Forestier Nicole, Reesink Hendrik W, Weegink Christine J, McNair Lindsay, Kieffer Tara L, Chu Hui-May, Purdy Susan, Jansen Peter L M, Zeuzem Stefan
Saarland University Hospital, Homburg, Germany.
Hepatology. 2007 Sep;46(3):640-8. doi: 10.1002/hep.21774.
Telaprevir (VX-950), an inhibitor of the hepatitis C virus (HCV) NS3/4A protease, substantially decreased plasma HCV RNA levels in a prior clinical study. The present study evaluated viral kinetics and safety during dosing with telaprevir alone and in combination with peginterferon alfa-2a for 14 days. Previously untreated patients with genotype 1 hepatitis C were randomized to receive placebo and peginterferon alfa-2a (n = 4); telaprevir (n = 8); or telaprevir and peginterferon alfa-2a (n = 8). Telaprevir was given as 750 mg oral doses every 8 hours; peginterferon alfa-2a was given as weekly 180 mug subcutaneous injections. The median change in HCV RNA from baseline to day 15 was -1.09 log(10) (range, -2.08 to -0.46) in the placebo and peginterferon alfa-2a group; -3.99 log(10) (range, -5.28 to -1.26) in the telaprevir group, and -5.49 log(10) (range, -6.54 to -4.30) in the telaprevir and peginterferon alfa-2a group. Day 15 HCV RNA levels were undetectable in 4 patients who received telaprevir and peginterferon alfa-2a and in 1 patient who received telaprevir alone. No viral breakthrough occurred in patients who received telaprevir and peginterferon alfa-2a. The majority of adverse events were mild. There were no serious adverse events or premature discontinuations. Twelve weeks after starting off-study standard therapy, HCV RNA was undetectable in all 8 patients in the telaprevir and peginterferon alfa-2a group, 5 patients in the telaprevir group, and 1 patient in the placebo and peginterferon alfa-2a group.
This study confirmed the substantial antiviral effects of telaprevir and showed an increased antiviral effect of telaprevir combined with peginterferon alfa-2a.
特拉匹韦(VX - 950)是一种丙型肝炎病毒(HCV)NS3/4A蛋白酶抑制剂,在之前的一项临床研究中可显著降低血浆HCV RNA水平。本研究评估了单独使用特拉匹韦以及与聚乙二醇干扰素α - 2a联合使用14天期间的病毒动力学和安全性。既往未经治疗的1型丙型肝炎患者被随机分为三组,分别接受安慰剂和聚乙二醇干扰素α - 2a(n = 4);特拉匹韦(n = 8);或特拉匹韦与聚乙二醇干扰素α - 2a联合治疗(n = 8)。特拉匹韦每8小时口服750 mg;聚乙二醇干扰素α - 2a每周皮下注射180 μg。安慰剂和聚乙二醇干扰素α - 2a组从基线到第15天HCV RNA的中位数变化为 -1.09 log(10)(范围为 -2.08至 -0.46);特拉匹韦组为 -3.99 log(10)(范围为 -5.28至 -1.26);特拉匹韦与聚乙二醇干扰素α - 2a联合治疗组为 -5.49 log(10)(范围为 -6.54至 -4.30)。在接受特拉匹韦与聚乙二醇干扰素α - 2a联合治疗的4例患者以及单独接受特拉匹韦治疗的1例患者中,第15天HCV RNA水平检测不到。接受特拉匹韦与聚乙二醇干扰素α - 2a联合治疗的患者未发生病毒突破。大多数不良事件为轻度。未出现严重不良事件或提前停药情况。开始非研究标准治疗12周后,特拉匹韦与聚乙二醇干扰素α - 2a联合治疗组的所有8例患者、特拉匹韦组的5例患者以及安慰剂和聚乙二醇干扰素α - 2a组的1例患者的HCV RNA均检测不到。
本研究证实了特拉匹韦具有显著的抗病毒作用,并显示出特拉匹韦与聚乙二醇干扰素α - 2a联合使用时抗病毒效果增强。