Both hepatitis C drugs work about the same: study

CHICAGO (Reuters) - Two standard treatments for hepatitis C work equally well at knocking down the virus for most patients, U.S. researchers reported on Wednesday.

The findings, from a 3,000-patient comparative effectiveness study, are meant to help guide doctors' decisions about which treatments work best -- an idea at the center of Present Barack Obama's hopes for healthcare reform.

Obama is spending $1.1 billion in stimulus money to fund comparative effectiveness research to give doctors hard evidence about how medications or medical devices stack up.

"When considering treatments for hepatitis C infection, patients and their doctors now have solid evidence that they can weigh both antiviral therapies equally for effectiveness, safety and tolerability," said Dr. Mark Sulkowski of Johns Hopkins University in Baltimore. He worked on the study that is to be published in the New England Journal of Medicine.

Schering-Plough Corp funded the study, which compared its pegylated-interferon drug Pegintron and ribavirin antiviral combination with Roche Holding AG's Pegasys and ribavirin regimen.

Analysts estimate the U.S. prescription market for hepatitis C to be about $3 billion a year.

Even though the findings did not strongly favor one drug over another, knowing that both treatments are effective will allow doctors to pick the treatments best suited for their patients, Dr. Andrew Muir of Duke University in North Carolina, who also worked on the study, said in a telephone interview.

"There had been a lot of debate about these two regimens. It's great to have a study of this size that really answers this question," he said.

The two drugs cost about the same, he said.

Treatment costs generally range from $12,000 to about $25,000, depending on the type of illness and whether treatment lasts 24 or 48 months.

INCURABLE VIRUS

Hepatitis C is a blood-borne liver disease that can lead to chronic liver problems, liver cancer, cirrhosis and death. The virus affects an estimated 3.2 million people in the United States alone and 170 million worldwide.

In infected people who began either of two standard combination drug therapies during early or less-advanced stages of hepatitis C liver disease, the virus was driven down to undetectable levels in 40 percent to 43 percent.

Those with more advanced liver disease, with the buildup of scar tissue, had a 20-23 percent success rate.

The year-long therapy activates the body's natural defenses against viruses, but patients often feel as though they have a bad case of influenza.

Muir said doctors currently push patients to stay on a higher dose of treatment to ensure the best response, but a subgroup of 700 patients in the study took a lower dose and fared just as well, with a cure rate of 38 percent.

Muir said he will still encourage patients to start with the higher dose, but said, "Maybe I don't need to push my patients as much if they are having side-effects."

Sulkowski said comparative-effectiveness studies such as this one, despite their high cost and lengthy timelines, form the "fundamental backbone" for figuring out which treatment will work best with newer drugs now in the pipeline.

Doctors are eagerly anticipating new treatments, called protease inhibitors, now under development by Schering-Plough and Vertex Pharmaceuticals Inc.

Both are considered potential big sellers.

(Editing by Maggie Fox and Eric Walsh)