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Interferonfreie Therapie der Hepatitis C mit/ohne nukleosidischen Polymeraseinhibitor

Interferon-free therapy of hepatitis C with/without nucleoside polymerase inhibitor

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Der Gastroenterologe Aims and scope

Zusammenfassung

Hintergrund

In den letzten Jahren kam es zu einer umfassenden Erneuerung des medikamentösen Repertoires zur Therapie der Hepatitis C. Diese Entwicklung stellt einen enormen Fortschritt in der Hepatologie dar, sie stellt die behandelnden Ärzte aber auch vor neue Herausforderungen.

Ziel der Arbeit

Eine praxisnahe Darstellung und Bewertung zugelassener und noch in klinischer Prüfung (Phase II–III) befindlicher interferonfreier Regime zur Therapie der Hepatitis C bei Patienten ohne Leberzirrhose.

Material und Methoden

Es erfolgt eine Bewertung der wichtigsten Studien und Leitlinien zur interferonfreien Therapie der Hepatitis C.

Ergebnisse und Diskussion

Dank der Zulassung der direkt antiviral wirksamen Medikamente Sofosbuvir, Daclatasvir, Ledipasvir, Simeprevir, Paritaprevir/r, Ombitasvir, und Dasabuvir können bereits heute die allermeisten Patienten mit chronischer Hepatitis C geheilt werden. Die Therapie der Hepatitis C ist allerdings mit erheblichen Kosten verbunden. Problematisch bleibt momentan teilweise noch die Therapie des Hepatitis-C-Virus (HCV) vom Genotyp 3. Eine Reihe weiterer direkt antiviraler Medikamente befindet sich in fortgeschrittener klinischer Entwicklung, sodass mit weiteren Verbesserungen der Therapie der Hepatitis C inklusive des HCV-Genotyps 3 in naher Zukunft gerechnet werden kann.

Abstract

Background

In recent years, numerous potent directly acting antiviral agents (DAAs) have been developed for the treatment of chronic hepatitis C. These exciting developments constitute enormous medical progress, but they also challenge physicians with novel treatment algorithms and legal issues.

Aims

This article critically presents recently approved interferon-free regimens and promising regimens in clinical evaluation (phase II–III) for the treatment of chronic hepatitis C in patients without liver cirrhosis.

Materials and methods

Recent clinical studies and guidelines for interferon-free therapy of chronic hepatitis C are reviewed.

Results and discussion

To date, the vast majority of patients infected with hepatitis C virus (HCV) can be cured with the recently approved DAAs sofosbuvir, daclatasvir, ledipasvir, simeprevir, paritaprevir/r, ombitasvir, and dasabuvir. However, modern therapy of hepatitis C is burdened with significant treatment costs, and treatment modalities for HCV genotype 3 still require improvement. A number of additional DAAs are currently in advanced clinical development, which will likely lead to further optimization of hepatitis C therapy including more potent regimens for HCV genotype 3.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. C. Sarrazin hat die Firmen Abbvie, Bristol-Myers Squibb, Gilead, Janssen Pharmaceuticals, Merck/MSD beraten. S. Zeuzem hat die Firmen Abbvie, Bristol-Myers Squibb, Gilead, Janssen, Merck/MSD beraten. C.M. Lange gibt an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Medizinische Klinik 1, Klinikum der Goethe-Universität Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland

    C.M. Lange, C. Sarrazin & S. Zeuzem

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  1. C.M. Lange
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  2. C. Sarrazin
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  3. S. Zeuzem
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Correspondence to C.M. Lange.

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Lange, C., Sarrazin, C. & Zeuzem, S. Interferonfreie Therapie der Hepatitis C mit/ohne nukleosidischen Polymeraseinhibitor. Gastroenterologe 10, 292–296 (2015). https://doi.org/10.1007/s11377-015-0996-6

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  • DOI: https://doi.org/10.1007/s11377-015-0996-6

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