Treating HCV/New And Old Therapies
Telaprevir/INCIVEK
FDA approves Telaprevir / INCIVEK For The Treatment Of Hepatitis C
Full U.S. Prescribing Information
Medication Guide
Boceprevir/Vicrelis
Vicrelis/Boceprevir IS NOW FDA Approved May 13 2011
VICTRELIS™- Boceprevir: Prescribing Information and Medication Guide
May 2012
Telaprevir/Boceprevir - Side effects-direct-acting antivirals
May 2012-Standardization of Terminology of Virological Response in the
Treatment of Chronic Hepatitis C
March 2012
Treatment of chronic hepatitis C genotype 1 with triple therapy comprising telaprevir or boceprevir
A significant increase in the number of patients with CHC to be treated is expected for 2012, with triple therapy regimens that are more complex. These expected developments represent
a significant challenge and will stretch current resources.
May 2012
Interferons and hepatitis C virus
2011- An update on treatment of genotype 1 chronic hepatitis C virus infection: 2011
practice guideline by the American Association for the Study of Liver Diseases
2011 - A Practical Guide for the Use of Boceprevir and Telaprevir for the Treatment of Hepatitis C
Today’s Standard of Care:
The current standard of care by genotype is listed below:
• Genotype 1: a combination of pegylated interferon, ribavirin and an HCV protease
inhibitor (boceprevir or telaprevir).
The standard duration of treatment is a total of 24,36 or 48 weeks.
Pegylated interferon is a subcutaneous injection—once weekly.
Ribavirin is a pill. The dose is based on body weight (1,000/1,2000mg) and
divided into two equal doses twice a day.
HCV protease inhibitor (boceprevir or telaprevir) is taken every 7 to 9 hours with
food –
Boceprevir can be taken with a snack or meal; telaprevir is taken with food
that is not low-fat.
• Genotypes 2 and 3: a combination of pegylated interferon and ribavirin taken for 24 weeks.
o Pegylated interferon is a subcutaneous injection—once weekly.
o Ribavirin is a pill. The dose is given 800mg daily—dose is divided into two equal
doses. Ribavirin is taken with food.
Source HCV Advocate
What is the Conventional Medical Treatment for Hepatitis C?
Not all people who have been diagnosed with Hepatitis C need treatment,
especially in the case of acute Hepatitis. Medication may be prescribed,
however, bed rest, drinking plenty of fluids, avoidance of alcohol and eating a
healthy diet will be recommended by the doctor. It is important to work closely
with one’s doctor and follow up with tests to make sure the virus has cleared
the body.
Some people won’t be treated because they don’t know they have the Hepatitis
C virus.
Individuals who have been diagnosed with chronic Hepatitis C will probably be
treated with interferon combination therapy or interferon monotherapy. The
monotherapy only consists of interferon, while combination therapy combines
interferon with ribavarin. Combination therapy is the treatment of choice.
However, some people will still receive monotherapy due to intolerance to
ribavirin
The type of treatment as well as the length of treatment for Hepatitis C
depends on the genotype of the virus. Working closely with one’s physician,
using an open line of communication will help in determining the best course of
action.
People with genotype 1 have a lower rate of response to combination therapy
(most studies have shown that treatment with combination therapy works for up to
50% of people with genotype 1), whereas people with genotypes 2 and 3 have a
high rate of response to combination therapy (around 80%).
Current treatment options for Hepatitis C include various types of interferon
- either genetically engineered or a synthetic replica of the body’s natural
protein produced and secreted by special immune cells which act as an antiviral,
immune-regulating chemical.
Once in the bloodstream, interferon interferes with the Hepatitis C virus’
ability to replicate. In addition, interferon appears to build up the immune
system’s disease fighting T helper-1 cells so that they are strong enough to
kill off the Hepatitis C viruses.
Types of interferon used in the treatment of Hepatitis C include:
to dose reduction or discontinuation of treatment. All side effects should be
reported to one’s doctor right away for management of symptoms and to prevent
serious complications from occurring.
Not all people experience the same side effects, nor are all side effects
necessarily severe. Some people experience few or no side effects at all. Having
a good support system in place prior to starting treatment will help in managing
side effects whether few or many. Family, friends, and support groups can be
helpful to most people during difficult times while undergoing Hepatitis C
treatment.
Side effects from interferon may include:
Ribavirin, an antiviral drug that suppresses the Hepatitis C virus is
commonly used in conjunction with interferon to treat Hepatitis C. When used
alone, Ribavirin promptly brings down liver enzymes but the results don’t last
long and liver enzymes go back up. The best success for sustained results has
been shown when treatment consists of pegylated interferon/peginterferon (a
time-released, longer acting interferon), and Ribavirin combined. Similar to
interferon side effects, Ribavirin has been known to cause anemia, thyroid
disease, hypertension and depression. Pregnant women and anyone with
cardiovascular disease should not take Ribavirin. Ribavirin can cause birth
defects so it is important for both men and women to use an effective form of
contraception.
