“Findings from hepatitis C study should not deter patients from seeking treatment or governments from funding it” says World Hepatitis Alliance

13 Jun 2017 Tara Farrell

The World Hepatitis Alliance is concerned that the findings of the Cochrane Review on the new direct acting antiviral (DAA) hepatitis C drugs could have a damaging effect on patient health without a proper understanding of the findings.

The Cochrane Collaboration, an independent global network of researchers, assessed 138 trials of breakthrough hepatitis C treatments found there is insufficient evidence to show if DAAs have or have not any long-term clinical health impacts. The findings based on a meta-analysis of 25,000 people in trials concluded “the lack of valid evidence and the possibility of potentially harming people with chronic hepatitis ought to be considered before treating people with hepatitis C with DAAs”. These findings are being used by several media outlets to call into question if countries should fund the treatment of hepatitis C using DAAs.

Following the launch of the report, the World Hepatitis Alliance spoke on behalf of hepatitis C patients across the world to Janus Christian Jakobsen, chief physician at a clinical trial unit in Copenhagen and deputy co-ordinating editor of the Cochrane Hepato-Biliary Group, to discuss the report in detail.

Following the call, it's the World Hepatitis Alliance’s opinion that there is no evidence of long term health impacts. There is not enough evidence yet to judge their impact on health outcomes like mortality and morbidity, partly because of the way the trials were designed and partly because these outcomes take a long time to become apparent. Although there is good evidence that clearing the virus with interferon-based regimes does reduce mortality and morbidity, we do not yet have the evidence for DAAs. Equally, we do not yet have the evidence to be sure that the DAAs are safe over the long term and therefore, as with any new drug there is always the potential for harm that has not so far shown up. The main message, therefore, is that as yet there is insufficient evidence of what happens in the long term and that properly constructed trials are needed to investigate this matter further.

In light of this, the World Hepatitis Alliance is keen to continue to advocate strongly for immediate access to DAAs. Results from around the world have shown significant falls in deaths. For example in England the use of DAAs in people with decompensated cirrhosis in 2016 showed a fall of 11% in deaths among this very sick group of patients and a fall in nearly 50% in the need for transplants.

 “As a patient-led and patient-driven organisation, we have seen, heard and experienced the real evidence of being treated with DAAs. The true story is one of remarkable, if surprising, success over just a decade, transforming an unpleasant and sometimes fatal disease into one that is readily cured.” said Charles Gore, President of the World Hepatitis Alliance. “What is absolutely imperative is that this Review should not be used as another excuse not to treat, when currently only 1.5% of people living with hepatitis C are accessing treatment worldwide. ”