Clinical Cases Hepatitis C Naïve Patients. Rafael Esteban Liver Unit. Hospital General Universitari Vall Hebron. Barcelona.
|
|
- Teresa Palmer
- 5 years ago
- Views:
Transcription
1 Clinical Cases Hepatitis C Naïve Patients Rafael Esteban Liver Unit. Hospital General Universitari Vall Hebron. Barcelona.
2 Case study 1 27 year old woman, Diagnosed with Chronic Hepatitis C 3 years ago Never treated Risk factor: occasional IVDU 10 years ago Weight: 65 kg No comorbidity, no medications Genotype 1b, HCV RNA UI/mL Fibroscan: 8 KPa
3 Case study 1 Asymptomatic She wants to clear the viral infection quickly before being pregnant, so she wants to start a treatment rapidly No contraindication for the treatment
4 Would you treat her? No, because she has no significant fibrosis Yes, because she is really motivated
5 Would you perform an IL28B genotyping in this patient? Yes, because the IL28B polymorphism can influence the treatment strategy No
6 Impact of IL28B polymorphisms on SVR in naïve patients RVS (%) CC CT TT RVS (%) CC CT TT 73 0 n/n= PR48 50/64 BOC RGT 63/77 BOC44/ PR48 44/55 PR48 BOC RGT 33/116 67/103 BOC44/ PR48 82/115 Poordad F, et al. J Hepatol 2011;54(Suppl.):S6 PR48 10/37 BOC RGT 23/42 BOC44/ PR48 26/44 0 PR48 n/n= 35/55 T12PR PR48 T12PR PR48 T12PR 45/50 20/80 48/68 6/26 16/22 Jacobson IM, et al. J Hepatol 2011;54(Suppl.):S542
7 RVS (%) Impact of IL28B polymorphisms on SVR in CC CT TT naïve patient RVS (%) 100 CC 90 CT TT n/n= PR48 50/64 BOC RGT 63/77 BOC44/ PR48 44/55 PR48 BOC RGT 33/116 67/103 BOC44/ PR48 82/115 Poordad F, et al. J Hepatol 2011;54(Suppl.):S6 PR48 10/37 BOC RGT 23/42 BOC44/ PR48 26/44 0 PR48 n/n= 35/55 T12PR PR48 T12PR PR48 T12PR 45/50 20/80 48/68 6/26 16/22 Jacobson IM, et al. J Hepatol 2011;54(Suppl.):S % of CC patients treated with BOC/PR were eligible for shorter therapy 80 % of CC patients treated with TVR/PR were eligible for shorter therapy
8 IL28B genotyping: CC Case study 1
9 Are you going to treat her? PegInterferon +Ribavirin PegInterferon +Ribavirin+Telaprevir PegInterferon+Ribavirinin + Boceprevir
10 SVR Rates by First Time to PCR Negativity in HCV-1 ( 600,000 IU/mL), 24 vs. 48 Weeks Tx. PEG-IFN α-2b 1.5 µg/kg QW + ribavirin mg/day 24 Weeks Tx. 1, N= Weeks Historical Control 2, N=38 100% 89% 100% 85% 93% 80% 80% 67% % of Patients 60% 40% 20% 25% 17% % of Patients 60% 40% 20% 0% 4, (n=110) 12, (n=61) 24, (n=24) 0% 4, (n=13) 12, (n=15) 24, (n=3) 47% HCV RNA PCR Negative (<29IU/mL at Week S. Zeuzem et al., Journal of Hepatology 44 (2006) Manns M. et al., Lancet 2001; 358:
11 Standard of Care for Genotype 1 Treatment-Naive Patients Boceprevir [1,2] PegIFN + RBV BOC + PegIFN + RBV BOC + PegIFN + RBV Telaprevir [2,3] TVR + PegIFN + RBV PegIFN + RBV *Undetectable HCV RNA at Wk 8 of therapy (Wk 4 of triple therapy). Undetectable HCV RNA at Wks 4 and 12 of triple therapy. Early response*; stop at Wk 28; f/u 24 wks PegIFN + RBV ervr ; stop at Wk 24, f/u 24 wks No ervr; PegIFN + RBV F/u 24 wks F/u 24 wks 1. Boceprevir [package insert]. May Ghany MG, et al. Hepatology. 2011;54: Telaprevir [package insert]. May 2011.
12 Case study 1 IL28B genotyping: CC Day 1: start of antiviral therapy Peginterferon α-2a 180 ug/week Ribavirin: 400 mg BID Telaprevir 750 mg every 8 hours Week 4: Side effect: fatigue Hb decline to 11 g/dl Bad Tolerance to High fat- food every 8 h HCV RNA undetectable
13 100 OPTIMIZE: Efficacy of Telaprevir BID vs Telaprevir q8h in GT1 HCV Infection Primary endpoint: SVR ,8 74,3 SVR12 (%) / /369 T12(q8h)/PR T12(bid)/PR T12(bid)/PR was non-inferior to T12(q8h)/PR for SVR12 Difference (95% CI): 1.5% ( 4.9%, 12%) Buti M, et al. AASLD Abstract LB-8.
