Treatment of Chronic Hepatitis C Infection Among Current and Former Injection Drug Users Within a Multidisciplinary Treatment Model at a Community Health Centre.

Treatment of chronic hepatitis C infection among current and former injection drug users within a multidisciplinary treatment model at a community health centre.

Can J Gastroenterol. 2013 Apr; 27(4): 217-23
Newman AI, Beckstead S, Beking D, Finch S, Knorr T, Lynch C, Mackenzie M, Mayer D, Melles B, Shore R

The aim of the present prospective observational study was to assess uptake and success of hepatitis C virus (HCV) treatment among a group of former and current injection drug users with chronic HCV infection at the Street Health Centre in Kingston, Ontario. The Street Health Centre offers hepatitis C education, assessment and treatment within a multidisciplinary, integrated and collaborative treatment model of care delivered by primary care professionals. The study enrolled a convenience sample of 34 patients. Seventy per cent of study patients had no postsecondary education, 85% were unemployed and one-third were unstably housed. A majority of study patients self-reported mental health problems. Of the 14 patients who initiated antiviral treatment in the study period, eight (57%) achieved sustained virological response. Regardless of virological outcome, patients who initiated treatment showed positive trends toward increased social and psychiatric stability, and decreases in high-risk behaviours. These results suggest that not only is successful treatment of chronic HCV infection in current and former injection drug users with concurrent psychiatric disorders possible, but the benefits of such treatment delivered in a community-based, multidisciplinary, primary care model may extend beyond narrowly defined virological outcomes. HubMed – drug

Ivacaftor: the first therapy acting on the primary cause of cystic fibrosis.

Drugs Today (Barc). 2013 Apr; 49(4): 253-60
McPhail GL, Clancy JP

Cystic fibrosis (CF) is a life-shortening disorder that affects over 30,000 people in the U.S. and 70,000 worldwide. CF is caused by mutations in the CFTR gene, which codes for the cystic fibrosis transmembrane conductance regulator (CFTR) protein. CFTR is a chloride and bicarbonate channel and regulates several ion transporters at the epithelial cell membrane, controlling hydration or ionic composition of epithelial secretions. Management of CF is currently supportive, but recent advances in drug development have focused on therapies that assist mutant CFTR function. In the current review, we summarize the development and clinical experience with VX-770 (ivacaftor), a small molecule that increases CFTR chloride conductance in vitro and in vivo, including wild-type and G551D CFTR. The G551D CFTR mutation is the third most common CF disease-causing mutation, in which the CFTR protein localizes to the epithelial cell membrane but has defective gating. With restoration of adequate CFTR function through pharmacotherapy, it is possible that the clinical course of patients with CF could be markedly improved, including longevity, quality of life and treatment burden. HubMed – drug

Cobicistat, a pharmacoenhancer for HIV treatments.

Drugs Today (Barc). 2013 Apr; 49(4): 233-7
Temesgen Z

Cobicistat is a novel cytochrome P450 3A4 (CYP3A4) inhibitor in advanced clinical evaluation for use as a pharmacoenhancer of antiretroviral drugs. It lacks significant anti-HIV activity and is more selective than ritonavir in its enzyme inhibition. In addition, its water solubility may lend itself to coformulation with other drugs. Renal adverse effects and a considerable drug interaction potential limit its clinical utility and caution is required when using it. A fixed-dose combination product containing cobicistat in addition to elvitegravir, tenofovir and emtricitabine, and providing a one-pill, once-a-day, antiretroviral regimen was recently approved. HubMed – drug