title: The position of the Sociedad Española de Patología Digestiva on the current situation of hepatitis C management in Spain.
abstract: The advent of direct-action antivirals telaprevir and boceprevir has entailed a radical change in the healing possibilities for patients with hepatitis C. This change has coincided with the emergence of highly robust evidence on the benefits of cure as regards increased overall survival, mainly brought about by a reduction in liver-related events in the long run. Therefore, a finite-in-time treatment is available that achieves very notable results both short- and long-term. Triple therapy, consisting of the association of one of these novel drugs with the previously standard regimen of pegylated interferon and ribavirin, has come in the setting of a financial crisis, which has led to restrict its use primarily for patients with advanced fibrosis. These patients--who need a cure the most--are those with the lowest healing rates and the commonest, most severe side effects. The time has then come to shift the aim point towards patients with less severe fibrosis, better cure rates, and fewer side effects where therapeutic intervention may prevent the development of significant liver disease. Despite record-time approval by the European Medicines Agency, various barriers--mainly at the Autonomic regional level--have delayed access to these therapies by our patients, thus giving rise to inequality situations. New oral therapies are now on the near horizon that will increase the numbers of patients eligible for treatment with fewer side effects and a higher cure rate. We hope that the lesson is learned and no such situation will be repeated. An Integrated National Action Plan Against Hepatitis C would be an essential tool for countering this disease.
authors.lastname: Sociedad Española de Patología Digestiva
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use; D006526:Hepatitis C / Q000188:drug therapy / Q000473:pathology / Q000628:therapy*; D006801:Humans; D009842:Oligopeptides / Q000627:therapeutic use; D011392:Proline / Q000031:analogs & derivatives / Q000627:therapeutic use; D013030:Spain
chemical_list: D000998:Antiviral Agents; D009842:Oligopeptides; C486464:telaprevir; C512204:N-(3-amino-1-(cyclobutylmethyl)-2,3-dioxopropyl)-3-(2-((((1,1-dimethylethyl)amino)carbonyl)amino)-3,3-dimethyl-1-oxobutyl)-6,6-dimethyl-3-azabicyclo(3.1.0)hexan-2-carboxamide; D011392:Proline