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Telaprevir resulted in higher SVR in Japanese patients with HCV

Japanese patients with chronic hepatitis C virus genotype 1 treated with telaprevir combined with pegylated interferon alfa-2b and ribavirin achieved a sustained virologic response, according to study results.  

Researchers, including Naoki Hiramatsu, MD, PhD, of the department of gastroenterology and hepatology at Osaka University Graduate School of Medicine in Japan, evaluated 166 patients with chronic HCV enrolled in the Osaka Liver Forum between December 2011 and December 2012. Each patient was treated with 500 mg or 750 mg of telaprevir every 8 hours, a weight-based weekly dose of PEG-IFN a-2b and between 600 mg and 1,000 mg ribavirin a day for 12 weeks, followed by just PEG-INF a-2b/ribavirin for another 12 weeks. If any patient was positive for HCV RNA between weeks 13 and 20, they were not allowed to continue therapy. Of all patients, 119 completed 12 weeks of therapy with telaprevir and 24 weeks of PEG-IFN a-2b/ribavirin, 42 discontinued telaprevir therapy and 22 discontinued PEG-IFN a-2b/ribavirin therapy.

Naoki Hiramatsu

The overall SVR rate was 82%; however, the SVR rate was highest among patients who received between 25 mg/kg and 35 mg/kg per day telaprevir (91%) compared with patients who received less than 25 mg/kg per day (71%) and at least 35 mg/kg per day (78%) telaprevir. Seventy percent of patients who discontinued telaprevir treatment (26/37), 57% (12/21) of those who discontinued PEG-INF a-2b/ribavirin and 44% (7/16) of those who discontinued all therapies before week 12 achieved SVR. Five patients were lost to follow-up. The treatment discontinuance rate due to an adverse event for patients who underwent telaprevir treatment was higher (26%) compared with patients who discontinued therapy for all drugs (11%). Older age and high dosage were associated with discontinuance.  

“In Japanese patients, the administration of 25-35 mg/kg/day of [telaprevir] can result in the highest SVR rate in [telaprevir], PEG-INF and [ribavirin] triple therapy,” the researchers wrote. “Although it is important to avoid adverse effects by reducing [telaprevir] dosage and to complete treatment, when [telaprevir] is reduced, special attention is needed not to reduce it to <25 mg/kg/day.”

Disclosure: One of the researchers reports receiving scholarship funds from Bristol-Myers Squibb, Chugai Pharmaceutical Co., Ltd. and Merck Sharp & Dohme Corp.