Effectiveness of triple therapy with simeprevir for chronic hepatitis C genotype 1b patients with prior telaprevir failure. Issue 12 (15th June 2015)

• Record Type: Journal Article
• Authors: 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.; The Kyushu University Liver Disease Study (KULDS) Group
• Is Part Of: Journal of viral hepatitis. Volume 22:Issue 12(2015)
• Page Start: 992
• Page End: 1001
• Publication Date: 2015-06-15
• Subjects: Hepatitis, Viral -- Periodicals; Hepatitis, Viral, Animal; Hepatitis, Viral, Human; 616.3623
• DOI: 10.1111/jvh.12427
• Languages: English
• ISSNs: 1352-0504

Abstract

<abstract abstract-type="main" id="jvh12427-abs-0001"> <title>Summary</title> <p>Favourable efficacy and safety profiles for simeprevir in combination with pegylated interferon alpha (PEG‐IFN<italic>α</italic>) 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 NS3/4A 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<italic>α</italic> 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 (SVR12). 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<italic>α</italic> and ribavirin, almost all achieved SVR12, 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<italic>α</italic> and ribavirin, only one (11.1%) achieved SVR12, 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<italic>α</italic> and ribavirin. For patients with prior null response to PEG‐IFN<italic>α</italic> and ribavirin, retreatment with simeprevir‐based triple therapy is not a useful option.</p> </abstract>