Poor Sustained Virological Response in a Multicenter Real-Life Cohort of Chronic Hepatitis C Patients Treated with Pegylated Interferon and Ribavirin plus Telaprevir or Boceprevir

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• 作者：Kevin P. Vo ; Philip Vutien ; Matthew J. Akiyama…
• 关键词：HCV ; Routine practice ; Effectiveness ; PEG ; IFN ; TVR ; BOC
• 刊名：Digestive Diseases and Sciences
• 出版年：2015
• 出版时间：April 2015
• 年：2015
• 卷：60
• 期：4
• 页码：1045-1051
• 全文大小：401 KB
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• 作者单位：Kevin P. Vo (1)
  Philip Vutien (1)
  Matthew J. Akiyama (5)
  Vinh D. Vu (1)
  Nghiem B. Ha (1)
  Joy I. Piotrowski (2)
  James Wantuck (1)
  Marina M. Roytman (2)
  Naoky Tsai (2)
  Ramsey Cheung (3)
  Jiayi Li (4)
  Mindie H. Nguyen (1)
  
  1. Division of Gastroenterology and Hepatology, Stanford University Medical Center, 750 Welch Rd. Suite 210, Palo Alto, CA, 94304, USA
  5. Division of Infectious Diseases, New York University School of Medicine, 16S 5-13 462 First Ave, New York, NY, USA
  2. The Queens Medical Center, University of Hawaii, Liver Center POBIII #405, 550 S. Beretenia Street, Honolulu, HI, 96813, USA
  3. VA Palo Alto, 3801 Miranda Ave, Palo Alto, CA, 94304, USA
  4. Palo Alto Medical Foundation Camino Division, 701 East El Camino Real, Mountain View, CA, 94040, USA
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Gastroenterology
  Hepatology
  Oncology
  Transplant Surgery
  Biochemistry
  
• 出版者：Springer Netherlands
• ISSN：1573-2568

文摘

Background There are limited data analyzing the effectiveness of boceprevir (BOC) or telaprevir (TVR) in combination with pegylated interferon (PEG-IFN) plus ribavirin (RBV) in a real-life patient cohort. Aims In clinical trials, patients with chronic hepatitis C (CHC) treated with BOC or TVR plus PEG-IFN and RBV achieved sustained virological response (SVR) rates of 70?%. However, it is not clear whether similar results can be realized in routine practice. Our goal is to examine SVR rates of these triple regimens for CHC in a multicenter real-life patient cohort. Methods We retrospectively studied 200 consecutive CHC genotype 1 patients who were initiated on PEG-IFN, RBV, and either TVR (n?=?113) or BOC (n?=?87) from July 2011 to February 2014 at two US academic liver clinics, a Veterans Affairs liver clinic and a community gastroenterology clinic. Results Both BOC and TVR treatment groups were similar in regard to comorbidities, BMI, and HCV RNA levels. BOC patients were more likely to have cirrhosis than TVR patients (47 vs. 24?%, P?=?0.001). SVR rates were low in both cohorts (40?% for BOC, 53?% for TVR, P?=?0.05). On multivariate logistic regression, treatment adherence by the -0/80/80 rule,-diagnosis of cirrhosis, and use of erythropoietin were statistically significant predictors for SVR. Of these, treatment adherence was the strongest predictor (OR 4.43, 95?% CI 2.8-.06, P?<?0.001). Conclusion SVR was much lower in a real-life patient cohort than in clinical trials (53?% for TVR and 40?% for BOC, compared to 66-5?% in clinical trials).