Published: Nov 6, 2014
By Michael Smith, North American Correspondent, MedPage Today
As the therapeutic picture for hepatitis C begins to settle down, the volume of abstracts on the topic is plateauing at the annual meeting of the American Association for the Study of Liver Diseases (AASLD).
But, he told MedPage Today in advance of the meeting, "there's a big shift toward fatty liver disease ... that reflects what people are seeing in the clinics."
Over the past several years, direct-acting HCV medications have stolen the show, with a host of new drugs and drug combinations working through the clinical trials process.
Now, with many of those drugs approved and others in the home stretch, meeting participants will be getting mature data, he said.
For instance, the meeting will get an update on the research that underpinned the recent approval of Gilead's ledipasvir/sofosbuvir combination, trade-named Harvoni.
And, Davis said, they can look forward to seeing the data that AbbVie is using to support its multidrug combination -- dubbed 3D -- which is now under review at the FDA.
"It's going to be pretty exciting to see where that's at," he said.
Gilead famously unleashed a firestorm of debate when it priced sofosbuvir (Sovaldi) at $1 a pill and Davis said participants might take all the drug-makers to task over pricing of HCV drugs.
"I'm anxious to hear the audience questions on this, what with the whole controversy over pricing," he said.
The picture in fatty liver disease is less clear than in HCV, but the condition is increasingly prevalent and researchers are now turning their attention to it, looking at the basic mechanisms as well as drug therapy.
It's a "hot area," he said.
Among the hot topics this year:
- The role of bariatric surgery in non-alcoholic steatohepatitis.
- Prednisone and pentoxifylline in alcoholic hepatitis
- Combinations of direct-acting HCV agents post-transplant.
- A recombinant enzyme in liposomal acid lipase deficiency.
Davis also said that there is increased interest in possible curative options for hepatitis B, an area of research that has been "stuck in the mud for years." HBV is tricky to cure, because the virus integrates itself into host cells and -- rather like HIV -- therapy has aimed at suppressing the virus rather than getting rid of it.
But several new compounds in the early stages of investigation aim to change that and the "HBV people are quite excited about it," Davis said.
As well, he said, participants will get results from a major trial of terlipressin, a drug for hepatorenal syndrome that is approved in several countries but not the U.S.
An initial report from the so-called REVERSE study -- of terlipressin plus albumin versus albumin alone -- will attract considerable interest, Davis said, since improvement in renal function in patients with the syndrome is correlated with improved survival.