14 Case study 1 Week 4 Therapy adjusted Peginterferon α-2a 180 ug/week Ribavirin: 400 mg BID Telaprevir bid Week 8 Better tolerance and compliance Minimal Rash in arms
15 Case study 1 Week 10 Rash increases arms and thorax (Moderate rash- Grade 2) HCV-RNA undetectable
16 Management of mild rash: which antihistamine? Chlorpheniramine Promethazine OK to use with HCV PIs Desloratidine Levocetirizine In this patient, desloratidine was initiated
17 Case study 1 Week 10 Rash increased arms and thorax (Moderate rash- Grade 2) Topic steroids and desloratidine was initiated Anemia stable HCV-RNA undetectable Week 11 No improvement in rash Telaprevir was stopped
18 Drug considerations: mild and moderate rash Mild Telaprevir discontinuation is generally NOT required Rash Moderate Telaprevir discontinuation is generally NOT required For moderate rash that progresses, permanent discontinuation (do not dose-reduce) of telaprevir should be considered If the rash does not improve within 7 days following telaprevir discontinuation, ribavirin should be interrupted. Peginterferon alfa may be continued unless interruption is medically indicated Treating patients with mild or moderate rash Use topical corticosteroids* Permitted systemic antihistaminic drugs may be tried for the treatment of associated pruritus Limit exposure to sun/heat and wear loose-fitting clothes *Concomitant use of systemic dexamethasone with telaprevir may result in loss of therapeutic effect of telaprevir. This combination should be used with caution or alternatives should be considered Telaprevir EU SmPC
19 Case study 1 Week 10 Rash increased arms and thorax (Moderate rash-grade 2) Topic steroids and desloratidine was initiated Anemia stable HCV-RNA undetectable Week 11 No improvement in rash Telaprevir was stopped Week 12 No Changes in rash All the drugs were stopped HCV RNA undetectable
20 What are the chances to get an SVR? 40% 60% > 90% 20
21 PROVE2 (telaprevir): study design Phase IIb, randomized, placebo-controlled, partially double-blind trial in 323 treatment-naïve patients with chronic HCV genotype 1 infection PR48 (n=82) Placebo + Peg-IFN + RBV Peg-IFN + RBV T12PR24 (n=81) T12PR12 (n=82) T12P12 (n=78) (no RBV) TVR + Peg-IFN + RBV TVR + Peg-IFN + RBV TVR + Peg-IFN Peg-IFN + RBV PR: peginterferon/ribavirin; Peg-IFN: peginterferon alfa-2a; RBV: ribavirin; TVR: telaprevir; HCV: hepatitis C virus Weeks Hézode C, et al. N Engl J Med 2009;360:
22 PROVE2 (telaprevir): overall SVR Rates 100 Patients with SVR (%) /82 28/78 49/82 56/81 PR48 T12P12 (no RBV) T12PR12 T12PR24 SVR: sustained virologic response Hézode C, et al. N Engl J Med 2009;360:
23 SVR according to the treatment and IL28B genotype (telaprevir PROVE2 post-hoc analysis) CC CT TT Proportion of patients (%) T12PR12 T12PR24 T12P12 PR Bronowicki J-P, et al. J Hepatol 2012;56 (Suppl 2):S430 1
24 Case study 1 Follow-up 24-week HCV RNA: undetectable. 24
25 Summary Naïve patients infected with HCV genotype 1 Easy to treat patients IL28B CC, Caucasian/White Non-cirrhotic Can be cure with 12 weeks of triple combination treatment with telaprevir, peginterferon, and ribavirin
26 Case Study 2 54 year old man, lawyer IVDU sporadically 20 years ago Chronic Hepatitis C diagnosed 6 years ago HCV genotype 1 b, F3 Friends with HCV treated and non responders He was afraid about his disease He would like to be treated with DAAs but he was also afraid about therapy!!!!!! 26
27 Case study 2 He started Peginterferon α-2b 1.5 ug/kg/week Ribavirin: 600 mg BID Week 4: Side effect: fatigue Viral load: 4.2 log10 (vs 6.1 log10 at D1)
28 Lead-in Predicts SVR SVR (%) PR BOC RGT BOC/PR PR BOC RGT BOC/PR48 Non-Black Patients 1 log 10 HCV RNA decline from baseline Black Patients <1 log 10 HCV RNA decline from baseline Poordad F. N Engl J Med. 2011; 364:
29 Case study 2 Started boceprevir 800 mg/8h at Week 4. Week 8. Side effects: fatigue, dysgeusia, no rash. Hb: 10.5 g/dl (vs 13 g/dl at Day 1). HCV RNA: undetectable. 29
30 SVR for Early and Late Viral Responders With Boceprevir ADVANCE SVR (%) Undetectable HCV RNA at Week 8 Detectable HCV RNA at Week 8 Poordad F. N Engl J Med. 2011; 364:
31 SVR for Early and Late Viral Responders With Boceprevir ADVANCE SVR (%) 18 % % Undetectable HCV RNA at Week 8 Detectable HCV RNA at Week 8 Poordad F. N Engl J Med. 2011; 364:
32 Case study 2 Week 12. Side effects: fatigue. Hb: 9 g/dl. HCV RNA undetectable. How to manage anemia? 32
33 Impact of Anemia on SVR 100 SPRINT RESPOND-2 SVR (%) SVR (%) Hgb 10 g/dl Hgb <10 g/dl Hgb Hgb 10 g/dl <10 g/dl n/n = n/n = Hgb 10 g/dl Hgb <10 g/dl 5 20 Hgb 10 g/dl Hgb <10 g/dl PR48 BOC/PR48 Sulkowski M et al, EASL 2011
34 Efficacy endpoints: EPO vs RBV dose reduction for managing anemia with boceprevir Δ (95% CI) 0.7% ( 8.6, 7.2)* Patients (%) 178/ /251 RBV DR EPO Secondary anemia management intervention was used in 18% of RBV DR patients and in 37% of EPO patients *The stratum-adjusted difference (EPO vs RBV DR) in SVR rates, adjusted for stratification factors and protocol cohort CI: confidence interval; EOT: end of treatment Poordad FF, et al. J Hepatol 2012;56 (Suppl 2):S559
35 Case study 2 Week 12. Side effects: fatigue. Hb: 9 g/dl. HCV RNA undetectable Ribavirin was reduced to 800 mg/gay What are the chances to achieve an SVR? 35
