Report from the European Association for the Study of Liver Diseases (EASL)

Drs. Bacon and Di Bisceglie recently attended the 43rd Annual Meeting of the European Association for the Study of Liver Diseases (EASL) in Milan, Italy from April 22-27, 2008. The Saint Louis University Liver Center was well represented at this meeting as Drs. Bacon and Di Bisceglie were co-authors on 7 presentations.

Several bits of information from this meeting are of interest to supporters of the SLULC. The final results of the IDEAL trial were presented. This large multi-center study of patients with hepatitis C in the United States compared the effectiveness of PEG-interferon 2a (Pegasys) with PEG-interferon 2b (PEG-Intron) along with ribavirin in patients with chronic hepatitis C due to genotype 1 HCV. The results showed that the sustained response rates (cure rates) were the same between the two medications at 40% and 41%. Side effect profiles were also similar.

Also, final results of a large trial called COPILOT were reported. This study investigated maintenance therapy with PEG-interferon 2b in patients with advanced liver disease and showed that there may be a benefit in those patients who have portal hypertension with a decreased incidence of bleeding from enlarged veins in the esophagus (esophageal varices). It is unclear whether this benefit should result in a change in our practice. Finally, numerous results were reported of studies evaluating protease inhibitors and polymerase inhibitors, the new “small molecules” that are being developed as adjunctive treatments for patients with hepatitis C. It seems apparent that these new treatments will indeed change the way in which patients with hepatitis C are treated; although final results with FDA approval will not be available for 3 to 4 years.

All in all, the meeting was very successful and a tremendous amount of new information was presented.