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A Competent Hepatocyte Model Examining Hepatitis B Virus Entry through Sodium Taurocholate Cotransporting Polypeptide as a Therapeutic Target
Published on: May 10, 2022
[New drugs in the treatment of chronic hepatitis C]
R Jimenez Galan1, A Albacete Ramirez2, P Monje Agudo3
1Hospital Universitario de Valme. España.. rociojg85@hotmail.com.
Objectives:
To analyze the efficacy and safety of the new direct antiviral agents (DAA) that will become the new therapeutic arsenal for the treatment of hepatitis C.
Methods:
We carried out a research in the electronic database with the following criteria: phase II and III clinical trials (CT) published until February 2014. The Mesh term used was "chronic hepatitis C" and "therapy".Studies with boceprevir or telaprevir were excluded. For the analysis of efficacy, we evaluated the rate of Sustained Viral Response(SVR), and for the safety, side effects and safety-related discontinuations were analyzed.
Results:
We included 24 CT that include associations with ribavirine(RBV) with or without peginterferon (PegINF) and associations of several DAA. The results associated of daclatasvir with PegINF and RBV have not been very successful. On the contrary, sofosbuvir presents activity in all viral genotypes . Sofosbuvir may be administered in free PegINF regimens. Around 90% of naïve patients achieve sustained virological response (RVS) and 80% in previously treated. In relation to second wave of NS3/4A protease inhibitors, simeprevir has achieved RVS in 90% of naïve patients and close to 80% in previously treated.The main combination of DAA were sofosbuvir and daclatasvir and sofosbuvir and ledipasvir. Both have achieved SVR in 100% of patients who previously had virological failure after receiving a protease inhibitor regimen with boceprevir or telaprevir.
Conclusions:
The new generation of AAD for the treatment of hepatitis C will lead to higher response rates in all subtypes of patients with lower complexity regimens and better tolerated.
Insights
New direct antiviral agents (DAA) offer highly effective hepatitis C treatment. These advanced therapies achieve high sustained virologic response rates with improved safety profiles for diverse patient groups.
Area of Science:
- Hepatology
- Virology
- Pharmacology
Context:
- Hepatitis C virus (HCV) infection remains a significant global health concern.
- Current treatment paradigms are evolving with the advent of novel antiviral therapies.
- Understanding the efficacy and safety of these new agents is crucial for clinical practice.
Purpose:
- To evaluate the efficacy and safety of new direct antiviral agents (DAA) for hepatitis C treatment.
- To analyze clinical trial data on sustained virologic response (SVR) rates.
- To assess the safety profiles, including side effects and discontinuations, of DAA regimens.
Summary:
- A systematic review of 24 Phase II and III clinical trials (CT) published up to February 2014 was conducted, excluding boceprevir and telaprevir.
- Sofosbuvir demonstrated broad activity across all HCV genotypes, achieving SVR rates of approximately 90% in treatment-naïve and 80% in treatment-experienced patients, with potential for interferon-free regimens.
- Combinations like sofosbuvir/daclatasvir and sofosbuvir/ledipasvir achieved 100% SVR in patients with prior treatment failures, indicating high efficacy for difficult-to-treat populations.
Impact:
- The introduction of new DAAs promises higher treatment success rates for all hepatitis C subtypes.
- Simplified and better-tolerated treatment regimens are expected.
- These advancements represent a significant shift in the therapeutic arsenal against chronic hepatitis C.
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