36 Higher SVR Rates if Undetectable HCV RNA Levels at Start Time of Primary Anemia Management
37 Week 24. Case Report 2 Side effects: fatigue. HCV RNA: undetectable. What will be the duration of therapy? 37
38 Triple therapy with Boceprevir for Genotype 1 Treatment-Naive Patients Boceprevir [1,2] PegIF N + RBV BOC + PegIFN + RBV BOC + PegIFN + RBV Early response*; stop at Wk 28; f/u 24 wks PegIFN + RBV 48 F/u 24 wks 1. Boceprevir [package insert]. May Ghany MG, et al. Hepatology. 2011;54:
39 SVR in Non-Black Patients with Undetectable HCV RNA Between Weeks 8-24 Column SVR (%) BOC RGT BOC/PR48
40 Case study 1 Treatment stopped at Week 28. Follow-up 12-week and 24-week visits: HCV RNA: <25 IU undetectable. 40
41 Summary Anaemia is the main effect of Triple therapy with Boceprevir, peginterferon, and ribavirin Anaemia is associated with a higher SVR rates Anaemia can be managed by Ribavirin dose reduction without impacting SVR rates
Hepatitis C: Management of Treatment Naïve Patients with First Line Protease Inhibitors
Hepatitis C: Management of Treatment Naïve Patients with First Line Protease Inhibitors Eric Lawitz, MD, AGAF, CPI The Texas Liver Institute Clinical Professor of Medicine University of Texas Health Science
More informationHepatitis C: Management of Previous Non-responders with First Line Protease Inhibitors
Hepatitis C: Management of Previous Non-responders with First Line Protease Inhibitors Fred Poordad, MD The Texas Liver Institute Clinical Professor of Medicine University of Texas Health Science Center
More informationTratamiento de la Hepatitis C Rafael Esteban Hospital General Universitario Valle de Hebrón Barcelona
Tratamiento de la Hepatitis C Rafael Esteban Hospital General Universitario Valle de Hebrón Barcelona rrent HCV Therapy 8% % sustained response 6% 4% 2% % 54-61% 41% 34% 25% 16% 6% IFN 24w IFN 48w Peg
More informationHow to optimize current therapy for GT1 patients Shortened therapy with IFNa-based therapy
How to optimize current therapy for GT1 patients Shortened therapy with IFNa-based therapy Thomas Berg Sektion Hepatologie Klinik und Poliklinik für Gastroenterologie und Rheumatologie Leber- und Studienzentrum
More informationManagement of CHC G1 patients who are relapsers or non-responders to Peg IFN and RBV therapy: Wait or Triple Therapy?
Management of CHC G1 patients who are relapsers or non-responders to Peg IFN and RBV therapy: Wait or Triple Therapy? Prof. Teerha Piratvisuth NKC Institute of Gastroenterology and Hepatology Prince of
More informationProtease inhibitor based triple therapy in treatment experienced patients
Protease inhibitor based triple therapy in treatment experienced patients Universitätsklinikum Leipzig Thomas Berg Sektion Hepatologie Klinik und Poliklinik für Gastroenterologie und Rheumatologie Leber
More informationTreatement Experienced patients without cirrhosis. Rafael Esteban Hospital Universitario Valle Hebron Barcelona
Treatement Experienced patients without cirrhosis Rafael Esteban Hospital Universitario Valle Hebron Barcelona Agenda With IFN PegIFN+ Ribavirin + Simeprevir PegIFN+ Ribavirin+ Sofosbuvir Without IFN Sofosbuvir
More informationSAVINO BRUNO, MD Director Internal Medicine and Hepatology Unit AO Fatebenefratelli e Oftalmico, Milano
SAVINO BRUNO, MD Director Internal Medicine and Hepatology Unit AO Fatebenefratelli e Oftalmico, Milano Market wheretelaprevir has not yet launched Victrelis is still launching January 29 th 214 Developed
More informationSimeprevir + PEG + RBV in Treatment-Naïve Genotype 1 QUEST-1 Trial
Phase 3 Treatment Naïve Simeprevir + in Treatment-Naïve Genotype 1 QUEST-1 Trial Jacobson IM, et al. Lancet. 2014;384:403-13. Simeprevir + PEG + Ribavirin for Treatment-Naïve HCV GT1 QUEST-1 Trial QUEST-1
More informationPersonalised Treatment with Telaprevir in Graham R Foster Professor of Hepatology Queen Marys University of London
Personalised Treatment with Telaprevir in 2014 Graham R Foster Professor of Hepatology Queen Marys University of London Telaprevir in 2014 Disclaimers I have received funds from: BI, BMS, Janssen, Novarts,
More informationCURRENT TREATMENTS. Mitchell L Shiffman, MD Director Liver Institute of Virginia. Richmond and Newport News, VA, USA
CURRENT TREATMENTS FOR HCV Mitchell L Shiffman, MD Director Liver Institute of Virginia Bon Secours Health System Richmond and Newport News, VA, USA Liver Institute of Virginia Education, Research and
More informationHepatitis C Treatment 2014
Hepatitis C Treatment 214 Brendan M. McGuire, MD UAB Liver Center Outline Epidemiology/National History Terminology for Treatment Treatment Considerations Current Treatment Options Genotype 1 (GT 1) Genotype
More information5/12/2016. Learning Objectives. Management of Hepatitis C Virus Genotype 2 or 3 Infected Treatment-Naive or Experienced Patients
5/12/216 Management of Hepatitis C Virus Genotype 2 or 3 Infected Treatment-Naive or Experienced Patients Alexander Monto, MD Professor of Clinical Medicine University of California San Francisco San Francisco,
More informationOptimal Treatment with Boceprevir. Michael Manns
Optimal Treatment with Boceprevir Michael Manns 6th Paris Hepatitis Conference, 14th January 2013 Acknowledgements Benjamin Maasoumy Optimal Patient Selection Defining the Ideal Candidate Treatment Urgency
