A new drug which doubles the chances of a cure and halves the treatment time for hepatitis C patients has been hailed by a liver disease expert as “a major step forward” for sufferers.
The approval of Incivo (telaprevir) by the Scottish Medicines Consortium for use by the NHS in Scotland is seen as the most important in a decade.
Dr John Dillon, consultant gastroenterologist and hepatologist leader of the Gut Research Group, based at the Biomedical Research Institute at Ninewells Hospital and Medical School, welcomed the recommendation.
He said: “For many adults with chronic genotype-1 hep C, treatment with a telaprevir-based regimen could provide a shorter treatment duration with improved response rates compared to standard treatment.”
Used in combination with current standard treatment drugs for adults in Scotland who have not previously had treatment and adult patients for whom treatment has previously failed, telaprevir, one of a new class of medicines which directly targets the hep C virus, now offers significantly more patients in Scotland the chance of clearing the virus.
Dr Dillon said: “Before the introduction of protease inhibitors, of which telaprevir is the latest, treatment for hep C required a long duration and less than 50% of chronic genotype-1 hep C patients got rid of the virus.
“This arrival doubles their chances of a cure and halves their treatment period so it’s a major step forward.”
Dr Dillon said one of the biggest problems facing the NHS is the fact that while there are around 2,000 hep C sufferers in Tayside, it is thought that at least the same number of people have the virus but do not know it.
He explained that while it is mainly people in their 20s or 30s who contract the blood-borne virus, it slowly chews away at the liver for the next 20-30 years, leading to cirrhosis and eventually cancer.
The people most at risk of contracting it are drug abusers who share needles or people who have been infected through blood transfusions or, more rarely, body piercings.
Dr Dillon added: “It’s a common illness in Tayside and we are concerned that there are a lot of people who don’t know they have it. We are keen to raise awareness of that fact, the people we are keen to attract are those who are not in touch with the services.
“It’s not really the problem drug users because most of them are known, it’s people who maybe once or twice have shared needles and then think it’s not for them, but they may be infected without showing any symptoms.”
In Scotland, it is estimated that 50,000 individuals are infected with hep C5 which doctors say is a “significant public health threat”.
It is highly infectious, often has no symptoms and can lead to fatal liver conditions. Of those who develop hep C an estimated 30% will develop cirrhosis (deterioration of the liver), others will develop liver cancer, some of whom may require liver transplantation. Hep C is the most common reason for patients requiring a liver transplants in Europe.
In tests, the addition of telaprevir as a treatment cleared the hep C virus in almost twice as many previously untreated patients (79% compared to 46%) and almost four times as many who had previously relapsed following treatment (84% compared to 22%).
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