Review of Boceprevir and Telaprevir for the Treatment of Chronic Hepatitis C

Abstract

OBJECTIVE: To summarize and evaluate the published literature pertaining to boceprevir and telaprevir, and to provide clinicians with suggestions for use in patients with chronic hepatitis C infection.METHODS: A standardized search strategy was performed using the MEDLINE, EMBASE, Google Scholar and International Pharmaceuticals Abstracts databases using the search terms “boceprevir”, “telaprevir”, “boceprevir and hepatitis C” and “telaprevir and hepatitis C”. A manual search of references was performed to identify articles missed by the electronic search. Studies were included in the review if they assessed either boceprevir or telaprevir in comparison with standard of care in chronic hepatitis C patients.RESULTS: The studies identified assessed boceprevir and telaprevir in genotype-1 hepatitis C patients. In both treatment-naive and treatment-experienced patients, sustained virological response rates were achieved more often with boceprevir or telaprevir in combination with pegylated interferon and ribavirin compared with pegylated interferon and ribavirin alone. Both medications were well tolerated, with anemia presenting as the most treatment-limiting adverse effect.CONCLUSIONS: Boceprevir and telaprevir will revolutionize the management of hepatitis C genotype 1 patients and will most likely decrease the burden of end-stage disease worldwide. However, current clinical limitations include establishing appropriate and cost-effective treatment durations, and use in special populations such as transplant patients and patients coinfected with HIV. Future research will need to clarify these clinical obstacles to clearly define the role of these agents in hepatitis C management.

Basic Concepts in Population Modeling, Simulation, and Model‐Based Drug Development: Part 3—Introduction to Pharmacodynamic Modeling Methods

“…Models describing hepatitis C viral RNA decline over time suggested that the primary mode of action of interferon involved blocking viral production from infected cells rather than preventing infection 10 . PD modeling has been used to stop further drug development 11 or can be used to develop clinical studies and facilitate identification of meaningful drug activity (e.g., boceprevir and telaprevir) 12 , 13 …”

“…10 PD modeling has been used to stop further drug development 11 or can be used to develop clinical studies and facilitate identification of meaningful drug activity (e.g., boceprevir and telaprevir). 12,13 In this article, we examine fundamentals of population PD modeling of continuous data together with methods for comparing and evaluating population PD models.…”

HIV and HCV Medications in End‐Stage Renal Disease

“…The combination of zidovudine and ribavirin is also not recommended due to increased risk of anemia (19). Boceprevir, an inhibitor of CYP3A4 and OATP1B1 and 1B3 (36), is associated with reduced concentrations when administered with efavirenz (48,64,65). Thus, co-administration of this drug is not recommended (19).…”

Adaptive T-Cell Response in Pathogenesis of Hepatitis C Infection

“…Однако такая терапия позволяет подавить репликацию вируса только у 40-50% пациентов с ВГС 1-го генотипа и часто вызывает развитие тяжелых осложнений, вынуж-дающих прекратить лечение [36,61]. Обещающая стать прорывом в лечении ХГС таргетная тера-пия ингибиторами протеаз, которые участвуют в репликации вируса, также имеет ограничения, в частности, разработана для пациентов с ВГС 1-го генотипа и является исключительно дорого-стоящей [60].…”