Telaprevir-based triple therapy potent for chronic HCV with advanced fibrosis

Telaprevir-based triple therapy potent for chronic Hep C with advanced fibrosis

A study in November's issue of the Alimentary Pharmacology & Therapeutics investigates telaprevir-based triple therapy for chronic Hepatitis C patients with advanced fibrosis.

Antiviral treatment is recommended for chronic hepatitis C patients with advanced fibrosis to reduce and prevent cirrhosis-related complications. Dr Hayashi and colleagues from Japan evaluated the efficacy and safety of telaprevir-based triple therapy for patients with advanced fibrosis in a clinical practice setting.

The team performed a prospective, multicenter study of 102 patients with advanced fibrosis who were infected with HCV genotype 1b.

All received 12 weeks of telaprevir in combination with 24 weeks of pegylated interferon (PEG-IFN) α2b and ribavirin.

The research team found that the sustained virological response rate was 70%.

The team observed that for treatment-naïve and prior relapse patients the sustained virological response rate was over 80%.

Previous treatment response, interleukin 28B polymorphism, and rapid virological response were independently associated with sustained virological response rate.

To achieve sustained virological response, an adequate dosage of PEG-IFNα2b, and ribavirin is preferable.

However, the team noted that the mean weight-adjusted telaprevir dosage had little impact on treatment outcome.

Although severe blood cytopenia and a dermatological disorder were frequently found, the rate of discontinuation due to adverse effects was 13%.

The researchers found that the inosine triphosphatase CC allele (rs1127354) was independently associated with the development of severe anemia, and lower serum albumin level was associated with the occurrence of infection.

Dr Hayashi's team concludes, "The great gain in the sustained virological response rate by telaprevir-based triple therapy offsets the problems with adverse effects."

"It should be considered as a potent treatment protocol for patients with advanced fibrosis, especially for those with treatment-naïve and prior relapse."

Aliment Pharmacol Ther 2013: 38(9): 1076–1085
18 October 2013