{"id":5100,"date":"2014-04-12T07:53:07","date_gmt":"2014-04-12T11:53:07","guid":{"rendered":"http:\/\/blogs.nejm.org\/?p=5100"},"modified":"2015-05-18T10:40:10","modified_gmt":"2015-05-18T14:40:10","slug":"unwittingly-hcv-news-brackets-our-current-treatment-era-on-successive-days","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/unwittingly-hcv-news-brackets-our-current-treatment-era-on-successive-days\/2014\/04\/12\/","title":{"rendered":"Unwittingly, HCV “News” Brackets Our Current Treatment Era on Successive Days"},"content":{"rendered":"

I’ve already told you what a fan I am of Physician’s First Watch<\/em><\/a>, the daily email summary of hot medical news provided by my colleagues here at the Massachusetts Medical Society.<\/p>\n

If you haven’t signed up, you must do so — let’s play a short tune (always a favorite) for background music while you head over there and take care of it. I’ll still be here when you get back:<\/p>\n

<\/object>Linus and Lucy by Vince Guaraldi on Grooveshark<\/a><\/span><\/p>\n

Finished? Great.<\/p>\n

Anyway, this week the diligent First Watchers sent me this on Thursday:<\/p>\n

The World Health Organization has issued its first recommendations on screening for and treating hepatitis C infection …\u00a0Pegylated interferon with ribavirin is the recommended treatment.<\/strong><\/p>\n

Interferon plus ribavirin? Blast from the past.<\/p>\n

Now of course the WHO guidelines are much more nuanced than that — the full document<\/a> includes discussions of telaprevir, boceprevir, simeprevir, and sofosbuvir.<\/p>\n

But on a day-to-day basis right now, in places lucky enough to have access to the newest drugs, sofosbuvir is part of\u00a0every<\/em>\u00a0recommended regimen<\/a>, so it’s startling to see interferon and ribavirin listed alone. And barely mentioned at all is the sofosbuvir plus simeprevir combination — a regimen astoundingly free of side effects, and arguably the treatment of choice today for virtually everyone with genotype 1 if drug costs were no issue. (Which they most emphatically are.<\/em>)<\/p>\n

By contrast, First Watch<\/em> sent this off the very next day:<\/p>\n

An 8-week course of sofosbuvir and ledipasvir was not inferior to a 12-week course, or to an 8-week course that also added ribavirin … Another research group studied the combination of a protease inhibitor (ABT-450)… plus two inhibitors of hepatitis C virus replication (ombitasvir and dasabuvir) for 12 weeks … [Both studies had] response rates of roughly 95%.<\/p>\n

They were referring, of course, to two remarkable studies (here<\/a>\u00a0and here<\/a>) just published in the New England Journal of Medicine,\u00a0<\/em>showing us what’s soon to come: both a sofosbuvir\/ledipasvir single pill regimen for just 8 weeks, and an interferon-free approach that doesn’t include sofosbuvir at all.<\/p>\n

So in the future we’ll have choices<\/em> between several excellent options.<\/p>\n

Now get over to the First Watch<\/em> site and sign up. You won’t regret it.<\/p>\n","protected":false},"excerpt":{"rendered":"

I’ve already told you what a fan I am of Physician’s First Watch, the daily email summary of hot medical news provided by my colleagues here at the Massachusetts Medical Society. If you haven’t signed up, you must do so — let’s play a short tune (always a favorite) for background music while you head […]<\/p>\n","protected":false},"author":6,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3,8,9,10],"tags":[267,408,558,671,855,861],"class_list":["post-5100","post","type-post","status-publish","format-standard","hentry","category-health-care","category-patient-care","category-policy","category-research","tag-dasabuvir","tag-hcv","tag-ledipasvir","tag-ombitasvir","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\/5100","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=5100"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/5100\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/media?parent=5100"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/categories?post=5100"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/tags?post=5100"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}