‘Game-changing’ hepatitis C treatments, coupled with UB faculty expertise, will transform patient care

BUFFALO, N.Y. – The Food and Drug Administration’s approval last week of the first hepatitis C virus (HCV) treatments that cure patients without interferon is a dramatic, positive development, according to a University at Buffalo expert in liver disease.

The new therapies are oral medications and do not require interferon, a drug that is administered via injection and that has significant side effects. New treatments are likely to make liver transplants for HCV much less common, says Andrew H. Talal, MD, professor in the Department of Medicine in the UB School of Medicine and Biomedical Sciences.

“This new wave of therapies, which are taken orally instead of through injection, is game-changing, a major paradigm shift in how we treat patients with HCV,” Talal says.

In response to the changing therapeutic landscape, UBMD Internal Medicine is launching a center for Clinical Care and Research in Liver Disease, which Talal will direct. The center’s primary objective will be to advance research, clinical management and education on liver disease to lessen the burden of these diseases in Western New York.

“The center will foster interdisciplinary collaborations between different disciplines with the goal of enhancing the understanding of how these new therapies work in the body and expanding access to treatment for populations that have traditionally been excluded from therapy,” Talal explains.

In addition to the drug that received approval last week, additional HCV therapies are expected to receive approval between now and the end of 2014, he adds, with others in development. A primary advantage of the new therapies is that they are the first that are effective against all HCV genotypes.

“A major therapeutic advance is occurring with the approvals of these new drugs, which typically have a cure rate of 95 percent or higher,” says Talal.
“That’s nearly double the success rate of interferon-based therapies.”

New York State recently enacted a law requiring all hospital and health care clinics to offer HCV antibody screening to any patient born between 1945 and 1965.

Left untreated, HCV and other liver diseases can cause liver failure for which a liver transplant is the only management strategy.

“In the next several years, we will have the ability to use these new therapies, which are more effective and can be used for shorter duration with fewer side effects than the older treatments,” Talal says.

Talal is among a small group of scientists who specialize in studying exactly what happens to drugs in patients. When he and his colleague Anthony Martinez were recruited to UB in 2012 from Weill Cornell Medical College and the University of California, San Diego respectively, as part of the UB 2020 strategic plan, the region gained a full gamut of innovative approaches to liver disease.

Such specialists are in high demand across the nation as the complications of chronic liver disease soar, with at least 3.2 million affected people in the U.S. and as many as 170 million worldwide.

Talal and Martinez see patients at outpatient clinics at Buffalo General Medical Center and at Erie County Medical Center through UBMD Internal Medicine. The new liver center is located in UB’s Clinical and Translational Research Center (CTRC) on the Buffalo Niagara Medical Campus.

“What we’re doing here at UB is truly translational. We’re assessing drug concentrations in the liver to better define dosing guidelines and developing new approaches to patient care,” says Talal.

Talal and other researchers also are investigating the use of telemedicine to deliver treatment on site in a methadone maintenance treatment program.

“We’re able to do this type of research because we are part of an academic health center on the Buffalo Niagara Medical Campus,” he continues. “We obtain samples from patients who are evaluated in our clinics or through telemedicine, we conduct laboratory research here at the CTRC and then use this knowledge in treating our patients. As leaders in the field, our findings are going to be critical to how patients with HCV and other liver diseases will be treated.”

This seamless integration between clinical care and research creates a supportive environment for trainees seeking academic careers in liver disease.

“Laboratory scientists do not typically have ready access to clinical samples, and that is what we are creating here at UB,” adds Talal. “This is exactly the type of environment that research trainees are seeking.”