Genomics triples the chances of response to treatment in patients with Viral Hepatitis.

-the next available of the protease inhibitors for the treatment of viral hepatitis, increased by 25% the number of patients responders

Sevilla, 2011-June during digestive disease week VI, find reference science organized by the Spanish society of digestive pathology (EDPS), which held its annual Congress LXX with presence of more than 1,000 gastroenterologists in Seville from Saturday 11 to Tuesday, June 14the main available news about the treatment of viral hepatitis has been.

The experts discuss two new scenarios in tackling the disease: on the one hand, this year there will be two drug inhibitors of the protease to deal with viral hepatitis. Run with the standard treatment, the protease inhibitors increase 25% the number of patients responders.

On the other hand, we are witnessing the application of genomics to the treatment of viral hepatitis, which will make it possible to choose the therapy most appropriate to each patient, increasing the likelihood of response to one or another therapy.

Customization of the treatment

Genomics identifies patients with greater possibilities of response based on the presence of a particular genotype. The search for genetic signals in the patient is a key objective for the majority of the research groups in Spain and the rest of the world, that they can be extremely useful in the management of liver disease.

In the case of the viral hepatitis treatment response if there is one of the polymorphisms of the IL28 is three times, according to experts. Genetic signals of interleukin 28b allow partly know chances of healing in a patient’s viral hepatitis and choose the therapy most appropriate to each person. When a patient has the favourable genotype of the IL28b and C virus genotype 1, the chances of cure are 80% ”, explains Dr. Manuel Romero, Director of the surgical unit of digestive diseases and Ciberehd, University Hospital of Valme in Seville. According to Dr. Romero, this group of patients, which represent a third of the total number of patients with genotype 1, you could save on the one hand in economic resources and adverse effects could be avoided.

New therapeutic options

With respect to the provision of new therapies, study results have recently been published in phase III showing an increase in the effectiveness of the protease inhibitors combined with standard treatment (triple therapy). According to these results the combination would lead to an increase in the rate of viral response sustained by 25-30% on standard therapy, both in naïve patients (those who have not had previous treatment) as those who have not previously responded to standard therapy. This would dispose of the protease inhibitors would rescue them almost one-third of patients not answering to the conventional treatment.

In the words of Dr. José Luis Calleja, of Gastroenterology and Hepatology of the Hospital Puerta de Hierro Madrid service while the triple therapy can be associated to certain undesirable effects (skin irritations – skin rash-, anemia or alteration in the perception of taste – dysgeusia-) and the absence of a reply is associated with the development of mutations that confer resistance to the antiviral, these advances are spectacular to expand the therapeutic spectrum in the treatment of hepatitis C ”

in the face of this new stage, the expert stresses that these treatments triple the cost of current therapy, which is why it is necessary to develop strategies that optimize the management of the patient. This strategy will considerably help customizing the treatment through genomics and development sections and specific units within the services of Gastroenterology.

Following this line there are several drugs in phase II and III is available in the near future and that can mean one greater increase in the rate of healing, with less time for treatment and fewer side effects. Experts insist that any treatment prescribed at the present time must take into account these data for the future.

Viral hepatitis

Viral hepatitis is one of the most common liver diseases, caused as a result of infection by the hepatitis virus, of which five types are known (virus of hepatitis A, B, C, D and E). Generic are transmitted through blood or sexual. In the case of the virus B, C and D, hepatitis evolves to the chronicity and may eventually lead to cirrhosis and hepatocellular carcinoma.

In particular chronic hepatitis C is the viral hepatitis that generates greater socio-health problem in Spain, both because of its prevalence (between 1% – 1.5% of the population) by its morbidity and mortality remain the leading cause of liver transplantation in the world.

Chronic hepatitis B has a prevalence and incidence lower but a significant mortality and morbidity. Fortunately available drugs are now able to control viral replication in almost all patients, getting a clear improvement of the prognosis in patients with chronic hepatitis B and after liver transplantation.

Challenges for the future

during the SED 2011 have been discussed the main challenges for the management of viral hepatitis. During these four days of scientific forum in Seville have taken place the meeting of liver disease, on Sunday 12 June, the liver meeting which dealt with the handling of the resistant patient with chronic hepatitis B, Monday 13 and “New paradigms in the treatment of viral hepatitis” was held in the afternoon of 14.

This last session presented a study of the Group of Hospital Universitario de Valme, which reveals that the genotypes of the IL28b might predict the risk of developing complications such as bleeding or ascites by esophageal-gastric varices. Also many of hepatocellular cancer and risk of progressing hepatic dysfunction in liver cirrhosis.

Spanish society of digestive pathology (EDPS)

The EDPS is a scientific and professional organization non-profit, which is 78 years of existence and currently brings together more than 2,100 associated physicians. It is oriented to the promotion and dissemination of research and knowledge in the field of digestive diseases, health promotion and preventive diagnóstico-terapéuticos Basic, epidemiological aspects, as well as the promotion of its practical application, with the aim to be a reference for specialists in digestive systemrelated specialties and general population and an ally of the Administration and social partners.

Between the end of the EDPS stresses the promote the formation of multicenter and multidisciplinary groups to carry out basic, epidemiological research and clinics in the field of digestive diseases, and maintaining scientific relations and links with similar or related companies, as well as with academic institutions, and any other institution interested in the development of digestive pathology.