DGI-055 Protease Inhibitors: New Drugs For Treatment of Chronic Hepatis C

Abstract

Background The protease inhibitors boceprevir and telaprevir are indicated for treatment of chronic hepatitis C (CHC) genotype 1 in combination with peginterferon-alfa and ribavirin. These drugs increase efficacy and adverse effects. Purpose To study the effectiveness and safety of boceprevir and telaprevir for treatment of CHC. Materials and Methods Retrospective observational study including all patients who started treatment with telaprevir or boceprevir for treatment of CHC from January to September 2012. Collected data: age, sex, type of patient (treatment-naive, recurrent or non-responder), liver fibrosis, HIV coinfection, viral loads at weeks 0, 4, 8, 12, 24 to evaluate efficacy and adverse effects and supportive treatment to evaluate safety. Abstract DGI-055 Table 1Baseline characteristics Telaprevir Boceprevir Patients 29 (58%) 21 (42%) Type of patient treatment-naive 5 (17.24%) 4 (19.05%) recurrent 4 (13.79%) 10 (47.62%) non-responder 20 (68.97%) 7 (33.33%) Liver fibrosis 0–1 6 (20.69%) 1 (4.76%) 2 6 (20.69%) 2 (9.52%) 3–4 17 (58.62%) 19 (90.48%) Abstract DGI-055 Table 2Efficacy and safety Telaprevir Boceprevir Negative viral loads at week 4 15/23 (65.22%) 7/15 (46.67%) 8 18/21 (85.71%) 8/14 (57.14%) 12 19/19 (100%) 4/5 (80.00%) 24 8/8 (100%) 1/1 (100%) Anaemia Reduced dose of ribavirin 6 (20.69%) 6 (28.57%) Treatment with erythropoiesis-stimulating agent 2 (6.90%) 1 (4.76%) Discontinued 1 (3.45%) 1 (4.76%) Neutropenia Reduction dose of peginterferon-alfa 2 (6.90%) 4 (19.05%) Treatment with granulocyte colony-stimulating factor (G-CSF) 1 (3.45%) 4 (19.05%) Rash Discontinued 1 (3.45%) 0 (0%) Results We included 51 patients, 35 (70%) men and 15 (30%) women, with a mean age of 51 years. 5 patients were co-infected with HIV (off-label use). Conclusions Most patients had grade 3–4 liver fibrosis. Most patients were recurrent or non-responders to previous treatment. Telaprevir was the most used protease inhibitor. Patients using telaprevir got negative viral loads before patients using boceprevir. A high percentage of patients using boceprevir required the dose of peginterferon-alfa to be reduced and treatment with G-CSF due to neutropenia. No conflict of interest.