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New drug improves hepatitis C outcome
A new class of drugs promises to boost the effectiveness of hepatitis C treatment, according to a recent study.

The team of North American and European researchers, led by Dr John McHutchison of Duke University Medical Center in North Carolina, found telaprevir, a new class of drugs called protease inhibitors, substantially boosted cure rates and reduced treatment times in people with hepatitis C.

Their findings appear in a recent edition of the New England Journal of Medicine.

In Australia, more than 200,000 people have hepatitis C.

Treatment currently consists of dual therapy with interferon - an immune stimulant given by weekly injection - and ribavirin - an antiviral drug given as twice daily tablets. This combination cures between 40% and 80% of people with the virus.

But for many the virus is difficult to eradicate.

In the case of the most common form of hepatitis C in Australia (genotype 1), standard treatment with interferon and ribavirin results in a cure rate of between 40% and 50% and requires a 48-week treatment period.

People with liver disease who cannot eradicate the virus face a high chance of subsequent liver cancer, require a liver transplant or both. The interferon-ribavirin combination also causes unpleasant side effects in many people.
Right combination

Researchers took a group of 453 people with hepatitis C genotype 1 who had previously failed on conventional combinations of interferon and ribavirin treatment.

They were randomly divided into four groups. One group received telaprevir for 12 weeks plus interferon and ribavirin for 24 weeks, while the second received telaprevir for 24 weeks with interferon and ribavirin for 48 weeks. The third group were given telaprevir and interferon only for 24 weeks, and the control group received the standard therapy of interferon and ribavirin for 48 weeks

The results showed 51% in the first group cured of the disease, 53% in the second, and 24% in the third group - significantly higher than the 14% cure rate in the control group.

But the study aslo found patients receiving telaprevir experienced more side effects. Approximately half developed a rash and about 15% abandoned treatment compared to only 4% in the control group.
'New hope'

Professor Geoff McCaughan, head of the AW Morrow Gastroenterology and Liver Centre at the Royal Prince Alfred Hospital in Sydney says the results are exciting.

"The protease inhibitors offer new hope to people who've failed on current treatments and who up until now have had few options if they want to clear the virus," he says.

He says preliminary trials suggest the new class of drugs are also proving effective when used as a frontline therapy in combination with the existing drugs.

A study published by the same researchers last year showed that adding telaprevir increased the cure rate for genotype 1 patients who hadn't received treatment from 40% after 48 weeks treatment, to approximately 60% after only 24 weeks treatment.

McCaughan says, "We're hopeful the new drugs will be approved and available on the Pharmaceutical Benefits Scheme by the end of 2012 in Australia."

The study was funded by the manufacturer of telaprevir, Vertex Pharmaceuticals.

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