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New EASL guidelines prioritise interferon-free hepatitis C treatment
Liz Highleyman, 2015-04-27 11:20:00
The European Association for the Study of the Liver (EASL) released its latest hepatitis C treatment guidelines at the 50th International Liver Congress which took place last week in Vienna, Austria. The guidelines recommend a variety of interferon-free direct-acting antiviral (DAA) regimens for people with hepatitis C virus genotypes 1-6. The panel offered recommendations for patient groups that remain difficult to treat, such as those with decompensated cirrhosis, but noted that more research is still needed in several areas.
Also concurrent with the conference, EASL and the Latin American Association for the Study of the Liver released joint guidelines for non-invasive assessment of liver disease severity, noting that liver stiffness measurement is becoming the standard of care.
"Virtually everyone infected has a right to be treated for hepatitis C, but we have to acknowledge reality – the new drugs are too expensive and the huge number of patients make it impossible to treat everyone in the next couple years, so we have to prioritise accordingly," said EASL guidelines panel co-ordinator Jean-Michel Pawlotsky.
Pawlotsky presented an overview of the updated recommendations at a special session on Friday. Panel members Alessio Aghemo, David Back, Geoffrey Dusheiko, Xavier Forns, Massimo Puoti and Christoph Sarrazin then participated in a discussion of issues raised by the guidelines, joined by Donald Jensen representing the American Association for the Study of Liver Diseases (AASLD).
The guidelines, published in the April online edition of the Journal of Hepatology and available on the EASL website, are intended to assist physicians and other healthcare providers, as well as people with hepatitis C and other interested individuals, in clinical decision-making.
The new recommendations apply to therapies that have been approved in the European Union, but they are written broadly enough that new drugs can be considered as they become available, EASL Vice Secretary Laurent Castera told the press. Hepatitis C therapy has been a "very rapidly moving field," he said, "but our impression is that the field is stabilising" – with overall SVR rates above 90% – and is now moving to address "niche" populations like people with decompensated cirrhosis, liver transplant recipients, and patients with chronic kidney disease.
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