Incivek Approved by FDA for Treating Hepatitis C
Incivek (telaprevir) was approved by the U.S. Food and Drug Administration (FDA) yesterday to treat adult hepatitis C patients.
Less than 50% of patients respond to the current standard of care regimen: Peginterferon alfa and ribavirin taken for 48 weeks. Incivek will provide another option for treatment for patients who have either not received interferon-based drug therapy for their infection or who have not responded adequately to prior therapies.
Hepatitis C is a liver disease resulting from infection with the Hepatitis C virus. This contagious infection can be either “acute” or “chronic.” Acute Hepatitis C virus infection is a short-term illness that occurs within the first 6 months after someone is exposed to the Hepatitis C virus. For most people, acute infection leads to chronic infection.
Chronic Hepatitis C is a serious disease than can result in long-term health problems, or even death. According to the U.S. Centers for Disease Control and Prevention, about 3.2 million people in the United States have chronic hepatitis C infection.
Most people with hepatitis have no symptoms of the disease until liver damage occurs, which may take several years. Prevention is the key.
There is no vaccine to prevent Hepatitis C. The infection is usually spread when blood from a person infected with the Hepatitis C virus (HCV) enters the body of someone who is not infected. Common ways this spread of HCV can occur includes: being born to a mother with HCV; sharing a needle; having sex with an infected person; sharing personal items such as a razor or toothbrush with someone who is infected with the virus, or from unsterilized tattoo or piercing tools.
“With the approval of Incivek, there are now two important new treatment options for hepatitis C that offer a greater chance at a cure for some patients with this serious condition,” said Edward Cox, M.D., M.P.H, director, Office of Antimicrobial Products in FDA’s Center for Drug Evaluation and Research. “The availability of new therapies that significantly increase responses while potentially decreasing the overall duration of treatment is a major step forward in the battle against chronic hepatitis C infection.”
The safety and effectiveness of Incivek was evaluated in three phase 3 clinical trials with about 2,250 adult patients who were previously untreated, or who had received prior therapy. In all studies patients also received the drug with standard of care. In previously untreated patients, 79% of those receiving Incivek experienced a sustained virologic response (i.e. the infection was no longer detected in the blood 24 weeks after stopping treatment) compared to standard treatment alone.
The sustained virologic response for patients treated with Incivek across all studies, and across all patient groups, was between 20 and 45% higher than current standard of care.
The studies indicate that treatment with Incivek can be shortened from 48 weeks to 24 weeks in most patients. Sixty% of previously untreated patients achieved an early response and received only 24 weeks of treatment (compared to the standard of care of 48 weeks). The sustained virologic response for these patients was 90%.
When a person achieves a sustained virologic response after completing treatment, this suggests that the hepatitis C infection has been cured. Sustained virologic response can result in decreased cirrhosis and complications of liver disease, decreased rates of liver cancer (hepatocellular carcinoma), and decreased mortality.
Improved treatment of hepatitis C could decrease the need for liver transplants in the United States. Most are done in the U.S. for patients with progressive liver disease caused by hepatitis C virus infection.
Incivek is a pill taken three times a day with food. Incivek should be taken for the first 12 weeks in combination with peginterferon alfa and ribavirin. Most people with a good early response to the Incivek combination regimen can be treated for 24 weeks rather than the recommended 48 weeks of treatment with the standard of care. Incivek is part of a class of drugs referred to as protease inhibitors, which work by binding to the virus and preventing it from multiplying.
The most commonly reported side effects in patients receiving Incivek in combination with peginterferon alfa and ribavirin include rash, low red blood cell count (anemia), nausea, fatigue, headache, diarrhea, itching (pruritus), and anal or rectal irritation and pain. Rash can be serious and can require stopping Incivek or all three drugs in the treatment regimen.
On May 13, FDA approved Victrelis (boceprevir), another new treatment for chronic hepatitis C, marketed by Merck of Whitehouse Station, N.J.
Incivek is marketed by Cambridge, Mass.-based Vertex Pharmaceuticals.