{"id":290,"date":"2014-02-26T13:43:15","date_gmt":"2014-02-26T13:43:15","guid":{"rendered":"http:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/?p=290"},"modified":"2017-08-21T12:58:29","modified_gmt":"2017-08-21T12:58:29","slug":"primary-care-corner-with-geoffrey-modest-md-striking-successes-with-non-interferon-non-ribavirin-therapy","status":"publish","type":"post","link":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/2014\/02\/26\/primary-care-corner-with-geoffrey-modest-md-striking-successes-with-non-interferon-non-ribavirin-therapy\/","title":{"rendered":"Primary Care Corner with Geoffrey Modest MD: Striking successes with non-interferon, non-ribavirin therapy"},"content":{"rendered":"<p>the journal Gastroenterology just published a short-term oral (ie non-interferon based) and ribavirin-free regimens for genotype 1 hepatitis c infection. important since ribavirin does have some significant adverse reactions, including anemia.<\/p>\n<p>&#8211;phase 2 open-labeled study of 66 treatment-naive patients (see\u00a0<strong>doi:10.1053\/j.gastro.2013.10.057<\/strong>)\u00a0with hep c, genotype 1 and RNA level &gt;100,000, and without cirrhosis (either non-invasive FibroTest being low, or if high then a biopsy negative for cirrhosis), given daclatasvir 60mg\/d (an NS5A replication complex inhibitor), asunaprevir 200mg bid (an NS3 protease inhibitor) and BMS-791325, either 75mg or 150 mg bid (a non-nucleoside NS5B inhibitor) for 12 or 24 weeks. (so, about 16 pts in each group: either shorter or longer therapy, and either 75mg or 150mg of the\u00a0\u00a0BMS-791325). primary endpoint of HCV-RNA level &lt;25 IU\/ml at 12 weeks after treatment (SVR12). results:<\/p>\n<p style=\"padding-left: 30px\">&#8211;in 64 patients HCV-RNA suppressed by week 4 of treatment. (includes 48 of 49 with genotype 1a infection, and 45 of 46 with non-CC interleukin 28B genotype &#8212; these are less responsive to interferon)<br \/>\n&#8211;61 pts (92%) achieved SVR12.<br \/>\n&#8211;no diff if 12 or 24 weeks of therapy; no diff if 75mg or 150mg of BMS-791325; no diff if genotype 1a or 1b.<br \/>\n&#8211;no serious adverse events, mostly headache, asthenia, and GI symptoms<\/p>\n<p>so, a whirlwind of new studies have come out in the past couple of years on interferon-free and now ribavirin-free regimens, with striking successes with short-term therapy. \u00a0these are really remarkable advances. (though, as with the previous blogs on this subject, they will no-doubt be a tad costly).<\/p>\n<p>geoff<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Striking successes with non-interferon, non-ribavirin therapy for Hep C [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/2014\/02\/26\/primary-care-corner-with-geoffrey-modest-md-striking-successes-with-non-interferon-non-ribavirin-therapy\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":148,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[14283],"tags":[],"class_list":["post-290","post","type-post","status-publish","format-standard","hentry","category-archive"],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/posts\/290","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/users\/148"}],"replies":[{"embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/comments?post=290"}],"version-history":[{"count":0,"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/posts\/290\/revisions"}],"wp:attachment":[{"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/media?parent=290"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/categories?post=290"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/tags?post=290"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}