Telaprevir for Retreatment of HCV Infection

被引:1244
作者
Zeuzem, Stefan [1 ]
Andreone, Pietro [1 ]
Pol, Stanislas [1 ]
Lawitz, Eric [1 ]
Diago, Moises [1 ]
Roberts, Stuart [1 ]
Focaccia, Roberto [1 ]
Younossi, Zobair [1 ]
Foster, Graham R. [1 ]
Horban, Andrzej [1 ]
Ferenci, Peter [1 ]
Nevens, Frederik [1 ]
Muellhaupt, Beat [1 ]
Pockros, Paul [1 ]
Terg, Ruben [1 ]
Shouval, Daniel [1 ]
van Hoek, Bart [1 ]
Weiland, Ola [1 ]
Van Heeswijk, Rolf [1 ]
De Meyer, Sandra [1 ]
Luo, Don [1 ]
Boogaerts, Griet [1 ]
Polo, Ramon [1 ]
Picchio, Gaston [1 ]
Beumont, Maria [1 ]
机构
[1] Johann Wolfgang Goethe Univ Hosp, Dept Internal Med, D-60590 Frankfurt, Germany
关键词
CHRONIC HEPATITIS-C; PEGINTERFERON ALPHA-2A; RIBAVIRIN; BOCEPREVIR;
D O I
10.1056/NEJMoa1013086
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background Up to 60% of patients with hepatitis C virus (HCV) genotype 1 infection do not have a sustained virologic response to therapy with peginterferon alfa plus ribavirin. Methods In this randomized, phase 3 trial, we evaluated the addition of telaprevir to peginterferon alfa-2a plus ribavirin in patients with HCV genotype 1 infection who had no response or a partial response to previous therapy or who had a relapse after an initial response. A total of 663 patients were assigned to one of three groups: the T12PR48 group, which received telaprevir for 12 weeks and peginterferon plus ribavirin for a total of 48 weeks; the lead-in T12PR48 group, which received 4 weeks of peginterferon plus ribavirin followed by 12 weeks of telaprevir and peginterferon plus ribavirin for a total of 48 weeks; and the control group (PR48), which received peginterferon plus ribavirin for 48 weeks. The primary end point was the rate of sustained virologic response, which was defined as undetectable HCV RNA 24 weeks after the last planned dose of a study drug. Results Rates of sustained virologic response were significantly higher in the two telaprevir groups than in the control group among patients who had a previous relapse (83% in the T12PR48 group, 88% in the lead-in T12PR48 group, and 24% in the PR48 group), a partial response (59%, 54%, and 15%, respectively), and no response (29%, 33%, and 5%, respectively) (P<0.001 for all comparisons). Grade 3 adverse events (mainly anemia, neutropenia, and leukopenia) were more frequent in the telaprevir groups than in the control group (37% vs. 22%). Conclusions Telaprevir combined with peginterferon plus ribavirin significantly improved rates of sustained virologic response in patients with previously treated HCV infection, regardless of whether there was a lead-in phase.
引用
收藏
页码:2417 / 2428
页数:12
相关论文
共 22 条
[1]  
[Anonymous], 2010, GUID IND CHRON HEP C
[2]   Boceprevir for Previously Treated Chronic HCV Genotype 1 Infection [J].
Bacon, Bruce R. ;
Gordon, Stuart C. ;
Lawitz, Eric ;
Marcellin, Patrick ;
Vierling, John M. ;
Zeuzem, Stefan ;
Poordad, Fred ;
Goodman, Zachary D. ;
Sings, Heather L. ;
Poordad, Fred ;
Goodman, Zachary D. ;
Sings, Heather L. ;
Boparai, Navdeep ;
Burroughs, Margaret ;
Brass, Clifford A. ;
Albrecht, Janice K. ;
Esteban, Rafael .
NEW ENGLAND JOURNAL OF MEDICINE, 2011, 364 (13) :1207-1217
[3]   SVR WITH TELAPREVIR, PEGINTERFERON ALFA-2A AND RIBAVIRIN IN HCV PATIENTS WITH WELL-CHARACTERIZED PRIOR NULL RESPONSE, PARTIAL RESPONSE, VIRAL BREAKTHROUGH OR RELAPSE AFTER PR [J].
