Protease inhibitors improved sustained virologic response rate in HCV

Protease inhibitors improved sustained virologic response rate in HCV

Chou R. Ann Intern Med. 2012;[published online ahead of print Nov. 27].

 

December 12, 2012

 

Data from a systematic review indicate triple therapy that included a protease inhibitor was more likely to achieve a sustained virologic response rate in patients with hepatitis C virus genotype 1 when compared with dual therapy.

 

According to the Annals of Internal Medicine report, the data also indicate that a sustained virologic response (SVR) after antiviral therapy was associated with improved clinical outcomes.
Researchers from Oregon Health and Sciences University conducted the review to compare benefits and harms of treatment in patients who had not yet received treatment. The review included randomized trials of antiviral treatments and cohort studies that were published from 1947 to August 2012.

Patients treated with pegylated interferon alfa-2b and ribavirin were less likely to have an SVR compared with those who received pegylated interferon alfa-2a and ribavirin (RR=0.87; 95% CI, 0.8-0.95). For patients with genotype 2 or 3 infection who received dual therapy, those who received 12 to 16 weeks of therapy were less likely to have an SVR compared with those who received 24 weeks of therapy.

Lower doses of pegylated interferon alfa-2b in dual therapy were associated with fewer SVRs. A 48-week triple-therapy regimen including boceprevir (Victrelis, Merck) or telaprevir (Incivek, Vertex) was associated with an SVR compared with dual therapy. However, boceprevir triple therapy was associated with more hematologic adverse events and telaprevir triple therapy was associated with anemia and rash.

“Additional research would help clarify the comparative effectiveness,” the researchers wrote. “Studies are needed to understand the long-term clinical outcomes associated with different antiviral treatments, the long-term harms of telaprevir and boceprevir, the comparative effectiveness of triple therapy with telaprevir vs. boceprevir and effective strategies to improve adherence.”

Disclosure: Some researchers have received grant funding from the Agency for Healthcare Research and Quality.

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