Transplant Hepatology Comments on Future of Hep C Medications

For immediate release: February 04, 2014

The FDA has approved a new category of drugs that will treat cirrhosis of the liver faster, easier and more effectively in patients with liver damage caused by chronic Hepatitis C.

Dr. William Hutson, transplant hepatologist at the University of Maryland Liver Center, comments on what this new category of drugs means for patients with Hepatitis C.

Q: What are the differences between medications that already exist to treat Hepatitis C and new drugs that are coming to market for patients?

A: We’re seeing a new category of drug. Previous drugs for Hep C were protease inhibitors, which means they attack a certain part of the Hep C virus. Now we’re seeing a new category of medicines called polymerase inhibitors, which means they attack a different part of the Hep C virus. Because they attack a different part of the virus, they’re more effective than any drug we’ve had so far. Even in patients who have cirrhosis of the liver, which has been difficult to treat, we’re seeing high cure rates. It’s amazing.

Q: What should Hep C patients know about these new medications coming to market?

A: For starters, this new category of drug is very safe and has limited side effects. It does not interact with other drugs as previous medications have. One huge benefit: it doesn’t interact with immunosuppression. This is huge for our transplant patients. Previous Hep C drugs had major, major drug interactions with immunosuppressant medications.

In any patient with end-stage liver disease due to Hep C, the Hep C will recur 100% of the time, even after liver transplant. In some people, the Hep C recurrence after a liver transplant is very mild. In other patients, Hep C returns very quickly and intensely after transplant. This second group of patients, the rapid recurrence group, is the perfect group of patients for this category of drugs to help minimize the effects of Hep C after transplant. They will take an oral medication, along with interferon and ribavirin, after their transplant and will either be cured of Hep C or will experience a more mild recurrence of the disease.

Q: What do medical treatments that cure Hep C mean for the future of liver transplantation? Will people still need liver transplants?

A: I can tell you that my transplant surgeons are all excited about these new medical treatments because it’s going to make both pre- and post-transplant care much better, and patients will have better long-term outcomes, which is what we’re all pushing for.

Let’s first look at patients who have not had a liver transplant. Right now cirrhosis from Hepatitis C is the number one cause of liver transplant. Medications like the FDA is now approving will help treat patients with Hep C earlier in the disease process and will decrease the number of patients who need a liver transplant for Hep C.

Now, if we look at patients with Hep C who have already had a liver transplant, medications like this may save lives even after transplantation. As I said before, if a patient has Hep C, that Hep C will always come back, even after a liver transplant. The great news is that new medications will prevent Hep C from destroying that new liver. If you can eliminate Hep C in patients who have cirrhosis before they have a transplant, then you don’t have to treat the Hep C after transplant because the virus is already cured.

Q: How does the University of Maryland Liver Center contribute to discoveries of new drugs like these that will treat liver disease?

A: As part of an academic medical center, it is our job to conduct clinical trials and contribute to scientific research that will continue to improve the way we care for patients with liver disease. Our Liver Center has participated in several clinical trials involving direct acting antivirals (DAAs).  I’m continually applying to pharmaceutical companies so that the Liver Center can continue to participate in clinical trials and provide new medicine options to patients who may have exhausted all other treatment opportunities.

Q: What are your patients saying about this new Hep C medication and what it could mean for their condition?

A: My patients who follow future treatment options for Hep C are excited because we’re getting much higher cure rates than we’ve had before with fewer side effects. For example, these new drugs don’t cause rashes, and there’s no anemia, no itching, no burning anal pain and less fatigue than previous medicines for Hep C. It’s all good.