Treatment of hepatitis C can be shortened in 50 percent of patients, study findings



MAYWOOD, IL – Hepatitis C medications treat more than 90 percent of patients, but they can cost more than $ 50,000 per patient.

Findings from a new study could lead to significant cost savings. Preliminary study data, conducted by the theoretical modeling researcher at Loyola University Chicago School of Medicine and Loyola Medicine, found that in 50% of patients the standard 12-week treatment regimen could be reduced to just six weeks without compromising efficacy.

"There is potential to save up to 20 percent of the cost of hepatitis C drugs," said Loyola Harel Dahari, PhD, co-researcher, along with Dr. Ohmad Etzion of the Soroka University Medical Center in Israel. Seniors are Amir Shlomai, MD, PhD, Beilinson Hospital in Israel.

The study was presented on November 12 during the annual meeting of the American Association for the Study of Hepatic Disease in San Francisco.

Dr. Dahari is the co-researcher of the Experimental and Theoretical Modeling (PETM) program in the hepatology division of Loyola Medicine and the Loyola University Chicago Stritch School of Medicine. Two other Loyola authors are Susan Uprichard, PhD, co-author PETM and Associate Professor of Microbiology and Immunology, and MUDr. Scott Cotler, head of the hepatology department of Loyola Medicine, and professor at Loyola University Medical School Chicago Stritch.

Hepatitis C is an infection caused by the virus by spreading contaminated blood. This can lead to liver damage, liver failure and liver cancer. It is estimated that 70 million people worldwide, including about three million people in the United States, are chronically infected with hepatitis C.

The class of oral drugs called directly acting antivirals (DAA) revolutionized hepatitis C treatment. In more than 90 percent of patients, the drug eliminates the virus and treats the patient with minimal side effects. The high price, however, restricts access and represents a considerable financial burden for Medicare, Medicaid and private insurers.

"The treatment is currently standardized to be given for a certain period of time, usually 12 weeks, rather than being adapted to an individual patient," Dr. Cotler.

In the new study, scientists used a personalized healing technique, called a modeling reaction with controlled therapy, which shortened treatment time when possible. After weeks of treatment for the patients, the researchers found out how high the hepatitis C virus level was reduced. They have used mathematical modeling to estimate how long it will last until it completely removes the virus.

The study included 22 patients. Mathematical modeling assumed that treatment could be shortened to 10 weeks per patient (five percent of all patients), eight weeks in eight patients (36%) and six weeks in two patients (9%). A further 11 patients (50%) should be treated for a standard 12-week period.

21 patients remained without virus. The only patient who relapsed had the heaviest form of hepatitis C virus, known as genotype 3.

The Pilot Study on Evidence of Conception has shown that it is possible to carry out managed response therapy in order to reduce treatment time. A comprehensive multicentre study is ongoing in Israel to validate the results.

Dr. Dahari said that, in addition to reducing costs, shorter treatment regimes would facilitate the treatment of patients with hepatitis C who have limited health insurance benefits.

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The study was conducted with MUDr. David Yardeni, MUDr. Anat Nevo-Shor, Dr. Daniela Munteanu and MUDr. Naim Abufre from the Institute of Gastroenterology and Liver Disease, Soroka University Medical Center, Beesheba, Israel. MUDr. Assaf Issachar, MUDr. Michal Cohen-Naftaly, Orly Sneh Arbib, MD and MUDr. Marius Braun of the Liver Institute, Rabin Medical Center, Beilinson Hospital, Petah-Tikva, Israel; and Orna Morová, PhD, Central Virological Laboratory, Ministry of Health, Sheba Health Center, Israel.

The study is titled "Responsibly-directed DAA therapy reduces the duration of treatment in 50% of patients treated with HCV".

The study was partly supported by Clalit, the Health Services Organization in Israel, and the US National Institutes of Health.

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