Cookie policy: This site uses cookies (small files stored on your computer) to simplify and improve your experience of this website. Cookies are small text files stored on the device you are using to access this website. For more information please take a look at our terms and conditions. Some parts of the site may not work properly if you choose not to accept cookies.


Subscribe or Register

Existing user? Login

Hepatitis C

Study finds no evidence for clinical effect of direct-acting antivirals against hepatitis C

slide showing healthy liver tissue vs cirrhotic liver tissue


Researchers found that while it appears that direct-acting antivirals are successful in clearing hepatitis C from the blood, the virus can still reside elsewhere in the body, causing healthy liver tissue (l) to become cirrhotic (r)

Direct-acting antivirals (DAAs) for chronic hepatitis C (HCV), do not seem to have any effect on the risk of hepatitis C-related morbidity or all-cause mortality, according to a study carried out by the Cochrane Hepato-Biliary Group[1].

The study, published in the Cochrane Database of Systematic Reviews (online, 6 June 2017), set out to review the benefits and harms of DAAs in people with chronic HCV. It examined the results from 138 randomised clinical trials conducted between 2004 and 2016 of DAAs either on the market or under development (84 trials), or those that had been withdrawn from the market (57 trials). The trials featured both treatment-experienced and treatment-naïve patients.

The researchers found that while it appears that DAAs are successful in clearing the HCV from the blood, there is no evidence that they prevent harm from the disease or save lives because the virus can still reside elsewhere in the body.

“It is never possible to show that something does not work, but there is no evidence [that they do]. Our results indicate [the drugs] may have no clinical effect,” says Janus Christian Jakobsen, chief physician at a clinical trial unit in Copenhagen and deputy co-ordinating editor of the Cochrane Hepato-Biliary Group.

“From a patient perspective, it does not matter if the virus cannot be detected in the blood if DAAs do not improve survival or lead to fewer hepatitis C complications,” he adds.

DAAs are molecules that target specific non-structural proteins of HCV, resulting in the disruption of viral replication and thereby infection. There are four classes of DAAs, defined by their mechanism of action and therapeutic target. They were initially welcomed as a breakthrough treatment for hepatitis C after they were observed to clear HCV from the blood within 12 weeks.

However, at a price tag of around £30,000 per patient for a 12-week course, experts from the World Health Organization have previously voiced concerns about the affordability of DAAs.

In its review, the Cochrane Hepato-Biliary Group concludes that “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.”

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2017.20202945

Have your say

For commenting, please login or register as a user and agree to our Community Guidelines. You will be re-directed back to this page where you will have the ability to comment.

Recommended from Pharmaceutical Press

  • Handbook of Drug Administration via Enteral Feeding Tubes

    Handbook of Drug Administration via Enteral Feeding Tubes

    All you need to know about prescribing or administering drugs via enteral feeding tubes. Over 400 drug monographs as well as facts to inform clinical decision making.

    £54.00Buy now
  • Stockley's Drug Interactions

    Stockley's Drug Interactions

    Now in its twelfth edition, Stockley’s Drug Interactions is still the most comprehensive and authoritative international source of drug interaction information.

    £240.00Buy now
  • Disease Management

    Disease Management

    Disease Management covers the diseases commonly encountered in primary care by system, with common therapeutic issues. Includes case studies and self-assessment sections.

    £54.00Buy now
  • Physicochemical Principles of Pharmacy

    Physicochemical Principles of Pharmacy

    This established textbook covers every aspect of drug properties from the design of dosage forms to their delivery by all routes to sites of action in the body.

    £48.00Buy now
  • Pharmaceutical Toxicology

    Pharmaceutical Toxicology

    Explains the methodology and requirements of pre-clinical safety assessments of new medicines. Includes registration requirements and pharmacovigilance.

    £40.00Buy now

Search an extensive range of the world’s most trusted resources

Powered by MedicinesComplete
  • Print
  • Share
  • Comment
  • Save
  • Print Friendly Version of this pagePrint Get a PDF version of this webpagePDF

Supplementary images

  • slide showing healthy liver tissue vs cirrhotic liver tissue

Newsletter Sign-up

Want to keep up with the latest news, comment and CPD articles in pharmacy and science? Subscribe to our free alerts.