CATIE’s HepCInfo Updates 6.2

New and Noteworthy

Screening Canadians born between 1945 and 1965 could be cost effective
According to a modelling study, one-time screening for people 25 to 64 or 45 to 64 years of age could be cost-effective, reported researchers in the Canadian Medical Association Journal.

For both age ranges the researchers modelled four options:

1. No screening
2. Screening and treating with peg-interferon and ribavirin
3. Screening and treating with peg-interferon, ribavirin and a direct-acting antiviral (DAA) medication
4. Screening and treating with interferon-free DAA combinations

They found that the screen-and-treat strategies for adults aged 25 to 64 years were more costly than no screening, but they also were effective. For every 10,000 people screened, there would be approximately 63 cases of hepatitis C identified and 37 people or 59% of these people would be eligible for treatment.

Treating these people could prevent nine Hep C-related deaths if peg-interferon and ribavirin were used and 18 Hep C-related deaths if interferon-free DAA combinations or interferon containing DAA combinations were used.

According to the researchers, “a selective one-time hepatitis C screening program for people 25-64 or 45-64 years of age in Canada would likely be cost-effective.”(healio.com, January 2015, in English)

Boceprevir will be discontinued in the U.S. by December 2015
Boceprevir (Victrelis) will be discontinued in the U.S. as of December 2015. Boceprevir is a first-generation direct-acting antiviral medication that is used in combination with peg-interferon and ribavirin to treat hepatitis C. The availability of new treatments for hepatitis C has resulted in a decreased demand for boceprevir.

The manufacturer has not stated whether or not they will discontinue boceprevir in Canada. (HIVandhepatitis.com, January 2015, in English)

Harvoni plus an additional drug cures most people with hepatitis C in six weeks
In a small mid-stage clinical trial, Harvoni (ledipasvir + sofosbuvir) and a third drug (either GS-9669 or GS-9451) cured 95% of participants when taken for six weeks, reported researchers in The Lancet.

The study was led by the U.S. National Institutes of Allergy and Infectious Diseases (NIAID), which is conducting studies of hepatitis C treatments in underserved urban populations with hepatitis C.

This study included 60 participants with traditional predictors of poor response to Hep C treatment, such as having genotype 1a virus, advanced liver injury and being African-American.

Participants participated in one of three study arms:

1. Harvoni for 12 weeks
2. Harvoni + GS-9669 for six weeks
3. Harvoni + GS-9451 for six weeks

100% of participants in the first study arm were cured of hepatitis C. In the second and third arm 95% of participants were cured. People with cirrhosis were only eligible to participate in the first study arm.

The treatment was well tolerated. The most common side effects were headache, fatigue and diarrhea and were mostly mild.

“Addition of a third potent direct-acting antiviral drug can reduce the duration of treatment required to achieve sustained viral response in patients with chronic HCV genotype 1 infection without cirrhosis”, stated the researchers. (HIVandhepatitis.com, January 21, 2015, in English)