More informationPredictors of Response to Hepatitis C Therapy in the DAA Era. Pablo Barreiro Servicio de Enfermedades Infecciosas Hospital Carlos III, Madrid
Predictors of Response to Hepatitis C Therapy in the DAA Era Pablo Barreiro Servicio de Enfermedades Infecciosas Hospital Carlos III, Madrid Why Predicting HCV Response? Select candidates for therapy Prioritizing
More information47 th Annual Meeting AISF
47 th Annual Meeting AISF Rome, 21 February 2014 Present and future treatment strategies for patients with HCV infection: chronic hepatitis and special populations (HCV/HIV coinfection, advanced cirrhosis,
More informationABCs of Hepatitis C: What s New. The Long-Awaited New Era: Protease Inhibitors for HCV Genotype 1
ABCs of Hepatitis C: What s New ACG Postgraduate Course Washington, DC October 30, 2011 Ira M. Jacobson, M.D. Vincent Astor Professor of Medicine Chief, Division of Gastronterology and Hepatology Medical
More informationAntiviral agents in HCV
Antiviral agents in HCV : Upcoming Therapeutic Options Su Jong Yu, M.D., Ph.D. Department of Internal Medicine, Liver Research Institute, Seoul National University College of Medicine Estimated 170 Million
More informationTriple therapy with telaprevir or boceprevir: management of side effects
Triple therapy with telaprevir or boceprevir: management of side effects Universitätsklinikum Leipzig Thomas Berg Sektion Hepatologie Klinik und Poliklinik für Gastroenterologie und Rheumatologie Leber
More informationTreatment with the New Direct Acting Antivirals for Hepatitis C
Treatment with the New Direct Acting Antivirals for Hepatitis C Mary Olson, DNP, ANP-BC Clinical Trials Program Director Weill Cornell Medical College The Center for the Study of Hepatitis C Objectives
More informationBOCEPREVIR (BOC): EVIDENCE FROM TRIALS
BOCEPREVIR (BOC): EVIDENCE FROM TRIALS ROME, FEBRUARY 22 nd -25 th, 212 Savino Bruno, MD Department of Internal Medicine A.O. Fatebenefratelli e Oftalmico Milan, Italy Savino Bruno, MD Director of InternalMedicine,
More informationNew developments in HCV research and their implications for front-line practice
New developments in HCV research and their implications for front-line practice Dr. Curtis Cooper Associate Professor, University of Ottawa Director, Ottawa Hospital Viral Hepatitis Program June 17, 2013
More informationةي : لآا ةرقبلا ةروس
سورة البقرة: اآلية HCV RELAPSERS AND NONRESPONDERS: How to deal with them? BY Prof. Mohamed Sharaf-Eldin Prof. of Hepatology and Gastroenterology Tanta University Achieving SVR The ability to achieve a
More informationPierluigi Toniutto Clinica di Medicina Interna Azienda Ospedaliero Universitaria Udine
Pierluigi Toniutto Clinica di Medicina Interna Azienda Ospedaliero Universitaria Udine Il sottoscritto dichiara di non aver avuto negli ultimi 12 mesi conflitto d interesse in relazione a questa presentazione
More informationIntroduction. The ELECTRON Trial
63rd AASLD November 9-13, 12 Boston, Massachusetts Faculty Douglas T. Dieterich, MD Professor of Medicine and Director of CME Department of Medicine Director of Outpatient Hepatology Division of Liver
More informationASSAYS UTILZIED TO MONITOR HCV AND ITS TREATMENT
ASSAYS UTILZIED TO MONITOR HCV AND ITS TREATMENT Mitchell L Shiffman, MD Liver Institute of Virginia Bon Secours Health System Richmond and Newport News, VA Liver Institute of Virginia Education, Research
More informationPharmacological management of viruses in obese patients
Cubist Pharmaceuticals The Shape of Cures to Come Pharmacological management of viruses in obese patients Dr. Dimitar Tonev, Medical Director UKINORD 1 Disclosures } The author is a pharmaceutical physician
More informationHepatitis C Therapy Falk Symposium September 20, 2008
Hepatitis C Therapy Falk Symposium September 20, 2008 Ira M. Jacobson, MD Vincent Astor Professor of Clinical Medicine Chief, Division of Gastroenterology and Hepatology Medical Director, Center for the
More informationOral combination therapy: future hepatitis C virus treatment? "Lancet Oct 30;376(9751): Oral combination therapy with a nucleoside
Author manuscript, published in "Journal of Hepatology 2011;55(4):933-5" DOI : 10.1016/j.jhep.2011.04.018 Oral combination therapy: future hepatitis C virus treatment? Commentary article on the following
More informationThe role of triple therapy with protease inhibitors in hepatitis C virus genotype 1na «ve patients
The role of triple therapy with protease inhibitors in hepatitis C virus genotype 1na «ve patients David R. Nelson Clinical and Translational Science Institute, University of Florida, FL, USA Liver International
More informationCase #1. Case #1. Case #1: Audience vote VS. The Great Debate: When to Treat HCV in our HIV coinfected patients
Case #1 The Great Debate: When to Treat HCV in our HIV coinfected patients Medical Management of AIDS December, 2012 Moderated by George Beatty,MD 35 year old African American man, CD4 + 450, HIV RNA
More informationTreatments of Genotype 2, 3,and 4: Now and in the future
Treatments of Genotype 2, 3,and 4: Now and in the future THERAPY FOR THE TREATMENT OF GENOTYPE 2 1 GT 2 and GT 3 Treatment-Naïve: SOF+RBV vs PEG-IFN+RBV FISSION Study Design HCV GT 2 and GT 3 Treatment-naïve
More informationPEARL-I. Ombitasvir + Paritaprevir + Ritonavir +/- Ribavirin in HCV GT4. Treatment Naïve and Treatment Experienced
