Saturday , September 18 2021

Hepatitis C treatment may be shortened in 50% of patients, finding studies



MAYWOOD, IL – Hepatitis C drug cures more than 90 percent of patients, but can cost more than $ 50,000 per patient.

Results from a new study can lead to significant cost savings. Preliminary data from the study, led by a theoretical modeling researcher from Loyola University Chicago Stritch School of Medicine and Loyola Medicine, found that in 50 percent of patients, the normal 12 week treatment time could be shortened to as little as six weeks without endangering the effect.

"There is potential to save up to 20 percent of the cost of hepatitis C drugs," said Loyola researcher Harel Dahari, co-author of the study, together with Ohad Etzion, MD, of the Soroka University Medical Center in Israel. Senior writer is Amir Shlomai, doctoral student, doctor of Beilinson Hospital in Israel.

The study was presented on November 12 at the annual meeting of the United States Association for Studies in Liver Diseases in San Francisco.

Dr Dahari is co-director of the experimental and theoretical modeling (PETM) program in the Division of Hepatology by Loyola Medicine and Loyola University Chicago Stritch School of Medicine. Two other Loyola writers are Susan Uprichard, Doctor, Co-Director of PETM and Associate Professor at Microbiology and Immunology, and Scott Cotler, MD, Head of Loyola Medicine Division of Hepatology, and Professor of Medical Department at Loyola University Chicago Stritch School of Medicine.

Hepatitis C is an infection caused by a virus spread through contaminated blood. It can lead to liver damage, liver failure and liver cancer. An estimated 70 million people worldwide, including about three million in the United States, are chronically infected with hepatitis C.

A class of oral drugs called direct acting antivirals (DAA) has revolutionized the treatment of hepatitis C. In more than 90 percent of the patients, the drug eliminates the virus and cures the patient, with minimal side effects. However, the high cost limits access and is a major financial burden for Medicare, Medicaid and private insurance companies.

"The treatment is currently standardized for a given period of time, usually 12 weeks, instead of tailoring for the individual patient," said Dr. Cotler.

In the new study, researchers used a personal medical technology called model-based response-controlled treatment to reduce processing time whenever possible. After patients had been treated for a few weeks, the researchers measured how much hepatitis C virus levels had decreased. They used mathematical modeling to estimate how long it would take to completely eliminate the virus.

The study has included 22 patients so far. Mathematical modeling predicted that treatment could be shortened to 10 weeks in one patient (five percent of total patients), eight weeks in eight patients (36 percent) and six weeks in two patients (nine percent). The remaining 11 patients (50 percent) needed to be treated for standard 12 weeks.

Twenty-five patients remained virus-free. The only patient who recovered had the most difficult treatment of the hepatitis C virus, known as genotype 3.

The pilot study of the concept showed that the use of response-controlled treatment to reduce treatment time is possible. To validate the results, a large multicenter sample is under way in Israel.

Dr Dahari said that in addition to reducing costs, shorter treatment regimes would make it easier to treat hepatitis C patients with limited health insurance benefits.

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The study was conducted with David Yardeni, MD, Anat Nevo-Shor, MD, Daniela Munteanu, MD, and Naim Abufreha, MD, of the Department of Gastroenterology and Liver Diseases, Soroka University Medical Center, Beesheba, Israel; Assaf Issachar, MD, Michal Cohen-Naftaly, MD, Orly Sneh Arbib, MD, and Marius Braun, MD, of Liver Institute, Rabin Medical Center, Beilinson Hospital, Petah-Tikva, Israel; and Orna Mother, Doctor, of the Central Virology Laboratory, Ministry of Health, Sheba Medical Center, Israel.

The study is called "Response-Guided Therapy with DAA shortens treatment time in 50 percent of HCV-treated patients."

The study was partially supported by Clalit, a health care organization in Israel and the United States National Institute for Health.

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