treatment success in the former group from around 40% with standard care pegylated interferon (PEG-IFN) and ribavirin (RBN) to 67–73% with triple therapy 6. The National Institute of Health and Clinical Excellence (NICE) approved use of both drugs in March 2012 but it remains to be seen how widely available they will be given their considerable cost.…”

Section: The 5-year Outlook: Where We Should Bementioning

confidence: 99%

“…These include second-generation protease inhibitors such as danoprevir and tegobuvir as well as polymerase and cyclophilin inhibitors 6. Most of these trials use the agents in combination with PEG-IFN and RBN, although the prospect of being able to use interferon-free regimens (with significantly fewer adverse drug reactions occurring as a result) is coming ever nearer.…”

Section: The 5-year Outlook: Where We Should Bementioning

confidence: 99%

The future developments in hepatology: no need for a jaundiced view

Elsharkawy

Hudson²

2012

Frontline Gastroenterol

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There have been major advances in the diagnosis and management of all forms of liver disease since the British Society of Gastroenterology first came into existence 75 years ago. In this review some of the exciting developments that are likely to enter into routine clinical practice over the next 5 years are highlighted. It is suggested that some critical changes need to take place in UK hepatology over the next decade to ensure that the management of liver disease in this country continues to be among the best in the world.

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Interferon Free Hepatitis C Treatment Regimens: The Beginning of Another Era

Cited by 8 publications

References 26 publications

Physical, Social, and Psychological Consequences of Treatment for Hepatitis C

Physical, Social, and Psychological Consequences of Treatment for Hepatitis C

Hepatitis C virus treatment and liver transplantation in the era of new antiviral therapies

The future developments in hepatology: no need for a jaundiced view

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