20 BMS-790052 is a new, promising agent in the treatment of chronic HCV infection. It is the first drug with activity against NS5A. Further studies with longer courses of therapy of BMS-790052 in combination with other DAAs and pegylated interferon and ribavirin are required to
establish the long-term efficacy and safety of BMS-790052. BMS 790052 is one of over 50 new DAAs that are in different stages of development from preclinical to phase 3 clinical trials. These agents act on one of three targets on the HCV. They inhibit NS3-NS4A protease, NS5B polymerase (nucleoside or nonnucleoside), or the NS5A protein. Many of these agents result in viral suppression in over 80% of cases. These learn more classes of agents exhibit
different properties, with respect to development of resistance mutations, genotypic coverage, potency, and toxicity (Table 1). Most of these molecules appear to be well tolerated and exhibit pharmacokinetics that allow for daily or twice-daily administration. The pattern of resistance mutations induced by these agents find more varies among the different classes of agents. This suggests that a combination of agents may be effective in treating hepatitis C and minimizing the development of resistance mutations. Studies are under way with single DAAs and combinations of these agents with interferon and ribavirin. Preliminary results appear promising. It has now been shown that treatment of hepatitis C with a combination of DAAs (including BMS 790052) alone, without interferon, may result in sustained viral clearance.20 There are a number of ongoing studies utilizing combinations of DAAs without interferon that are showing
promise. It still remains to be seen whether ribavirin will be needed as part of these regimens to produce a sustained viral response. Oral, interferon-free Progesterone treatment of hepatitis C appears a possibility. It will require a combination of agents aimed at different targets on the HCV. We are approaching the dawn of a new era in the treatment of HCV with the possibility of oral, effective, and well-tolerated combination therapy. These regimens have the possibility of eradicating HCV in the majority of patients. Much work is still needed to define the most clinically effective and least toxic regimens. “
“Primary biliary cirrhosis (PBC) tends to affect females more than males. PBC selectively damages intrahepatic small bile ducts, particularly interlobular bile ducts. The clinical presentation of PBC has changed according to recent advances in clinicobiological diagnosis and improvements in therapeutic effects and prognosis. In particular, we encounter PBC patients with hepatocellular carcinoma (HCC), and the number of these patients appears to have increased.
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