Service d'hépatologie and INSERM CRB3, Hôpital Beaujon, APHP, Université Denis Diderot Paris 7, Clichy, France.
Gastroenterology. 2011 Feb;140(2):459-468.e1; quiz e14. doi: 10.1053/j.gastro.2010.10.046. Epub 2010 Oct 26.
BACKGROUND & AIMS: Recent studies have shown that 12 weeks of treatment with telaprevir, administered every 8 hours (q8h), combined with pegylated interferon (peginterferon) alfa-2a plus ribavirin significantly increased the rate of hepatitis C virus (HCV) eradication (sustained virologic response [SVR]) in patients infected with HCV genotype 1 compared with approved therapy. We investigated the efficacy, safety, tolerability, and pharmacokinetics of telaprevir given q8h or every 12 hours (q12 h) in combination with peginterferon alfa-2a or alfa-2b.
Treatment-naive patients (n = 161) infected with HCV genotype 1 were randomly assigned to groups that were given open-label telaprevir (750 mg q8 h or 1125 mg q12 h) in combination with standard doses of peginterferon alfa-2a (180 μg/wk) and ribavirin (1000-1200 mg/day) or peginterferon alfa-2b (1.5 μg·kg(-1)·wk(-1)) and ribavirin (800-1200 mg/day). Patients received triple therapy for 12 weeks, followed by 12 or 36 additional weeks of treatment with peginterferon alfa and ribavirin, based on virologic response.
Baseline characteristics were similar for all groups. SVR rates were 81.0% to 85.0% among groups; most patients received 24 weeks of therapy (68.0%). There were no significant differences in SVR rates (intent-to-treat analysis) among groups (P ≥ .787), between the pooled q8 h and q12 h groups (P = .997), or between the pooled peginterferon alfa-2a/ribavirin and peginterferon alfa-2b/ribavirin groups (P = .906). The safety profile was similar among all groups.
A high proportion (>80%) of patients achieved an SVR regardless of the telaprevir dosing frequency (q8 h or q12 h) or type of peginterferon alfa used (alfa-2a or alfa-2b).
最近的研究表明,与已批准的治疗方案相比,接受替拉瑞韦(每 8 小时给药 1 次,q8h)联合聚乙二醇干扰素(peginterferon)α-2a 和利巴韦林治疗 12 周,可显著提高丙型肝炎病毒(HCV)基因型 1 感染者的 HCV 清除率(持续病毒学应答[SVR])。我们研究了替拉瑞韦 q8h 或 q12h 联合 peginterferon α-2a 或 α-2b 治疗的疗效、安全性、耐受性和药代动力学。
161 例初治 HCV 基因型 1 感染者被随机分配至接受替拉瑞韦(750mg q8h 或 1125mg q12h)联合标准剂量 peginterferon α-2a(180μg/周)和利巴韦林(1000-1200mg/天)或 peginterferon α-2b(1.5μg·kg(-1)·wk(-1))和利巴韦林(800-1200mg/天)的开放标签治疗组。所有患者接受 12 周三联治疗,然后根据病毒学应答情况,接受 peginterferon α 和利巴韦林治疗 12 或 36 周。
各组的基线特征相似。各组 SVR 率为 81.0%至 85.0%;大多数患者接受了 24 周的治疗(68.0%)。各组间 SVR 率(意向治疗分析)无显著差异(P≥.787),pooled q8h 和 q12h 组间(P=1.000),或 pooled peginterferon α-2a/利巴韦林和 peginterferon α-2b/利巴韦林组间(P=1.000)也无显著差异。所有组的安全性特征相似。
替拉瑞韦的剂量频率(q8h 或 q12h)或所使用的 peginterferon α 类型(α-2a 或 α-2b)对 SVR 率的影响均不显著,>80%的患者获得 SVR。