On May 13, 2011, the U.S. Food and Drug Administration approved two
prescription medications Victrelis™ (boceprevir) and Incivek™ (telaprevir) for
use in combination with peginterferon alfa and ribavirin to treat chronic
Hepatitis C genotype 1 infection in those who have not been treated before or
who have failed previous Hepatitis C treatment.
There are contraindications with regard to both Victrelis™ and Incivek™ which
should be discussed thoroughly with one’s doctor as should all treatment
options.
It is important to note that not all people are candidates for antiviral drug
treatment. Antiviral drug treatment for Hepatitis C may not be recommended for
the following:
Finally, if the liver is severely damaged, a liver transplant may be
recommended. End-stage liver disease (cirrhosis) due to chronic Hepatitis C
viral infection is the number one reason for liver transplantation in the United
States. During the transplant procedure, the diseased liver will be replaced
with a healthy liver from an organ donor or from a live donor who donates a
portion of their healthy liver. However, contrary to popular misconception, a
liver transplant is not a cure for Hepatitis C. Unfortunately, the Hepatitis C
virus recurs in the new liver in almost all cases, with fibrosis (scarring of
the liver) or cirrhosis occurring in 10% to 30% of patients in as little as 5
years after the transplant.
Further studies are needed to develop better strategies to prevent recurrence
of infection after a liver transplant as well as better treatment protocols
after reinfection of the liver has occurred.
http://www.hepatitis-central.com/hepatitis-c/hepatitis-c-conventional-treatment.html
FDA approves Telaprevir / INCIVEK For The Treatment Of Hepatitis C
Full U.S. Prescribing Information
Medication Guide
Boceprevir/Vicrelis
Vicrelis/Boceprevir IS NOW FDA Approved May 13 2011
VICTRELIS™- Boceprevir: Prescribing Information and Medication Guide
May 2012
Telaprevir/Boceprevir - Side effects-direct-acting antivirals
May 2012-Standardization of Terminology of Virological Response in the
Treatment of Chronic Hepatitis C
March 2012
Treatment of chronic hepatitis C genotype 1 with triple therapy comprising telaprevir or boceprevir
A significant increase in the number of patients with CHC to be treated is expected for 2012, with triple therapy regimens that are more complex. These expected developments represent
a significant challenge and will stretch current resources.
May 2012
Interferons and hepatitis C virus
2011- An update on treatment of genotype 1 chronic hepatitis C virus infection: 2011
practice guideline by the American Association for the Study of Liver Diseases
2011 - A Practical Guide for the Use of Boceprevir and Telaprevir for the Treatment of Hepatitis C
Today’s Standard of Care:
The current standard of care by genotype is listed below:
• Genotype 1: a combination of pegylated interferon, ribavirin and an HCV protease
inhibitor (boceprevir or telaprevir).
The standard duration of treatment is a total of 24,36 or 48 weeks.
Pegylated interferon is a subcutaneous injection—once weekly.
Ribavirin is a pill. The dose is based on body weight (1,000/1,2000mg) and
divided into two equal doses twice a day.
HCV protease inhibitor (boceprevir or telaprevir) is taken every 7 to 9 hours with
food –
Boceprevir can be taken with a snack or meal; telaprevir is taken with food
that is not low-fat.
• Genotypes 2 and 3: a combination of pegylated interferon and ribavirin taken for 24 weeks.
o Pegylated interferon is a subcutaneous injection—once weekly.
o Ribavirin is a pill. The dose is given 800mg daily—dose is divided into two equal
doses. Ribavirin is taken with food.
Source HCV Advocate
What is the Conventional Medical Treatment for Hepatitis C?
Not all people who have been diagnosed with Hepatitis C need treatment,
especially in the case of acute Hepatitis. Medication may be prescribed,
however, bed rest, drinking plenty of fluids, avoidance of alcohol and eating a
healthy diet will be recommended by the doctor. It is important to work closely
with one’s doctor and follow up with tests to make sure the virus has cleared
the body.
Some people won’t be treated because they don’t know they have the Hepatitis
C virus.
Individuals who have been diagnosed with chronic Hepatitis C will probably be
treated with interferon combination therapy or interferon monotherapy. The
monotherapy only consists of interferon, while combination therapy combines
interferon with ribavarin. Combination therapy is the treatment of choice.
However, some people will still receive monotherapy due to intolerance to
ribavirin
The type of treatment as well as the length of treatment for Hepatitis C
depends on the genotype of the virus. Working closely with one’s physician,
using an open line of communication will help in determining the best course of
action.