Phase 2b Treatment Naïve and Treatment Experienced Ombitasvir + Paritaprevir + Ritonavir +/- Ribavirin in HCV GT4 PEARL-I Hézode C, et al. Lancet. 2015 March 30. [Epub ahead of print] PEARL-I: Study Design
More informationHIV and Hepatitis C: Advances in Treatment
NORTHWEST AIDS EDUCATION AND TRAINING CENTER HIV and Hepatitis C: Advances in Treatment John Scott, MD, MSc Asst Professor University of Washington Presentation prepared & presented by: John Scott, MD,
More informationCurrent Treatments for HCV
Current Treatments for HCV Mitchell L. Shiffman, MD, FACG Advisory Committee/Board Member: Achillion, Anadys, Boehringer-Ingelheim, BMS, Conatus, Genentech, Gen-Probe, Gilead, Globeimmune, GSK, Janssen,
More informationCase 4: A 61-year-old man with HCV genotype 3 with cirrhosis. Ira M. Jacobson, M.D. Weill Cornell Medical College New York, New York USA
Case 4: A 61-year-old man with HCV genotype 3 with cirrhosis Ira M. Jacobson, M.D. Weill Cornell Medical College New York, New York USA 1 Genotype 3 case 61-year-old man with HCV genotype 3 Cirrhosis on
More informationHCV treament with DAA Side effects: Anemia, Skin Manifestations Pr Patrice CACOUB
HCV treament with DAA Side effects: Anemia, Skin Manifestations Pr Patrice CACOUB Service de Médecine Interne, CNRS UMR 7211, INSERM UMR 959 Université Pierre et Marie Curie Centre National de Référence
More informationEASL 2013 Interferon Free, All Oral Regimens for Hepatitis C. Maria Buti Hospital Universitario Valle Hebron Barcelona Spain
EASL 2013 Interferon Free, All Oral Regimens for Hepatitis C Maria Buti Hospital Universitario Valle Hebron Barcelona Spain The first Results with Oral therapy: a Protease Inhibitor and NS5A inhibitor
More informationManagement of adverse effects of triple therapy
Management of adverse effects of triple therapy Giovanni Battista Gaeta Cattedra di Malattie Infettive UOC Epatiti Virali Seconda Università di Napoli Disclosures Advisory board: BMS, Gilead, Janssen Speaker:
More informationInfection with hepatitis C virus (HCV) is a global health concern,
Advances in the Treatment of Hepatitis C Virus Infection Arun B. Jesudian, MD, Maya Gambarin-Gelwan, MD, and Ira M. Jacobson, MD Dr. Jesudian is a Clinical Fellow, Dr. Gambarin-Gelwan is an Assistant Professor
More informationHCV Case Study. Treat Now or Wait for New Therapies
HCV Case Study Treat Now or Wait for New Therapies This program is supported by educational grants from Kadmon and Merck Pharmaceuticals. Program Disclosure This activity has been planned and implemented
More information29th Viral Hepatitis Prevention Board Meeting
29th Viral Hepatitis Prevention Board Meeting Madrid, November 2006 Treatment of chronic hepatitis C José M. Sánchez-Tapias Liver Unit Hospital Clínic University of Barcelona Spain CHRONIC HEPATITIS C
More informationTreatment of genotype 4 patient. with cirrhosis. Vincent LEROY Clinique Universitaire d Hépato-Gastroentérologie INSERM U823 CHU de Grenoble
Treatment of genotype 4 patient with cirrhosis Vincent LEROY Clinique Universitaire d Hépato-Gastroentérologie INSERM U823 CHU de Grenoble Clinical case 52 year-old patient Intra-venous drug user 1987-1989
More informationNew Therapies on the Horizon in Hepatitis C Patients Paul Y. Kwo, MD
Viral Targets for HCV New Therapies on the Horizon in Hepatitis C Patients Paul Y. Kwo, MD Sites for development of inhibitors Metalloproteinase Serine protease (trans) Core E E2 NS2 NS3 NS4a/NS4b NS5a/NS5b
More informationLes Inhibiteurs de Protéase du VHC
Les Inhibiteurs de Protéase du VHC Pr Jean-Michel Pawlotsky National Reference Center for Viral Hepatitis B, C and delta Department of Virology & INSERM U955 Henri Mondor Hospital University of Paris-Est
More informationInterferon free therapy Are we getting there? Graham R Foster Queen Marys University of London
Interferon free therapy Are we getting there? Graham R Foster Queen Marys University of London IFN free therapy Disclosures I have received personal and institutional funding from companies that sell drug
More informationClinical Сase A previously relapse to PEG IFN + RBV in HCV G3a patient. Konstantin Zhdanov
Clinical Сase A previously relapse to PEG IFN + RBV in HCV G3a patient Konstantin Zhdanov Genotype 3 in Europe Canada Norway Germany Sweden Czech Republic Poland Approximately 1/3 of HCV-infected patients
More informationTreatment Targets HCV Genotype 1 & PIs Treating HCV G2&3 Future Therapies. Advances in treatment of HCV Dr John F Dillon
Treatment Targets HCV Genotype 1 & PIs Treating HCV G2&3 Future Therapies Advances in treatment of HCV Dr John F Dillon Disclosure slide I have received consulting fees and Honoraria from MSD, Abbott,
More informationHighlights of AASLD 2012 CCO Official Conference Coverage of the 2012 Annual Meeting of the American Association for the Study of Liver Diseases
Highlights of AASLD 12 CCO Official Conference Coverage of the 12 Annual Meeting of the American Association for the Study of Liver Diseases November 9-13, 12 Boston, Massachusetts In partnership with
More informationUpdates on Current Status of HCV Therapy
Updates on Current Status of HCV Therapy K. Rajender Reddy, MD Professor of Medicine, Professor of Medicine in Surgery, Director of Hepatology and Medical Director of Liver Transplantation University of
More informationTreatment of chronic hepatitis C in drug-naïve patients
Treatment of chronic hepatitis C in drug-naïve patients 8th International Workshop on HIV & Hepatitis Co-infection Madrid, 31. May 2012 Christoph Sarrazin J. W. Goethe-University Hospital Medizinische
More informationHepatitis C Virus Treatments: Present and Future
Hepatitis C Virus Treatments: Present and Future Charles D. Howell, M.D., A.G.A.F Professor of Medicine University of Maryland School of Medicine Baltimore, MD Charles Howell Disclosures Boehringer Ingelheim,
More informationEmerging Therapies for HCV: Highlights from AASLD 2012 (Part 2)
Emerging Therapies for HCV: Highlights from AASLD 2012 (Part 2) Goals for Hepatitis C Therapy Compared to PegIFN α/rbv, new treatment regimens for chronic hepatitis C should offer: Improved efficacy Efficacy
More informationLatest Treatment Updates for GT 2 and GT 3 Patients
Latest Treatment Updates for GT 2 and GT 3 Patients Eric Lawitz, MD, AGAF, CPI Vice President, Scientific and Research Development The Texas Liver Institute Clinical Professor of Medicine University of
More informationThe Scope of The Problem US Prevalence: 1.8% are chronically infected with Hepatitis C virus (HCV)
The Scope of The Problem US Prevalence: 1.8% are chronically infected with Hepatitis C virus (HCV) World Health Organization. Hepatitis C: Fact Sheet. http://www.who.int/mediacentre/factsheets/fs164/en/index.html.
More informationClinical Management: Treatment of HCV Mono-infection
Clinical Management: Treatment of HCV Mono-infection Curtis Cooper, MD, FRCPC Associate Professor-University of Ottawa The Ottawa Hospital- Infections Diseases Viral Hepatitis Program- Director Industry
More informationVII CURSO AVANCES EN INFECCIÓN VIH Y HEPATITIS VIRALES
VII CURSO AVANCES EN INFECCIÓN VIH Y HEPATITIS VIRALES REGIMENES TERAPÊUTICOS DE LA HEPATITIS C, INTERFERÓN FREE A Coruña 2 Febrero 2013 Rui Sarmento e Castro Centro Hospitalar do Porto HJU ECS Universidade
More informationNew Therapeutic Strategies: Polymerase Inhibitors
New Therapeutic Strategies: Polymerase Inhibitors 6th Paris Hepatitis Conference 14 th - 15 th January, 2013 Stefan Zeuzem Goethe University Hospital Frankfurt, Germany Direct antiviral targets C E1 E2
More informationMEDIC CENTER. Case 2
Case 2 Case history 57 year old Vietnamese man He lives in HCM city and works as a engineer The patient presented in July 2012 with fatigue Diagnosed with HCV in 2004 Negative for both HBV and HIV antibodies
More informationEfficacy and safety of protease inhibitors for sever hepatitis C recurrence after liver transplantation: a first multicentric experience
Efficacy and safety of protease inhibitors for sever hepatitis C recurrence after liver transplantation: a first multicentric experience A. Coilly, B. Roche, J. Dumortier, D. Botta-Fridlund, V. Leroy,
More informationTITLE: Re-treatment with Direct Acting Antivirals for Chronic Hepatitis C Genotype 1: Emerging Evidence of Clinical Effectiveness and Safety An Update
TITLE: Re-treatment with Direct Acting Antivirals for Chronic Hepatitis C Genotype 1: Emerging Evidence of Clinical Effectiveness and Safety An Update DATE: 02 January 2015 RESEARCH QUESTION What is the
More informationEmerging Therapies for HCV: Highlights from AASLD 2012 (Part 2)
Emerging Therapies for HCV: Highlights from AASLD 2012 (Part 2) PegIFN and RBV remain vital components of HCV therapy-- selected presentations from: Program Disclosure This activity has been planned and
More informationSVR Updates from the 2013 EASL
Updates from the 2013 EASL By Tracy Swan, Treatment Action Group Streamlining HCV Treatment Treatment for hepatitis C virus (HCV) is becoming simpler, shorter, and more effective. All-oral combinations
More informationWhy make this statement?
HCV Council 2014 10 clinical practice statements were evaluated by the Council A review of the available literature was conducted The level of support and level of evidence for the statements were discussed
More informationThe legally binding text is the original French version TRANSPARENCY COMMITTEE OPINION. 14 December 2011
The legally binding text is the original French version TRANSPARENCY COMMITTEE OPINION 14 December 2011 INCIVO 375 mg, film-coated tablet B/4 bottles of 42 tablets (CIP code: 217 378-5) B/1 bottle of 42
More informationEmerging Approaches for the Treatment of Hepatitis C Virus
Emerging Approaches for the Treatment of Hepatitis C Virus Gap Analysis 1 Physicians may not be sufficiently familiar with the latest guidelines for chronic HCV treatment, including the initiation and
More informationInterferon-based and interferon-free new treatment options
Interferon-based and interferon-free new treatment options White Nights of Hepatology St. Petersburg, 7. June 2013 Christoph Sarrazin Klinikum der J. W. Goethe-Universität Medizinische Klinik I Frankfurt
More informationHepatitis C en 2013 Tratar o Esperar? Vicente Soriano Servicio de Enfermedades Infecciosas Hospital Carlos III Madrid
Hepatitis C en 2013 Tratar o Esperar? Vicente Soriano Servicio de Enfermedades Infecciosas Hospital Carlos III Madrid Caveats on hepatitis C therapy decision making We treat persons with a liver. They
More informationShould Elderly CHC Patients (>70 years old) be Treated?
