Abstract | BACKGROUND: OBJECTIVE: This meta-analysis compared 24- and 48-week sustained viral responses (SVR) and drug-related adverse events (AEs) between telaprevir and boceprevir triple- therapy regimens in the treatment of chronic HCV infection. METHODS: MEDLINE, EMBASE, and Cochrane databases were searched for articles published from January 1995 to October 2012 on randomized controlled trials that reported SVR at ≥24 weeks in patients with HCV receiving triple- therapy regimens that included telaprevir or boceprevir or placebo + pegylated interferon + ribavirin (Peg-IFN + RBV). Pooled odds ratios ( ORs) were calculated and used to compare SVR at 24 and 48 weeks. Secondary end points included common drug-related AEs and treatment discontinuations. RESULTS: Eight studies were included in this meta-analysis (N = 4144 treatment-naive and treatment-experienced patients). With telaprevir, the ORs (95% CI) for SVR at 24 weeks in treatment-naive and treatment-experienced patients were 3.31 (2.27-4.82; P < 0.0001) and 4.21 (1.83-9.72; P = 0.001), respectively. Telaprevir triple therapy did not result in more drug-related discontinuations but did cause additional rash, pruritis, and anemia. With boceprevir, the ORs (95% CI) were improved in both treatment-naive and treatment experienced patients (3.55 [2.66-4.56; P < 0.0001] and 7.34 [3.92-13.9; P < 0.0001]), but with more treatment-related anemia and dysgeusia. CONCLUSIONS: Based on the findings from this meta-analysis, telaprevir or boceprevir combined with Peg-IFN + RBV had favorable short-term data on SVR while resulting in more drug-related AEs. Extended follow-up is required to determine whether these agents offer a reduction in the risk for chronic hepatitis C genotype 1-related mortality and/or hospitalization.
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Authors | Mugdha Sitole, Matthew Silva, Linda Spooner, Morgan K Comee, Michael Malloy |
Journal | Clinical therapeutics
(Clin Ther)
Vol. 35
Issue 2
Pg. 190-7
(Feb 2013)
ISSN: 1879-114X [Electronic] United States |
PMID | 23369368
(Publication Type: Journal Article, Meta-Analysis)
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Copyright | Copyright © 2013 Elsevier HS Journals, Inc. All rights reserved. |
Chemical References |
- Interferon-alpha
- Oligopeptides
- Protease Inhibitors
- Recombinant Proteins
- Polyethylene Glycols
- Ribavirin
- telaprevir
- N-(3-amino-1-(cyclobutylmethyl)-2,3-dioxopropyl)-3-(2-((((1,1-dimethylethyl)amino)carbonyl)amino)-3,3-dimethyl-1-oxobutyl)-6,6-dimethyl-3-azabicyclo(3.1.0)hexan-2-carboxamide
- Proline
- peginterferon alfa-2a
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Topics |
- Clinical Trials, Phase II as Topic
- Clinical Trials, Phase III as Topic
- Drug Therapy, Combination
- Hepatitis C, Chronic
(drug therapy)
- Humans
- Interferon-alpha
(therapeutic use)
- Oligopeptides
(administration & dosage, adverse effects, therapeutic use)
- Polyethylene Glycols
(therapeutic use)
- Proline
(administration & dosage, adverse effects, analogs & derivatives, therapeutic use)
- Protease Inhibitors
(administration & dosage, adverse effects, therapeutic use)
- Randomized Controlled Trials as Topic
- Recombinant Proteins
(therapeutic use)
- Ribavirin
(therapeutic use)
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