20 June 2017

Cochrane report on hep C drugs ‘flawed’

Drugs Gastro

The Cochrane Review has come under fire from Australian gastroenterologists for saying the new hepatitis C drugs don’t save lives.

In its new report, authors at the non-profit NGO concluded that they “could neither confirm nor reject that [direct-acting antivirals] had any clinical effects”.

After analysing 138 trials with a total of 25,232 participants, the authors said that the research on hepatitis C medications had a high risk of bias.

“The clinical relevance of the effects of [direct-acting antivirals] on no sustained virological response is questionable, as it is a non-validated surrogate outcome,” the authors wrote.

But the Gastroenterology Society of Australia-Australian Liver Association (GESA-ALA) hit back, concerned that the report would put patients or doctors off the drugs, which have been touted as “miraculous”.

“The Cochrane report is flawed,” GESA-ALA chair Professor Alex Thompson said.

Professor Thompson said the clinical trials were short-term studies designed 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,” he said.

“As someone who has dedicated my career to treating viral hepatitis, I am worried that misinformation stemming from this report may sway doctors away from prescribing [direct-acting antivirals] and discourage patients from seeking and continuing treatment.”

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Justin Coleman
Justin Coleman
11 months 22 days ago

Perhaps Professor Thompson should declare his conflict of interest while discounting the Cochrane evidence. The beauty of the new mandated transparency reporting code is that now these conflicts are discoverable online.
A quick look at the Gilead (makers of Hep C drug Sovaldi) transparency report shows that Prof Thompson receives thousands of dollars for consultancy and being on the Gilead Advisory Board.
Advising both Gilead and Australian GPs about the benefits of Gilead’s most profitable drug must be a bit of a juggle.