Should Elderly CHC Patients (>70 years old) be Treated? Deepak Amarapurkar Consultant Gastroenterologist & Hepatologist Bombay Hospital & Medical Research Center, Mumbai & Jagjivanram Western Railway Hospital,
More informationHow to optimize treatment in G3 patients? Jérôme GOURNAY, MD Hépatologie Centre Hospitalier Universitaire de Nantes France
How to optimize treatment in G3 patients? Jérôme GOURNAY, MD Hépatologie Centre Hospitalier Universitaire de Nantes France Paris Hepatitis Conference, January 12, 2016 Disclosures I have received funding
More informationVirological Tools and Monitoring in the DAA Era
Virological Tools and Monitoring in the DAA Era Prof. Jean-Michel Pawlotsky, MD, PhD National Reference Center for Viral Hepatitis B, C and delta Department of Virology & INSERM U955 Henri Mondor Hospital
More informationUpdate on Real-World Experience With HARVONI
Update on Real-World Experience With A RESOURCE FOR PAYERS This information is intended for payers only. The HCV-TARGET and TRIO studies were supported by Gilead Sciences, Inc. Real-world experience data
More informationFeeling right at home
Feeling right at home Getting to Cure From Cure to Eradication Jordan J. Feld MD MPH Toronto Centre for Liver Disease Sandra Rotman Centre for Global Health University of Toronto SVR Dramatic Improvements
More informationTreating HCV Genotype 2 & 3
Treating HCV Genotype 2 & 3 3rd Workshop on HCV Therapy Advances, Rome 14.12.2013 Christoph Sarrazin Klinikum der J. W. Goethe-Universität Frankfurt am Main, Germany HCV Genotypes 2 & 3 Laurel and Hardy
More informationFor the RESPOND-2 Investigators
HCV RESPOND-2 Final Results High Sustained Virologic Response Among Genotype 1 Previous Non-Responders and Relapsers to Peginterferon/Ribavirin when Re- Treated with Boceprevir Plus PEGINTRON (Peginterferon
More informationHow do you optimize HCV Treatment for Cirrhotic Patients APASL STC Cebu
How do you optimize HCV Treatment for Cirrhotic Patients APASL STC Cebu Seng Gee Lim Chairman, APASL Liver Week 2013 Professor of Medicine Dept of Gastroenterology and Hepatology NUHS, Singapore Disclosures
More informationExpress Scripts, Inc. monograph dated 5/25/2011; selected revision 6/1/2011
BENEFIT DESCRIPTION AND LIMITATIONS OF COVERAGE ITEM: PRODUCT LINES: COVERED UNDER: DESCRIPTION: CPT/HCPCS Code: Company Supplying: Setting: Coverage Criteria: Approval Period: Victrelis (boceprevir capsules)
More informationCASE STUDY. Adverse Events in treatment chronic hepatitis C patients with PegInterferon and Ribavirin What would your management decision be?
Adverse Events in treatment chronic hepatitis C patients with PegInterferon and Ribavirin What would your management decision be? CASE STUDY Pham Thi Thu Thuy MD, PhD Ho Chi Minh City Vietnam Serious Adverse
More informationGlobal Hepatitis Programme. Guideline development for Hepatitis C virus Screening, Care and Treatment in low- and middle-income countries
WHO/HIV/2014.26 World Health Organization 2014 Global Hepatitis Programme Guideline development for Hepatitis C virus Screening, Care and Treatment in low- and middle-income countries WHO TECHNICAL REPORT
More informationMassimo Puoti Dept. of Infectious Diseases AO Ospedale Niguarda Cà Granda Milan, Italy. Side effects of new and old HCV medications
Massimo Puoti Dept. of Infectious Diseases AO Ospedale Niguarda Cà Granda Milan, Italy Side effects of new and old HCV medications The O.pe.r.a. Study Safety of PEG IFN and Ribavirin in 1523 HIV/HCV patients
More informationBackground: Narlaprevir (SCH )
Once Daily Narlaprevir (SCH 9518) in Combination with Peginterferon alfa-2b/ Ribavirin for Treatment-Naive Patients with Genotype-1 Chronic Hepatitis C: Interim Results from the NEXT-1 Study Vierling J,
More informationMonth/Year of Review: November 2011 End date of literature search: 4 th Quarter alone
Drug Use Research & Management Program Oregon State University, 500 Summer Street NE, E35, Salem, Oregon 97301-1079 Phone 503-945-5220 Fax 503-947-1119 Month/Year of Review: November 2011 End date of literature
More informationExperience with pre-transplant antiviral treatment: PEG/RBV and DAA. Xavier Forns, MD Liver Unit Hospital Clínic IDIBAPS and CIBREHD Barcelona
Experience with pre-transplant antiviral treatment: PEG/RBV and DAA Xavier Forns, MD Liver Unit Hospital Clínic IDIBAPS and CIBREHD Barcelona Interferon-free regimens G1b nulls Asunaprevir (PI) + Daclatasvir
More informationApproved regimens for cirrhotic patients
5th Workshop on HCV THERAPY ADVANCES New antivirals in clinical practice Approved regimens for cirrhotic patients Amsterdam, 4-5 december 2015 Disease burden in Spain 400000 350000 300000 F0 Peak cirrhosis
More informationAreas of Interest. HCV Epidemiology, Natural History HCV Treatment. HBV Epidemiology and Prevention. Monoinfected Coinfected
