For someone with liver disease, a cocktail is normally a forbidden luxury. But in some cases, it may be just what the doctor ordered. Two recently approved medications are now being combined with traditional treatments to form a powerful new drug cocktail, improving the outcomes among patients with this challenging disease.
The new cocktail, part of the arsenal of treatment at the Center for Liver Disease and Transplantation, adds the newly approved drugs (telaprevir and boceprevir) to antivirals already in use for Hepatitis C (pegylated interferon and ribavirin). Together, the formula increases the cure rate from 40-50% to 70-80%, and shortens the treatment time by half.
Although the cocktail causes a number of undesirable side effects, it is nevertheless viewed as a "huge advance," says Elizabeth Verna, MD, MS, Assistant Professor of Medicine at NYP/Columbia's Center for Liver Disease and Transplantation. "With chances of recovery no better than a coin toss (with the traditional regimen), there was plenty of room for improvement. Despite the effects of these medications, the vastly improved outcomes make the cocktail worthwhile."
Side effects of the pegylated interferon and ribavirin include anemia, low platelet counts, fever, weight loss, and thyroid problems. The addition of telaprevir or boceprevir can result in more substantial anemia, sometimes requiring a transfusion. Telaprevir is also associated with a rash, among other undesirable effects.
"The goal is to eventually have a regimen that does not include the interferons," Dr. Verna says, "something that cures more people but with less toxicity." In the meantime, she is putting most of her hepatitis C patients on the triple drug plan, with very good results.