Directly acting antivirals for the treatment of patients with hepatitis C infection: A clinical development update addressing key future challenges

[Guest guest]

J Hepatol. 2008 Nov 4. [Epub ahead of print]

Directly acting antivirals for the treatment of patients with hepatitis C

infection: A clinical development update addressing key future challenges.

A, Patel K, Tillman H, McHutchison JG.

Duke Clinical Research Institute and Division of Gastroenterology, Duke

University Medical Center, P.O. Box 17969, Durham, NC 27715, USA.

Current therapy for chronic hepatitis C virus (HCV) infection is effective in

less than 50% of genotype 1-infected patients. Antiviral agents specifically

targeting either the HCV protease or polymerase, or other targets, are now in

clinical development. In general, direct antivirals are potent inhibitors of HCV

replication and can result in rapid declines in serum HCV RNA levels. Yet these

agents drive selection pressure for mutant viruses that can reduce

susceptibility to any given drug. Using pegylated interferon (PEG-IFN) and

ribavirin (RBV) in combination with direct antivirals can suppress viral

breakthrough and increase the likelihood of sustained virologic response. Direct

antivirals also result in adverse events in a proportion of patients, adding to

concerns of tolerability that exist with PEG-IFN and RBV. Direct antivirals are

very likely to become an integral part of treatment within the next decade, and

already their use in clinical trials has raised important issues related to

duration of treatment, early stopping rules, retreatment of previously treated

patients, and how or when direct antivirals should be combined. Here, we provide

current information regarding the effectiveness of direct antivirals in treating

chronic HCV infection and discuss the key questions and challenges now facing

the field.

PMID: 19022518 [PubMed - as supplied by publisher]

[Guest guest]

J Hepatol. 2008 Nov 4. [Epub ahead of print]

Directly acting antivirals for the treatment of patients with hepatitis C

infection: A clinical development update addressing key future challenges.

A, Patel K, Tillman H, McHutchison JG.

Duke Clinical Research Institute and Division of Gastroenterology, Duke

University Medical Center, P.O. Box 17969, Durham, NC 27715, USA.

Current therapy for chronic hepatitis C virus (HCV) infection is effective in

less than 50% of genotype 1-infected patients. Antiviral agents specifically

targeting either the HCV protease or polymerase, or other targets, are now in

clinical development. In general, direct antivirals are potent inhibitors of HCV

replication and can result in rapid declines in serum HCV RNA levels. Yet these

agents drive selection pressure for mutant viruses that can reduce

susceptibility to any given drug. Using pegylated interferon (PEG-IFN) and

ribavirin (RBV) in combination with direct antivirals can suppress viral

breakthrough and increase the likelihood of sustained virologic response. Direct

antivirals also result in adverse events in a proportion of patients, adding to

concerns of tolerability that exist with PEG-IFN and RBV. Direct antivirals are

very likely to become an integral part of treatment within the next decade, and

already their use in clinical trials has raised important issues related to

duration of treatment, early stopping rules, retreatment of previously treated

patients, and how or when direct antivirals should be combined. Here, we provide

current information regarding the effectiveness of direct antivirals in treating

chronic HCV infection and discuss the key questions and challenges now facing

the field.

PMID: 19022518 [PubMed - as supplied by publisher]

[Guest guest]

J Hepatol. 2008 Nov 4. [Epub ahead of print]

Directly acting antivirals for the treatment of patients with hepatitis C

infection: A clinical development update addressing key future challenges.

A, Patel K, Tillman H, McHutchison JG.

Duke Clinical Research Institute and Division of Gastroenterology, Duke

University Medical Center, P.O. Box 17969, Durham, NC 27715, USA.

Current therapy for chronic hepatitis C virus (HCV) infection is effective in

less than 50% of genotype 1-infected patients. Antiviral agents specifically

targeting either the HCV protease or polymerase, or other targets, are now in

clinical development. In general, direct antivirals are potent inhibitors of HCV

replication and can result in rapid declines in serum HCV RNA levels. Yet these

agents drive selection pressure for mutant viruses that can reduce

susceptibility to any given drug. Using pegylated interferon (PEG-IFN) and

ribavirin (RBV) in combination with direct antivirals can suppress viral

breakthrough and increase the likelihood of sustained virologic response. Direct

antivirals also result in adverse events in a proportion of patients, adding to

concerns of tolerability that exist with PEG-IFN and RBV. Direct antivirals are

very likely to become an integral part of treatment within the next decade, and

already their use in clinical trials has raised important issues related to

duration of treatment, early stopping rules, retreatment of previously treated

patients, and how or when direct antivirals should be combined. Here, we provide

current information regarding the effectiveness of direct antivirals in treating

chronic HCV infection and discuss the key questions and challenges now facing

the field.

PMID: 19022518 [PubMed - as supplied by publisher]

[Guest guest]

J Hepatol. 2008 Nov 4. [Epub ahead of print]

Directly acting antivirals for the treatment of patients with hepatitis C

infection: A clinical development update addressing key future challenges.

A, Patel K, Tillman H, McHutchison JG.

Duke Clinical Research Institute and Division of Gastroenterology, Duke

University Medical Center, P.O. Box 17969, Durham, NC 27715, USA.

Current therapy for chronic hepatitis C virus (HCV) infection is effective in

less than 50% of genotype 1-infected patients. Antiviral agents specifically

targeting either the HCV protease or polymerase, or other targets, are now in

clinical development. In general, direct antivirals are potent inhibitors of HCV

replication and can result in rapid declines in serum HCV RNA levels. Yet these

agents drive selection pressure for mutant viruses that can reduce

susceptibility to any given drug. Using pegylated interferon (PEG-IFN) and

ribavirin (RBV) in combination with direct antivirals can suppress viral

breakthrough and increase the likelihood of sustained virologic response. Direct

antivirals also result in adverse events in a proportion of patients, adding to

concerns of tolerability that exist with PEG-IFN and RBV. Direct antivirals are

very likely to become an integral part of treatment within the next decade, and

already their use in clinical trials has raised important issues related to

duration of treatment, early stopping rules, retreatment of previously treated

patients, and how or when direct antivirals should be combined. Here, we provide

current information regarding the effectiveness of direct antivirals in treating

chronic HCV infection and discuss the key questions and challenges now facing

the field.

PMID: 19022518 [PubMed - as supplied by publisher]