Added benefit of daclatasvir drug not proven for chronic hepatitis C infection

In continuation of my update on daclatasvir 

The drug daclatasvir (trade name Daklinza) has been available since August 2014 for the treatment of adults with chronic hepatitis C (CHC) infection. The German Institute for Quality and Efficiency in Health Care (IQWiG) examined in a dossier assessment whether this new drug offers an added benefit over the appropriate comparator therapy.

The drug manufacturer presented data for patients without cirrhosis of the liver who are infected with hepatitis C virus (HCV) genotype 1, and for patients with HCV genotype 4. However, these data are unsuitable in various aspects to prove an added benefit.

The manufacturer dossier contained no data at all for three further patient groups with HCV genotype 1 infection (pretreated patients, untreated patients with cirrhosis of the liver, and patients with HIV coinfection) as well as for patients with HCV genotype 3 (with compensated cirrhosis and/or treatment-experienced).

Added benefit of daclatasvir drug not proven for chronic hepatitis C infection

Enoxaparin prevents PVT in advanced cirrhosis

In continuation of my update on Enoxaparin

Enoxaparin (see structure) significantly reduces portal vein thrombosis (PVT) and increases overall survival in patients with advanced cirrhosis, the results of an Italian study show. The authors also found additional benefits beyond the drug's established effect on PVT.

The study included 70 cirrhosis patients with a Child-Pugh score of 7-10, aged 18-75 years who received enoxaparin 4000 IU/day for 48 weeks or no treatment. Patients were followed up for a mean of 58 weeks in the control group and 89 weeks in the enoxaparin group, with ultrasound evaluation of the portal vein system every 3 months.

As reported by the authors, patients receiving enoxaparin were 90% less likely to experience PVT than those who did not. Overall, 8.8% of enoxaparin-treated patients developed PVT compared with 27.7% in the control group, and no cases developed in the enoxaparin group within the first 2 years.

While decompensation occurred at an equal rate in both groups during the follow-up period, significantly fewer patients experienced progression during active treatment (11.7 vs 59.4%).

 Enoxaparin prevents PVT in advanced cirrhosis