Berg, T. ;
McHutchison, J. G. ;
Adda, N. ;
Poordad, F. ;
Shiffman, M. L. ;
Ferenci, P. ;
Heathcote, J. ;
Pawlotsky, J. -M. ;
Zeuzem, S. ;
Reesink, H. ;
Dusheiko, G. ;
Martin, E. ;
Alexanderian, D. ;
George, S. ;
Muir, A. J. .
JOURNAL OF HEPATOLOGY, 2010, 52 :S2-S2
[4]   Genetic variation in IL28B predicts hepatitis C treatment-induced viral clearance [J].
Ge, Dongliang ;
Fellay, Jacques ;
Thompson, Alexander J. ;
Simon, Jason S. ;
Shianna, Kevin V. ;
Urban, Thomas J. ;
Heinzen, Erin L. ;
Qiu, Ping ;
Bertelsen, Arthur H. ;
Muir, Andrew J. ;
Sulkowski, Mark ;
McHutchison, John G. ;
Goldstein, David B. .
NATURE, 2009, 461 (7262) :399-401
[5]   Telaprevir and Peginterferon with or without Ribavirin for Chronic HCV Infection [J].
Hezode, Christophe ;
Forestier, Nicole ;
Dusheiko, Geoffrey ;
Ferenci, Peter ;
Pol, Stanislas ;
Goeser, Tobias ;
Bronowicki, Jean-Pierre ;
Bourliere, Marc ;
Gharakhanian, Shahin ;
Bengtsson, Leif ;
McNair, Lindsay ;
George, Shelley ;
Kieffer, Tara ;
Kwong, Ann ;
Kauffman, Robert S. ;
Alam, John ;
Pawlotsky, Jean-Michel ;
Zeuzem, Stefan .
NEW ENGLAND JOURNAL OF MEDICINE, 2009, 360 (18) :1839-1850
[6]   Telaprevir for Previously Untreated Chronic Hepatitis C Virus Infection [J].
Jacobson, Ira M. ;
McHutchison, John G. ;
Dusheiko, Geoffrey ;
Di Bisceglie, Adrian M. ;
Reddy, K. Rajender ;
Bzowej, Natalie H. ;
Marcellin, Patrick ;
Muir, Andrew J. ;
Ferenci, Peter ;
Flisiak, Robert ;
George, Jacob ;
Rizzetto, Mario ;
Shouval, Daniel ;
Sola, Ricard ;
Terg, Ruben A. ;
Yoshida, Eric M. ;
Adda, Nathalie ;
Bengtsson, Leif ;
Sankoh, Abdul J. ;
Kieffer, Tara L. ;
George, Shelley ;
Kauffman, Robert S. ;
Zeuzem, Stefan .
NEW ENGLAND JOURNAL OF MEDICINE, 2011, 364 (25) :2405-2416
[7]   Telaprevir and pegylated interferon-alpha-2a inhibit wild-type and resistant genotype 1 hepatitis C virus replication in patients [J].
Kieffer, Tara L. ;
Sarrazin, Christoph ;
Miller, Janice S. ;
Welker, Martin W. ;
Forestier, Nicole ;
Reesink, Hendrik W. ;
Kwong, Ann D. ;
Zeuzem, Stefan .
HEPATOLOGY, 2007, 46 (03) :631-639
[8]   Efficacy of boceprevir, an NS3 protease inhibitor, in combination with peginterferon alfa-2b and ribavirin in treatment-naive patients with genotype 1 hepatitis C infection (SPRINT-1): an open-label, randomised, multicentre phase 2 trial [J].
Kwo, Paul Y. ;
Lawitz, Eric J. ;
McCone, Jonathan ;
Schiff, Eugene R. ;
Vierling, John M. ;
Pound, David ;
Davis, Mitchell N. ;
Galati, Joseph S. ;
Gordon, Stuart C. ;
Ravendhran, Natarajan ;
Rossaro, Lorenzo ;
Anderson, Frank H. ;
Jacobson, Ira M. ;
Rubin, Raymond ;
Koury, Kenneth ;
Pedicone, Lisa D. ;
Brass, Clifford A. ;
Chaudhri, Eirum ;
Albrecht, Janice K. .
LANCET, 2010, 376 (9742) :705-716
[9]   VX-950, a novel hepatitis C virus (HCV) NS34A protease inhibitor, exhibits potent antiviral activities in HCV replicon cells [J].
Lin, K ;
Perni, RB ;
Kwong, AD ;
Lin, C .
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 2006, 50 (05) :1813-1822
[10]  
Marcellin P, 2011, GASTROENTEROLOGY, V140