Dutch guidance for the treatment of chronic hepatitis C virus infection in a new therapeutic era

A new era for the treatment of chronic hepatitis C is about to transpire. With the introduction of the first-generation protease inhibitors the efficacy of hepatitis C treatment improved significantly. Since then, the therapeutic agenda has moved further forward with the recent approval of sofosbuvi...

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Published in:	Netherlands journal of medicine Vol. 72; no. 8; pp. 388 - 400
Main Authors:	Berden, F A C, Kievit, W, Baak, L C, Bakker, C M, Beuers, U, Boucher, C A B, Brouwer, J T, Burger, D M, van Erpecum, K J L, van Hoek, B, Hoepelman, A I M, Honkoop, P, Kerbert-Dreteler, M J, de Knegt, R J, Koek, G H, van Nieuwkerk, C M J, van Soest, H, Tan, A C I T L, Vrolijk, J M, Drenth, J P H
Format:	Journal Article
Language:	English
Published:	Netherlands 01-10-2014
Subjects:	Antiviral Agents - pharmacology Antiviral Agents - therapeutic use Clinical Trials as Topic Genotype Hepatitis C, Chronic - complications Hepatitis C, Chronic - drug therapy Hepatitis C, Chronic - genetics Heterocyclic Compounds, 3-Ring - pharmacology Heterocyclic Compounds, 3-Ring - therapeutic use Humans Liver Cirrhosis - complications Liver Cirrhosis - drug therapy Practice Guidelines as Topic Protease Inhibitors - pharmacology Protease Inhibitors - therapeutic use Simeprevir Sofosbuvir Sulfonamides - pharmacology Sulfonamides - therapeutic use Uridine Monophosphate - analogs & derivatives Uridine Monophosphate - pharmacology Uridine Monophosphate - therapeutic use
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Summary:	A new era for the treatment of chronic hepatitis C is about to transpire. With the introduction of the first-generation protease inhibitors the efficacy of hepatitis C treatment improved significantly. Since then, the therapeutic agenda has moved further forward with the recent approval of sofosbuvir and the expected approval of agents such as simeprevir and daclatasvir. This paper, developed parallel to the approval of sofosbuvir, is to serve as a guidance for the therapeutic management of chronic hepatitis C. We performed a formal search through PubMed, Web of Science and ClinicalTrials.gov to identify all clinical trials that have been conducted with EMA-approved new agents in hepatitis C; for this version (April 2014) we focused on sofosbuvir. For each disease category, the evidence was reviewed and recommendations are based on GRADE. We identified 11 clinical trials with sofosbuvir and for each disease category recommendations for treatment are made. Not all disease categories were studied extensively and therefore in some cases we were unable to provide recommendations. The recent approval of sofosbuvir will most likely change the therapeutic landscape of chronic hepatitis C. The use of sofosbuvir-containing regimens can shorten the duration of therapy, increase efficacy and result in less side effects, compared with standard of care. The efficacy relative to standard of care needs to be weighed against the increased costs of sofosbuvir. With future approval of the other direct-acting antivirals, the outcome of hepatitis C treatment will likely improve further and this guidance will be updated.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-3 content type line 23 ObjectType-Review-1
ISSN:	1872-9061