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Telaprevir Improves Hepatitis C Retreatment Outcomes

Response rates higher when the drug is used with peginterferon alfa-2a and ribavirin

THURSDAY, April 8 (HealthDay News) -- In patients with genotype 1 hepatitis C virus (HCV) who failed to respond to peginterferon alfa-2a and ribavirin, retreatment that involves telaprevir in combination with the two drugs is more effective than the two drugs alone, according to a study in the April 8 issue of the New England Journal of Medicine.

John G. McHutchison, M.D., of Duke University Medical Center in Durham, N.C., and colleagues randomized patients with HCV genotype 1 who had no sustained response to peginterferon alfa-2a and ribavirin therapy to one of four retreatment groups. The T12PR24 group received telaprevir for 12 weeks and the other two drugs for 24 weeks; the T24PR48 group received telaprevir for 24 weeks and the other two for 48 weeks; the T24P24 group received telaprevir and peginterferon alfa-2a for 24 weeks; the control group received peginterferon alfa-2a and ribavirin for 48 weeks.

The researchers found that the three telaprevir groups had significantly higher sustained virologic response rates (T12PR24, 51 percent; T24PR48, 53 percent; T24P24, 24 percent) than the control group (14 percent). The response rates were higher among the patients who had previously relapsed than among non-responders. Rash occurred in 51 percent of patients in the telaprevir groups, and study drugs were discontinued due to adverse events more frequently in these groups than the control group (15 versus 4 percent).

"The addition of telaprevir to current therapy as a retreatment strategy in HCV-infected patients who had not had a sustained response to previous therapy significantly increased the likelihood of eradication of HCV infection," the authors write.

The study was supported by Vertex Pharmaceuticals, and multiple authors disclosed financial ties to it and other pharmaceutical companies.

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