Liver Unit, Hospital General, Universitario Valle Hebron and CIBERHED del Instituto Carlos III, Paseo Valle Hebron 119, Barcelona 08035, Spain.
Best Pract Res Clin Gastroenterol. 2012 Aug;26(4):445-53. doi: 10.1016/j.bpg.2012.09.001.
Boceprevir and telaprevir are the first two protease inhibitors available for the treatment of patients infected with HCV genotype 1. In treatment naïve patients, a sustained virologic response (SVR) of 70-80% is observed when either of these protease inhibitors is used with peginterferon and ribavirin A rapid virologic response (RVR) is observed in 56-60% of them allowing a shorter course of 24-28 weeks of therapy with an excellent SVR rate of 90% or even higher. Patients who do not achieve RVR, and those with cirrhosis should be treated for 48 weeks. Both drugs, boceprevir and telaprevir, achieve similar SVR rates but treatment strategies are completely different for each drug. The decision of which protease inhibitor to utilize should weigh several factors including the treatment strategy, duration of therapy, the likelihood of achieving an RVR, adverse event profile, and cost. Besides, the physician's experience with each drug and the wishes of the patient also have to be considered.
博赛泼维与特拉泼维是两种用于治疗 HCV 基因 1 型感染患者的蛋白酶抑制剂。在初治患者中，当这两种蛋白酶抑制剂与聚乙二醇干扰素和利巴韦林联合使用时，可观察到 70-80%的持续病毒学应答（SVR）。其中约 56-60%的患者可观察到快速病毒学应答（RVR），这使得治疗疗程缩短至 24-28 周，SVR 率高达 90%，甚至更高。未达到 RVR 的患者和肝硬化患者应接受 48 周的治疗。博赛泼维和特拉泼维均可达到相似的 SVR 率，但两种药物的治疗策略完全不同。选择使用哪种蛋白酶抑制剂需要权衡多个因素，包括治疗策略、治疗持续时间、实现 RVR 的可能性、不良事件谱和成本。此外，医生对每种药物的经验和患者的意愿也需要考虑在内。
