I have know Mr. B and his family for about 2 years, most of which has been quite challenging. Unfortunately, he has HCV and alcohol induced cirrhosis. He had failed IFN based therapy ( Ribavirin, teleprevir) last year because on treatment, he had become aggressive, temperamental and developed severe skin rash. During our last meeting, we all felt defeated but had high hopes for better treatment in future. That day final came, when FDA in December 2013 approved the newer class of drug – Sofosbuvir to treat HCV.
Introduction of newer agents to treat HCV definitely brings excitement because they offer better cure rate, and at times, better tolerability.
For almost 20 years, GI specialist have been using interferon (IFN) and ribavirin based regimes with dismally low cure rates of about 40-50% in non-cirrhotic patients. During my fellowship training at UTMB, I was involved in treating many TDC inmates and learnt a great deal in using IFN-R with caution because of extensive side effect profile.
SInce 2011, we have been using the protease inhibitor – Teleprevir with IFN+R to achieve cure rates close to 50-70%. However, the therapy is limited by drug-drug interactions, 24 week duration of treatment, anemia, rash and administration of pill thrice a day with 20 gm fat.
Hence, we really needed a better medication which would have the following features:
1. High efficacy cure rate >75%
2. Short duration
3. Better tolerability
4. Can be given to well compensated cirrhotic patients.
December 2013, FDA approved The agent – Sofosbuvir (Sovaldi, Gilead) – NS5B nucleotide inhibitor. Four phase 3 trials – NEUTRINO, FISSION, FUSION, and POSITRON have consistently shown cure rate of up to 90% in Genotype 1 HCV infection which in the past has been difficult to cure.
I am planning to start Mr. B on the newer agent, and would update the blog hopefully after eradication of his HCV infection.
In the meanwhile, some of my other non-cirrhotic patients who have received Sovaldi are undetectable for HCV, and have only 4 more weeks of treatment left to finish.
If you wish to see me, please schedule a visit at one of the locations : 281-557-2527
- Clear Lake Office (Wesbter)
1015 Medical Center Blvd
Suite 1300, Webster, TX 77598
Phone: (281) 557-2527
- Satellite Office 2
7111 Medical Center Drive
2nd Floor
Texas City, TX 77591
If you have any questions please do not hesitate to call my office 281-557-2527, and I would be more than happy to call you back and talk to you for free. I believe this is the least I can do to better the lives of people who are trying to find the right answers.
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