First-wave protease inhibitors for hepatitis C genotype 1 treatment: a real-life experience in Brazilian patients
Rev. Soc. Bras. Med. Trop; 51 (2), 2018
Publication year: 2018
Abstract INTRODUCTION:
Licensed for chronic hepatitis C treatment in 2011, the protease inhibitors (PIs) telaprevir (TVR) and boceprevir (BOC), which have high sustained viral responses (SVR), ushered a new era characterized by the development of direct-action drugs against the hepatitis C virus (HCV). The aim of this study was to analyze the effectiveness and safety of BOC and TVR administered with pegylated interferon and ribavirin and to share the experience of a Brazilian reference center.METHODS:
A retrospective descriptive study was conducted in patients with HCV genotype 1 infection who started treatment between July 2013 and December 2015. Data were collected using a computerized system.RESULTS:
A total of 115 subjects were included, of which 58 (50.4 %) had liver cirrhosis and 103 (89.6 %) used TVR. The overall SVR rate was 61.7 % (62.1 % for TVR and 58.3 % for BOC). The presence of cirrhosis was associated with a lower SVR rate, whereas patients who relapsed after prior therapy had a greater chance of showing SVR than did non-responders. The incidence of adverse drug reactions (ADRs) was high. Almost all patients (~100 %) presented with hematologic events. Furthermore, treatment had to be discontinued in 15 subjects (13 %) due to severe ADRs.CONCLUSIONS:
In conclusion, the SVR rates in our study were lower than those reported in pre-marketing studies but were comparable to real-life data. ADRs, particularly hematological ADRs, were more common compared to those in previous studies and resulted in a high rate of treatment discontinuity.
Antivirales/administración & dosificación, Antivirales/efectos adversos, Quimioterapia Combinada, Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos, Genotipo, Hepacivirus/efectos de los fármacos, Hepacivirus/genética, Hepatitis C Crónica/tratamiento farmacológico, Hepatitis C Crónica/genética, Hepatitis C Crónica/virología, Interferón alfa-2, Interferón-alfa/administración & dosificación, Interferón-alfa/efectos adversos, Persona de Mediana Edad, Oligopéptidos/administración & dosificación, Oligopéptidos/efectos adversos, Polietilenglicoles/administración & dosificación, Polietilenglicoles/efectos adversos, Prolina/administración & dosificación, Prolina/efectos adversos, Prolina/análogos & derivados, Inhibidores de Proteasas/administración & dosificación, Inhibidores de Proteasas/efectos adversos, Proteínas Recombinantes/administración & dosificación, Proteínas Recombinantes/efectos adversos, Estudios Retrospectivos, Ribavirina/administración & dosificación, Ribavirina/efectos adversos, Resultado del Tratamiento