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New Drug Combo for Hepatitis C Shows Promise

New Drug Combo for Hepatitis C Shows Promise [St. Louis Post-Dispatch]

From St. Louis Post-Dispatch (MO) (March 17, 2011)

March 16--Researchers at St. Louis University have been testing a new drug that could increase the cure rate for hepatitis C by half or more.

If the Food and Drug Administration approves the new drug combination this summer as researchers predict, the medical community will be able to cure about 75 percent of known hepatitis C cases, said Dr. Bruce R. Bacon, principal investigator of the "HCV Respond-2" study.

Bacon announced his findings at a recent conference of hepatology researchers.

Bacon explained that the current FDA-approved treatment for hepatitis C combines a weekly injection called peginterferon and daily pills called ribavirin. The combination cures about half of the cases of hepatitis C.

But hepatitis C comes in several varieties ranging from easily curable with standard treatment, to stubborn to not curable. Also, some people can appear cured, then the disease returns after treatment is stopped.

Bacon, known for helping several entertainers overcome hepatitis C, has been wrestling the virus for more than a decade.

The pharmaceutical company Merck developed a drug with the generic name of boceprevir to go after the more stubborn strains of hepatitis C. The company awarded a grant to St. Louis University for evaluation in preparation for an FDA submission.

In the study, more than 400 people were divided between those who got the old drugs and a placebo, and those who got the old drugs and the new drug. The new drug combination cured about half of the hard-to-cure cases.

Bacon called the results "huge." The U.S. has about 700,000 diagnosed cases of hepatitis C. About 3.2 million people have the disease and don't know it, according to epidemiology numbers. But it can sit dormant for years before it causes problems or never cause problems.

The disease is spread by sharing blood. The primary culprit is sharing needles while using intravenous drugs, Bacon said. However, most cases involve people who used drugs years, even decades ago during youthful indiscretions, not current misbehaviors, Bacon said.

Transfusions, tattoos and piercings are no longer among the major distributors, Bacon said.

Many people don't know they have the disease until their liver is about to fail from cancer or other scarring caused by hepatitis C.

That's what nearly happened to Buddy Foster, 49, of Springfield, Ill.

During a routine physical, his doctor found disturbing evidence that Foster's liver was in trouble, and the standard hepatitis C treatment didn't work.

"When my treatment failed, they put me on a liver transplant list," Foster said. "I wasn't at the top of the (transplant) list but that's what was likely to happen."

Foster speculates that he contracted hepatitis C sometime in the early to mid-1990s.

"I've never used drugs or anything that would have (transmitted the disease)," he said.

Indeed, Bacon said many people don't know where they contracted it. First responders and medical people who risk being stuck by contaminated needles make up about 1 percent of those with the disease.

The physician in Springfield referred Foster to Bacon. His research unit runs up to 30 clinical trials at any given time into hepatitis C, liver disease and related illnesses.

Foster joined the trial testing the new drug combination aimed at hard-to-treat cases.

"I was in the (study) for 36 weeks and they told me I was finished," Foster said. "I hadn't showed any of the virus since 20 weeks."

Foster said that after the first treatment failed, he rewrote his will to better accommodate grandchildren. He fought depression -- some from the news, some from the medicine. He continued to work.

"Staying busy was best for me," he said.

Once he completed the trial and got the all-clear, he said, he stepped up the pace of his life. He travels more, spends more time with his grandchildren, talks more with his children and still goes to work for the Illinois Department of Transportation.

Bacon says other treatments aimed at increasing the cure rate to 80 or 90 percent are being studied.

The downside of the new treatment is that after approval, it will cost about $60,000 from diagnosis to finish, which can last six months to a year.

That's why Bacon encourages applying for studies. People get free care plus access to drugs that may be three to four years from the pharmacy.

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Posted: March 2011

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