In patients with chronic infection with hepatitis C virus genotype 1, treatment with peginterferon alfa and ribavirin for 48 weeks results in rates of sustained virologic response of 40 to 50%.
Telaprevir is a specific inhibitor of the hepatitis C virus serine protease and could be of value in hepatitis C virus treatment.
Dr Christophe Hézode and colleagues from France assessed a total of 334 patients who had chronic infection with hepatitis C virus genotype 1.
The patients had not been treated previously to receive one of four treatments involving various combinations of telaprevir, peginterferon alfa-2a, and ribavirin.
The T12PR24 group received telaprevir, peginterferon alfa-2a, and ribavirin for 12 weeks, followed by peginterferon alfa-2a and ribavirin for 12 more weeks.
|Peginterferon alfa and ribavirin for 48 weeks results in rates of sustained virologic response of 50%. |
|New England Journal of Medicine|
The T12PR12 group received telaprevir, peginterferon alfa-2a, and ribavirin for 12 weeks.
The T12P12 group received telaprevir and peginterferon alfa-2a without ribavirin for 12 weeks.
The PR48 group received peginterferon alfa-2a and ribavirin for 48 weeks.
The primary end point, a sustained virologic response was compared between the control group and the combined T12P12 and T12PR12 groups.
The research team found that the rate of sustained virologic response for the T12PR12 and T12P12 groups combined was 48%.
As compared with 46% in the PR48 group, the rate was 60% in the T12PR12 group, as compared with 36% in the T12P12 group.
The rate was significantly higher in the T12PR24 group than in the PR48 group.
The adverse events with increased frequency in the telaprevir-based groups were pruritus, rash, and anemia.
Dr Hézode's team concluded, “In this phase 2 study of patients infected with hepatitis C virus genotype 1 who had not been treated previously.”
“One of the three telaprevir groups had a significantly higher rate of sustained virologic response than that with standard therapy.”
“Response rates were lowest with the regimen that did not include ribavirin.”