{"id":3973,"date":"2013-04-10T07:14:40","date_gmt":"2013-04-10T11:14:40","guid":{"rendered":"http:\/\/blogs.nejm.org\/?p=3973"},"modified":"2015-06-04T14:33:45","modified_gmt":"2015-06-04T18:33:45","slug":"simeprevir-and-sofosbuvir-submitted-to-fda-clock-ticking-on-boceprevir-telaprevir-even-interferon","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/simeprevir-and-sofosbuvir-submitted-to-fda-clock-ticking-on-boceprevir-telaprevir-even-interferon\/2013\/04\/10\/","title":{"rendered":"Simeprevir and Sofosbuvir Submitted to FDA &#8212; Clock Ticking on Boceprevir, Telaprevir, Even Interferon"},"content":{"rendered":"<p><a href=\"http:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2013\/04\/Cambridge-MA-SS-Deli2.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignright  wp-image-3975\" title=\"S&amp;S Deli, Cambridge MA\" src=\"http:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2013\/04\/Cambridge-MA-SS-Deli2.jpg\" alt=\"\" width=\"314\" height=\"207\" \/><\/a>Two weeks, two companies, two press releases, two future HCV drugs that begin with &#8220;S&#8221;:<\/p>\n<ol>\n<li><a href=\"http:\/\/www.prnewswire.com\/news-releases\/janssen-submits-new-drug-application-to-us-fda-for-simeprevir-tmc435-for-combination-treatment-of-adult-patients-with-genotype-1-chronic-hepatitis-c-200501671.html\" target=\"_blank\">March 28, 2013:<\/a>\u00a0Janssen Research &amp; Development\u00a0announced that\u00a0it has submitted a New Drug Application to the FDA seeking approval for <strong>simeprevir<\/strong> (TMC435), an investigational NS3\/4A protease inhibitor, administered as a 150 mg capsule once daily with pegylated interferon and ribavirin for the treatment of genotype 1 chronic\u00a0HCV in adult patients.<\/li>\n<li><a href=\"http:\/\/investors.gilead.com\/phoenix.zhtml?c=69964&amp;p=irol-newsArticle&amp;ID=1804362&amp;highlight=\" target=\"_blank\">April 8, 2013:<\/a>\u00a0Gilead Sciences announced that it has submitted a New Drug Application to the FDA for approval of <strong>sofosbuvir<\/strong>, a once-daily oral nucleotide analogue for the treatment of chronic\u00a0HCV infection. The data submitted in this NDA support the use of sofosbuvir and ribavirin as an all-oral therapy for patients with genotype 2 and 3 HCV infection, and for sofosbuvir in combination with\u00a0ribavirin and pegylated interferon for treatment-na\u00efve patients with genotype 1, 4, 5 and 6 HCV infection.<\/li>\n<\/ol>\n<p>For several years now, all clinicians who see patients with hepatitis C have been promising them better treatments &#8220;soon&#8221;, with admittedly little precision about exactly what this &#8220;soon&#8221; actually means.<\/p>\n<p>But with these filings, we have a pretty good idea. It will be less than a year &#8212; maybe <em>much<\/em> less. Why is that?<\/p>\n<ul>\n<li>The FDA has roughly 10 months to review these applications. (The exact timing is <a href=\"http:\/\/www.fda.gov\/Drugs\/DevelopmentApprovalProcess\/HowDrugsareDevelopedandApproved\/default.htm\" target=\"_blank\">somewhere on the FDA web site<\/a>, see if you can find it.)<\/li>\n<li>These two drugs have looked pretty great in clinical studies to date.<\/li>\n<li>The bar to leap over to be substantially better than current standard -of-care treatment for HCV isn&#8217;t exactly high &#8212; a fact that could get at least one drug,\u00a0if not both, priority review and even more rapid approval.<\/li>\n<li>One of my patients has joked that I&#8217;ve been saying &#8220;in a few years&#8221; for availability of better HCV treatment options for at least &#8220;a few years&#8221; now &#8212; so my time is up.<\/li>\n<\/ul>\n<p>Of course, stuff could happen that holds up the approvals. A toxicity could arise that hasn&#8217;t been reported previously, or a tricky drug-drug interaction could crop up. Or the sun could explode.<\/p>\n<p>But if these things don&#8217;t happen, then for patients with HCV genotypes 2 and 3, a non-interferon option looks like it&#8217;s right around the corner &#8212; sofosbuvir and ribavirin. For those with genotypes 1 and 4,\u00a0a shortened, more effective, and all-round improved interferon-based regimen will arrive at the same time &#8212; pegylated interferon\/ribavirin plus either simeprevir or sofosbuvir.<\/p>\n<p>And even better, how about an off-label combination of these two new drugs\u00a0as in <a href=\"http:\/\/www.retroconference.org\/2013b\/Abstracts\/47930.htm\" target=\"_blank\">this clinical study<\/a>\u00a0&#8212; in which case the interferon can be dropped entirely, right?<\/p>\n<p>Let the choir sing out when that happens, and enjoy a hearty celebratory brunch at the famous Cambridge deli pictured above in honor of the new regimen.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Two weeks, two companies, two press releases, two future HCV drugs that begin with &#8220;S&#8221;: March 28, 2013:\u00a0Janssen Research &amp; Development\u00a0announced that\u00a0it has submitted a New Drug Application to the FDA seeking approval for simeprevir (TMC435), an investigational NS3\/4A protease inhibitor, administered as a 150 mg capsule once daily with pegylated interferon and ribavirin for [&hellip;]<\/p>\n","protected":false},"author":6,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3,5,8,10],"tags":[408,513,810,855,861],"class_list":["post-3973","post","type-post","status-publish","format-standard","hentry","category-health-care","category-infectious-diseases","category-patient-care","category-research","tag-hcv","tag-interferon","tag-ribavirin","tag-simeprevir","tag-sofosbuvir"],"post_mailing_queue_ids":[],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/3973","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/comments?post=3973"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/3973\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/media?parent=3973"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/categories?post=3973"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/tags?post=3973"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}