Hepatitis C treatment, just a few years ago, consisted of only a small handful of treatment options. Any patient who failed treatment was simply out of luck. Today, the treatment landscape has expanded to include multiple different direct-acting antiviral choices. This means a world of difference for patients. It is no longer necessarily a matter of ‘treatment failure,’ but rather the realization that the ‘right’ treatment for a patient has not yet been applied. Treatment failure can now be considered an opportunity for trying something new and continuing on a path to success.
The potential of hepatitis C re-treatment was front and center during The International Liver Congress in Barcelona, Spain. In an exciting presentation, attendees heard about new data showing that patients who previously failed to be cleared of hepatitis C infection with a direct-acting antiviral could be later cured on a different combination of direct-acting antivirals. This is often referred to as “salvage therapy.”
In other words, treatment failure can be turned around into treatment success. A key step in this positive outcome is selecting the right combination of direct-acting antivirals for re-treatment of each previously failed patient. After reviewing the treatment of more than 3,500 patients (who had received interferon-free treatments), a group of 310 treatment failure patients were identified. Most of these had developed resistance associated variants of either genotype 1 or genotype 3 hepatitis C virus. Salvage therapy with a different direct-acting antiviral combination was able to bring about sustained virologic response (e.g., cure) in the majority of these patients.
With the growing number of approved hepatitis C medications and combinations, there are more options for alternative treatment than ever before. Increasingly, ‘treatment failure’ is becoming an obsolete concept for hepatitis C patients.
Stephen C. Vogt, Pharm.D.
President and CEO
BioPlus Specialty Pharmacy
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European Association for the Study of the Liver. New study challenges the concept of treatment failure in hepatitis C: ‘Personalization’ of direct-acting antiviral treatment could help eradicate hepatitis C virus from the body. ScienceDaily April 16, 2016.