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Effectiveness of triple therapy with simeprevir for chronic hepatitis C genotype 1b patients with prior telaprevir failure
Author(s) -
Ogawa E.,
Furusyo N.,
Dohmen K.,
Kajiwara E.,
Kawano A.,
Nomura H.,
Takahashi K.,
Satoh T.,
Azuma K.,
Nakamuta M.,
Koyanagi T.,
Kotoh K.,
Shimoda S.,
Hayashi J.
Publication year - 2015
Publication title -
journal of viral hepatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.329
H-Index - 100
eISSN - 1365-2893
pISSN - 1352-0504
DOI - 10.1111/jvh.12427
Subject(s) - telaprevir , simeprevir , ribavirin , medicine , pegylated interferon , gastroenterology , hepatitis c virus , pharmacology , virology , virus
Summary Favourable efficacy and safety profiles for simeprevir in combination with pegylated interferon alpha ( PEG ‐ IFN α ) and ribavirin (triple therapy) have been shown in clinical trials. This study was carried out to evaluate the effectiveness of simeprevir‐based triple therapy for patients with prior telaprevir treatment failure. This multicentre, observational cohort consisted of 345 consecutive Japanese patients infected with HCV genotype 1b, including 20 who had experienced telaprevir‐based triple therapy. Amino acid substitutions in the NS 3/4A region were identified by direct sequencing at the time of relapse or breakthrough in treatment with telaprevir and at the initiation of treatment with simeprevir. Patients were stratified according to prior response to PEG ‐ IFN α and ribavirin. Of the 20 patients with telaprevir treatment failure, 10 (50.0%) achieved sustained virological response at week 12 after the end of treatment ( SVR 12). For patients treatment naïve [3/4 (75.0%)] or with prior relapse [1/1 (100%)] or partial response [5/6 (83.3%)] to PEG ‐ IFN α and ribavirin, almost all achieved SVR 12, mainly because of the improvement of treatment adherence, especially to direct‐acting antiviral agent and ribavirin. However, of the nine patients with prior null response to PEG ‐ IFN α and ribavirin, only one (11.1%) achieved SVR 12, despite all having received an adequate treatment dosage, and five (55.6%) achieved rapid virological response. The treatment outcome of simeprevir‐based triple therapy for HCV genotype 1b patients with prior telaprevir failure depended on the prior response to PEG ‐ IFN α and ribavirin. For patients with prior null response to PEG ‐ IFN α and ribavirin, retreatment with simeprevir‐based triple therapy is not a useful option.