A new, shorter drug regimen to treat certain types of hepatitis C was found to be as effective as the current, longer course of treatment, according to the results of a large multi-center trial published in the New England Journal of Medicine.
A shorter treatment duration may reduce the number of patients who stop taking the drug before treatment ends, according to the study co-authored by Steven Flamm, MD, professor of Medicine in the Division of Gastroenterology and Hepatology.
“This is important because shorter treatment regimens offer an increased chance of compliance as well as less cost,” Flamm said.
Hepatitis C Virus (HCV) is the most common blood-borne infection in the United States; HCV genotypes 1 and 3 are together responsible for about 85 percent of infections. Antiviral treatments are now the standard of care and for most patients the treatment duration is 12 weeks long.
One regimen offers an eight-week time course for some patients, but the shorter duration is restricted to HCV genotype 1 patients who are non-cirrhotic, have not been previously treated and have a low baseline viral load.
Longer treatments involve a higher likelihood of patients discontinuing usage, but a new treatment, a combination of two drugs, glecaprevir and pibrentasvir, was the first therapy approved to treat the vast majority of patients with genotypes 1 or 3 who are non-cirrhotic and have not previously been treated with the shorter eight-week treatment plan.
In the current study, two parallel trials were conducted, assessing the effectiveness of glecaprevir-pibrentasvir in patients with HCV genotypes 1 and 3. A total of 1093 patients were treated with glecaprevir-pibrentasvir, taking the drug once a day for either eight (shorter course) or twelve (standard course) weeks. 115 additional patients with HCV genotype 3 were assigned to the previous standard medication as a control.
Patients taking glecaprevir-pibrentasvir responded well to treatment, with low rates of side effects and high rates of sustained virologic response — 99.1 percent for patients with HCV genotype 1 and 95 percent for patients with HCV genotype 3, according to the study. In addition, patients who were co-infected with HIV had continued HIV suppression throughout the trial.
These results indicate eight-week treatments of glecaprevir-pibrentasvir are a viable option for patients with HCV genotypes 1 and 3, according to the investigators. A shorter treatment duration could reduce the number of patients who discontinue the medication, increasing the number of treated patients — especially in resource-limited settings, Flamm said.
Further, while HCV genotypes 1 and 3 make up the majority of HCV infections, other trials have shown similarly positive results with the short eight-week course when testing glecaprevir-pibrentasvir in genotypes 2, 4, 5 and 6.
This combination of drugs treating appropriate HCV patients for eight weeks was approved by the FDA and is now available, according to Flamm.
Flamm is also a professor of Surgery.
This investigation was supported by AbbVie, and Flamm reported receiving grants and speaking/consultant fees from AbbVie.