People with genotype 1 have a lower rate of response to combination therapy
(most studies have shown that treatment with combination therapy works for up to
50% of people with genotype 1), whereas people with genotypes 2 and 3 have a
high rate of response to combination therapy (around 80%).
Current treatment options for Hepatitis C include various types of interferon
- either genetically engineered or a synthetic replica of the body’s natural
protein produced and secreted by special immune cells which act as an antiviral,
immune-regulating chemical.
Once in the bloodstream, interferon interferes with the Hepatitis C virus’
ability to replicate. In addition, interferon appears to build up the immune
system’s disease fighting T helper-1 cells so that they are strong enough to
kill off the Hepatitis C viruses.
Types of interferon used in the treatment of Hepatitis C include:
- Alpha Interferon – the standard treatment for management of acute and
chronic Hepatitis C - Consensus Interferon – a synthetic form of interferon
- Pegylated Interferon – a long-acting, time-release form of
interferon
to dose reduction or discontinuation of treatment. All side effects should be
reported to one’s doctor right away for management of symptoms and to prevent
serious complications from occurring.
Not all people experience the same side effects, nor are all side effects
necessarily severe. Some people experience few or no side effects at all. Having
a good support system in place prior to starting treatment will help in managing
side effects whether few or many. Family, friends, and support groups can be
helpful to most people during difficult times while undergoing Hepatitis C
treatment.
Side effects from interferon may include:
- Persistent flu-like symptoms (including body aches and headaches)
- Nausea
- Fatigue
- Loss of appetite
- Diarrhea
- Insomnia
- Mental and psychiatric symptoms, including depression, irritability,
anxiety, mania and trouble concentrating - Bone marrow suppression
- Anemia
- Dehydration
- Mouth sores
- Changes in the way food and beverages taste
- Skin rashes and itching
- Dry, brittle nails
- Injection site reactions (pain, irritation, swelling or infection)
- Hair loss
- Vision or eye problems (rare but can be serious)
- Libido changes (decreased interest in sex)
- Menstrual and menopausal changes
Ribavirin, an antiviral drug that suppresses the Hepatitis C virus is
commonly used in conjunction with interferon to treat Hepatitis C. When used
alone, Ribavirin promptly brings down liver enzymes but the results don’t last
long and liver enzymes go back up. The best success for sustained results has
been shown when treatment consists of pegylated interferon/peginterferon (a
time-released, longer acting interferon), and Ribavirin combined. Similar to
interferon side effects, Ribavirin has been known to cause anemia, thyroid
disease, hypertension and depression. Pregnant women and anyone with
cardiovascular disease should not take Ribavirin. Ribavirin can cause birth
defects so it is important for both men and women to use an effective form of
contraception.
On May 13, 2011, the U.S. Food and Drug Administration approved two
prescription medications Victrelis™ (boceprevir) and Incivek™ (telaprevir) for
use in combination with peginterferon alfa and ribavirin to treat chronic
Hepatitis C genotype 1 infection in those who have not been treated before or
who have failed previous Hepatitis C treatment.
There are contraindications with regard to both Victrelis™ and Incivek™ which
should be discussed thoroughly with one’s doctor as should all treatment
options.
It is important to note that not all people are candidates for antiviral drug
treatment. Antiviral drug treatment for Hepatitis C may not be recommended for
the following:
- People who use intravenous drugs
- People who drink alcohol
- People who have advanced cirrhosis of the liver
- People who have received a kidney or heart transplant, since treatment will
increase risk of rejection of the organ - People with liver cancer
- Men and women who are planning to conceive a child and women who are
pregnant - People who are severely depressed and/or have mental health issues because
antiviral medications used to treat Hepatitis C can make those issues worse - People who have an autoimmune disease such as rheumatoid arthritis, lupus,
or psoriasis - People with advanced heart disease or diabetes
- People with normal aminotransferase levels (ALT less than 30 independent
units per milliliter)
Finally, if the liver is severely damaged, a liver transplant may be
recommended. End-stage liver disease (cirrhosis) due to chronic Hepatitis C
viral infection is the number one reason for liver transplantation in the United
States. During the transplant procedure, the diseased liver will be replaced
with a healthy liver from an organ donor or from a live donor who donates a
portion of their healthy liver. However, contrary to popular misconception, a
liver transplant is not a cure for Hepatitis C. Unfortunately, the Hepatitis C
virus recurs in the new liver in almost all cases, with fibrosis (scarring of
the liver) or cirrhosis occurring in 10% to 30% of patients in as little as 5
years after the transplant.
Further studies are needed to develop better strategies to prevent recurrence
of infection after a liver transplant as well as better treatment protocols
after reinfection of the liver has occurred.
http://www.hepatitis-central.com/hepatitis-c/hepatitis-c-conventional-treatment.html