A.O. Fatebenefratelli e Oftalmico, Milan, Italy.
Dig Liver Dis. 2013 May;45(5):356-61. doi: 10.1016/j.dld.2012.09.011. Epub 2012 Oct 24.
Two first-generation non-specific protein 3/4A protease inhibitors (Boceprevir and Telaprevir) have been approved in the U.S. and in Europe in combination with the standard of care for treatment of both previously untreated and prior non responder genotype 1 chronic hepatitis C, based on the results of 5 large phase III trials. With these drugs, futility-stopping rules at weeks 4, 8 and 12 have been provided in order to avoid ineffective therapy and dangerous adverse events. However, despite several guidelines that have been published, a main question remains: how we can identify patients in whom triple therapy will be useless or ineffective? Based on the available data, this review proposes three algorithms to optimize triple antiviral therapy for chronic hepatitis C, to aid physicians avoid prescription of unnecessary treatment, given its substantial side effects and costs.
两种第一代非特异性蛋白酶 3/4A 抑制剂（Boceprevir 和 Telaprevir）已在美国和欧洲获得批准，与标准治疗方法联合用于治疗既往未治疗和既往无应答基因型 1 慢性丙型肝炎，这是基于 5 项大型 III 期临床试验的结果。有了这些药物，在第 4、8 和 12 周提供了无效停止规则，以避免无效治疗和危险的不良反应。然而，尽管已经发布了几个指南，但仍有一个主要问题悬而未决：我们如何识别三联疗法无效或无效的患者？基于现有数据，本综述提出了三种算法来优化慢性丙型肝炎的三联抗病毒治疗，以帮助医生避免开出不必要的治疗方案，因为它有很大的副作用和成本。