CROI 2011 UPDATE Kenneth E. Sherman, MD, PhD Gould Professor of Medicine Director, Division of Digestive Diseases Univ. of Cincinnati College of Medicine Areas of Interest HCV Epidemiology, Natural History
More informationPhase 3. Treatment Experienced. Ledipasvir-Sofosbuvir +/- Ribavirin in HCV Genotype 1 ION-2. Afdhal N, et al. N Engl J Med. 2014;370:
Phase 3 Treatment Experienced Ledipasvir-Sofosbuvir +/- Ribavirin in HCV Genotype 1 ION-2 Afdhal N, et al. N Engl J Med. 2014;370:1483-93. Ledipasvir-Sofosbuvir +/- Ribavirin in Treatment-Experienced HCV
More informationAssociate Professor of Medicine University of Chicago
Nancy Reau, MD Associate Professor of Medicine University of Chicago Management of Hepatitis C: New Drugs and New Paradigms HCV is More Lethal than HIV Infection HCV superseded HIV as a cause of death
More informationTreatment of chronic hepatitis C in HIV co-infected patients
Treatment of chronic hepatitis C in HIV co-infected patients Vicente Soriano Department of Infectious Diseases Hospital Carlos III, Madrid, Spain The most prevalent chronic viral infections in humans HBV
More informationTREATMENT OF HEPATITIS C IN THE LIVER TRANSPLANT SETTING. Dra. Zoe Mariño Liver Unit. Hospital Clinic Barcelona
TREATMENT OF HEPATITIS C IN THE LIVER TRANSPLANT SETTING Dra. Zoe Mariño Liver Unit. Hospital Clinic Barcelona Hepatitis C after LT Survival (%) HCV negative HCV positive Time from LT (years) HCV treatment
More informationDisclosures 29/09/2014. Genetic determinants of. HCV treatment outcome. IDEAL: IL28B-type is the strongest pre-treatment predictor of SVR
29/9/214 Genetic determinants of ᴧ HCV treatment outcome Disclosures Advisory board member - Gilead, Abbvie, Bristol-Myers Squibb (BMS), Janssen, Merck, and oche Speaker - Gilead, Janssen, Merck, BMS,
More informationSYNOPSIS Final Clinical Study Report for Study AI444031
Name of Sponsor/Company: Bristol-Myers Squibb Name of Finished Product: Name of Active Ingredient: () Individual Study Table Referring to the Dossier (For National Authority Use Only) SYNOPSIS for Study
More informationOptimal ltherapy in non 1 genotypes:
Optimal ltherapy in non 1 genotypes: genotype 2 and 3 patients Antonio Craxì GI & Liver Unit, Di.Bi.M.I.S. University of Palermo, Italy craxanto@unipa.it Peg IFN alpha plus ribavirin : SVR rate of >80%
More informationDr. Siddharth Srivastava
Dr. Siddharth Srivastava MD, DM (Gastroenterology) Associate Professor GIPMER, New Delhi Rashtriya Gaurav Award 2013 for work on hepatitis B and C Set up Liver clinic at GIPMER and in charge EUS laboratory.
More informationBest of AASLD 2010 For IAGH. April 2011 Reza Malekzadeh M.D. AGAF Professor of Medicne DDRC/TUMS
Best of AASLD 2010 For IAGH April 2011 Reza Malekzadeh M.D. AGAF Professor of Medicne DDRC/TUMS DAAs Direct-Acting Antivirals Understanding of HCV life cycle Identification of potential targets of antivirals
More informationThe Changing World of Hepatitis C
The Changing World of Hepatitis C Alnoor Ramji Gastroenterology & Hepatology Clinical Associate Professor Division of Gastroenterology University Of British Columbia St. Paul s Hospital Site Disclosures
More informationInterferon Side Effects and The Future of Interferon Sparing Regimens. Todd Wills, MD ETAC Infectious Disease Specialist
Interferon Side Effects and The Future of Interferon Sparing Regimens Todd Wills, MD ETAC Infectious Disease Specialist HEPATITIS C TREATMENT EXPANSION INITIATIVE MULTISITE CONFERENCE CALL FEBRUARY 15,
More informationWhat is the Optimized Treatment Duration? To Overtreat versus Undertreat. Nancy Reau, MD Associate Professor of Medicine University of Chicago
What is the Optimized Treatment Duration? To Overtreat versus Undertreat Nancy Reau, MD Associate Professor of Medicine University of Chicago Learning Objectives: 1. Discuss patient populations appropriate
More informationDirect Acting Antivirals for the Treatment of Hepatitis C Infection
Hepatitis C Core Curriculum, Module 2 Direct Acting Antivirals for the Treatment of Hepatitis C Infection Jason J. Schafer, PharmD, MPH, BCPS, AAHIVP Objectives Discuss the evolution of hepatitis C treatment
More information46th EASL Congress, Berlin, Germany March 30 April 3, 2011 Abstract 66
SILEN-C2: Sustained Virologic Response (SVR) and Safety of BI21335 Combined with Peginterferon Alfa-2a and Ribavirin (P/R) in Chronic HCV Genotype-1 Patients with Non-response To P/R M.S. Sulkowski, M.
More informationNovember 2013 AASLD Investor Event 4 November
November 2013 AASLD Investor Event 4 November Maris Hartmanis, President and CEO Charlotte Edenius, EVP Development Bertil Samuelsson, CSA Rein Piir, EVP Corporate Affairs & IR Corporate presentation,
More information