New drug against hepatitis C discovered

New drug against hepatitis C discovered. First clinical tests prove: New drug promises in addition to the standard medication significantly better chances of recovery in hepatitis C..

(09.08.2010) Hepatitis C is a viral disease of the liver that is often barely noticeable immediately after infection, i. is perceived by the patients as fatigue, fatigue, loss of appetite, joint pain and abdominal pain in the right upper abdomen. Not infrequently is the self-diagnosis „gripal infect“ and it is therefore much too late the doctor visited. In 70% of cases, the initial disease is transformed into chronic liver disease, which, without treatment, causes cirrhosis in the long term to 25% of those infected, and also significantly increases the risk of hepatocellular carcinoma.

In Germany, about 500,000 people suffer from hepatitis C, estimated at an estimated 170 million worldwide. The previous treatment sees in front of the patient a combined preparation of pegylated interferon α (Peginterferon) and the antiviral ribavirin over a timeframe of 24 to 48 weeks (rarely 72 weeks) to administer. If 6 weeks after the treatment, no more viruses can be detected, the patient is considered cured. The main problem with this form of therapy are the innumerable side effects which sometimes require treatment to be stopped. As an example of the side effects of peginterferon and ribavirin, the following may be mentioned: Peginterferon may cause flu symptoms (fever, chills), fatigue, mild hair loss, thyroid dysfunction and mental side effects (depression, aggression or anxiety), and ribavirin may decrease lead the red blood cells. In addition, the prospects of success of the previous treatment were rather poor, since - depending on the genetic conditions - almost half of the patients did not respond to the therapy.

Paul Kwo and his team from Indiana University (Indianapolis, USA) have now tested a new form of treatment in a clinical trial involving approximately 600 patients from the US, Canada and Europe. They used the drug boceprevir in addition to the combination of peginterferon and ribavirin in the patients. This inhibits certain enzymes that cleave proteins into protease. Protease is required by the hepatitis C virus to grow and it is possible by the protease blockers to reduce their emissions to a minimum, it may also be helpful against hepatitis C.

Protease blockers have already been used successfully in HIV therapy and their use has also been discussed many times in relation to hepatitis treatment. To further this discussion on a scientific level, Kwo and his team have supplemented boceprevir standard medication with patients and tested it for 44 weeks. The result was clear: 75 percent of patients treated with boceprevir were still virus-free 24 weeks after the therapy and were thus considered cured. This means that nearly twice as many patients have been able to achieve a treatment success as with conventional therapy (38 percent). In another study, the specialists around Laura Milazzo of the Department of Infectious Diseases and Immunopathology of the University of Milan now want to verify the results and thus create the legal basis for the therapy with Boceprevir. In addition, physicians have tested the use of the protease inhibitor telaprevir also successfully.

The problem with treatment with protease inhibitors, however, is that they are always used in combination with peginterferon and ribavirin, i. H. whose massive side effects could not be eliminated with the new form of therapy. It is not foreseeable when treatment with protease inhibitors will be possible. In addition lies „the greatest danger of the future (...) in the emergence of viruses that are resistant to boceprevir, "said Laura Milazzo in a commentary on the results so far.

Also, the infection pathways play a role in the selection of the right therapy and here are the first allegations in the direction of the pharmaceutical industry loud because they have weighted the sexual transmission so far too high, but in fact most infections with hepatitis C via the bloodstream. Particularly often, the viruses are passed on to severely drug addicts who share their syringes and cannulas. Here is the infection rate data of the Berlin Robert Koch Institute to episode between. 50 and 80 percent. To what extent a therapy with the combined preparation and boceprevir makes sense for them remains questionable. (Fp)

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