Experts reject “flawed report” about direct-acting antiviral hep C medicines

On 6 June 2017 the Cochrane Collaboration published a review of all the randomised controlled trials conducted by the manufacturers of hepatitis C medicines in order to get their drugs licensed. In short Cochrane finds that the drugs may clear the virus from the blood, but there is no evidence that they prevent harm from disease or save lives. Further, the review states “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”.

It’s fair to say the review has caused quite a stir; not only because of the findings but also because of their highly credible source – the Cochrane Collaboration. It’s also fair to say there’s a crowd gathering to disparage the Cochrane review and to reaffirm support for the new generation medicines.

Hepatitis ACT stresses that people living with hepatitis C should not delay treatment. “This Cochrane review is no reason for people to put off being treated for hepatitis C”, says John Didlick (Executive Officer), “and it is no reason for doctors to delay treatment initiation”. People who have already been cured of hepatitis C need not be alarmed by the findings, and should continue to follow their doctor’s advice about the need (or otherwise) for ongoing monitoring. The new hepatitis C treatments are fast and effective, and importantly access in Australia is unrestricted. There has never been a better time to talk to a doctor about starting treatment for hep C.

What others are saying about the Cochrane review:

The World Hepatitis Alliance
The WHA has responded criticising the review and noted that these findings are being used by several media outlets to call into question if countries should fund the treatment of hepatitis C using DAAs. The full response from the World Hepatitis Alliance is here:

The Gastroenterological Society of Australia (GESA)
On 15 June 2017 GESA issued a media release entitled “Experts reject flawed report and reaffirm support for new generation hepatitis C therapies”. In it GESA-ALA Chair, Professor Alex Thompson said, “The Cochrane report is flawed. The clinical trials analysed were designed as short-term studies to demonstrate antiviral efficacy in terms of curing hepatitis C. They were never intended to assess mortality and therefore it is not surprising that a mortality benefit was not identified.”

The Guardian
Has published the following article similarly critical of the review: