New (and expensive) hepatitis C drugs, such as Harvoni and Sovaldi, are keeping their promise and dramatically reducing the risk of liver cancer and death in patients, a new French study says.
The news did not surprise many an American liver expert.
The advent of this class of drugs "has led to an almost universal cure for chronic infection with hepatitis C," said Dr. David Bernstein, chief of the hepatology department of Northwell Health in Manhasset, New York.
Bernstein thinks that "this large study provides the best evidence so far to support the recommendations that all patients with chronic hepatitis C infection should be treated with [these drugs]. "
According to the study's baseline data, about 71 million people worldwide are suffering from chronic infection with hepatitis C, which can cause debilitating or life-threatening diseases such as cirrhosis, liver diseases and liver cancer. Over the last 15 years, these complications have tripled and it is expected that they will peak between 2030 and 2035, the researchers said.
The new research was funded by drug manufacturers and included nearly 9,900 patients in France.
About three-quarters of patients were treated with the new class of medications, called "direct-acting antivirals," while the other quarter was not.
Direct-acting antivirals act quickly – over a period of about three months – to push the hepatitis C virus, which damages the liver, to undetectable levels in patients' blood.
In the study, after a median follow-up of nearly three years, 218 patients died and 258 were diagnosed with liver cancer.
Compared to untreated patients, patients treated with direct-acting antivirals were 52% less likely to die prematurely (84 deaths per 10,000 untreated patients compared to 40 per 10,000 treated patients). In addition, treated patients were 33% less likely to be diagnosed with liver cancer in one year (129 out of 10,000 in untreated patients compared to 86 out of 10,000 in treated patients), the researchers said. .
At the beginning of the study, in a subgroup of more than 3,000 patients with cirrhosis of the liver, the same risk reductions were observed in patients receiving the new drugs, provided that they had reaches an undetectable rate of hepatitis C virus in the blood.
The study, published Feb. 11 in The Lancet, received funding from pharmaceutical companies MSD, Janssen, Gilead (manufacturer of direct-acting antiviral Harvoni, Sovaldi, Vosevi and Epclusa), AbbVie (maker of Mavyret ), Bristol-Myers Squibb (manufacturer of Daklinza) and Roche.
According to the researchers, this is the first study to demonstrate the effectiveness of direct-acting antivirals in patients with chronic hepatitis C. The authors of the study said they felt the findings were a strong case for increased drug use.
"We have found a reduction in the risk of complications related to disease and mortality, and believe that this treatment should be considered for all patients with chronic hepatitis C," said lead researcher Fabrice Carrat of University of the Sorbonne in Paris, in a newspaper. Release.
In a newspaper commentary, Dr. Raymond Chung, director of the Liver Center at Massachusetts General Hospital in Boston, pointed out that the findings "provide the best evidence to date for supporting referral documents recommending antiviral-action therapy." direct for all patients chronic infection with hepatitis C. "
Another problem is the cost of direct-acting antivirals, which initially cost about $ 90,000 for the required three-month course. Bernstein said these concerns have eased somewhat, but not completely.
"While prices for hepatitis C treatments have dropped dramatically in the United States over the past four years, making them affordable for most patients, access to these drugs that change and save lives. lives remain difficult for some patient groups, "he said.
"Some states have placed restrictions on their availability, based on the extent of liver damage, sobriety, and restrictions on who can prescribe these treatments," Bernstein said.