OBJECTIVE: To examine the effectiveness and tolerability of triple therapy with pegylated interferon (p-IFN), ribavirin (RBV), and telaprevir in patients with chronic hepatitis C receiving treatment in an academic practice setting and in a more clinically diverse population compared with patients receiving treatment in phase 3 trials. PATIENTS AND METHODS: A prospective database of all patients with viral hepatitis undergoing antiviral therapy from January 1, 2006, to July 1, 2012, was queried to identify treatment-naive and -experienced patients with chronic hepatitis C receiving dual and triple therapies. On-treatment response categories included rapid virologic response, extended rapid virologic response, early virologic response, and sustained virologic response. These patients were compared with matched controls, namely, patients who underwent dual therapy with p-IFN and RBV. Matching was performed for age, cirrhosis status, and prior treatment. RESULTS: There were 55 patients who received triple therapy and met the eligibility criteria, consisting of treatment-naive (n=35) and -experienced patients (n=20: those with relapse, 9; those with nonresponse, 9; and those who terminated the treatment early, 2). Rapid virologic response was achieved in 41% of the patients, extended rapid virologic response in 41%, and early virologic response in 75%. Sustained virologic response was observed in 51% (18/35) of treatment-naive patients, 67% (6/9) of the patients with prior nonresponse, and 56% (5/9) of those with prior relapse. Corresponding results after dual therapy were 37% (23/62), 11% (2/18), and 27% (3/11), respectively. The mean decrease in the hemoglobin level at weeks 4, 8, and 24 of triple therapy was 2.8, 3.8, and 3.2 mg/dL compared with 2.4, 2.6, and 2.4 mg/dL with dual therapy (to convert mg/dL to mmol/L, multiply values by 0.0259). CONCLUSION: Telaprevir-based triple therapy in clinical practice is considerably more effective than dual therapy with p-IFN and RBV despite the significant degree of anemia that complicated therapy, requiring RBV dose reduction and erythropoietin support.
OBJECTIVE: To examine the effectiveness and tolerability of triple therapy with pegylated interferon (p-IFN), ribavirin (RBV), and telaprevir in patients with chronic hepatitis C receiving treatment in an academic practice setting and in a more clinically diverse population compared with patients receiving treatment in phase 3 trials. PATIENTS AND METHODS: A prospective database of all patients with viral hepatitis undergoing antiviral therapy from January 1, 2006, to July 1, 2012, was queried to identify treatment-naive and -experienced patients with chronic hepatitis C receiving dual and triple therapies. On-treatment response categories included rapid virologic response, extended rapid virologic response, early virologic response, and sustained virologic response. These patients were compared with matched controls, namely, patients who underwent dual therapy with p-IFN and RBV. Matching was performed for age, cirrhosis status, and prior treatment. RESULTS: There were 55 patients who received triple therapy and met the eligibility criteria, consisting of treatment-naive (n=35) and -experienced patients (n=20: those with relapse, 9; those with nonresponse, 9; and those who terminated the treatment early, 2). Rapid virologic response was achieved in 41% of the patients, extended rapid virologic response in 41%, and early virologic response in 75%. Sustained virologic response was observed in 51% (18/35) of treatment-naive patients, 67% (6/9) of the patients with prior nonresponse, and 56% (5/9) of those with prior relapse. Corresponding results after dual therapy were 37% (23/62), 11% (2/18), and 27% (3/11), respectively. The mean decrease in the hemoglobin level at weeks 4, 8, and 24 of triple therapy was 2.8, 3.8, and 3.2 mg/dL compared with 2.4, 2.6, and 2.4 mg/dL with dual therapy (to convert mg/dL to mmol/L, multiply values by 0.0259). CONCLUSION:Telaprevir-based triple therapy in clinical practice is considerably more effective than dual therapy with p-IFN and RBV despite the significant degree of anemia that complicated therapy, requiring RBV dose reduction and erythropoietin support.
Authors: John G McHutchison; Michael P Manns; Andrew J Muir; Norah A Terrault; Ira M Jacobson; Nezam H Afdhal; E Jenny Heathcote; Stefan Zeuzem; Hendrik W Reesink; Jyotsna Garg; Mohammad Bsharat; Shelley George; Robert S Kauffman; Nathalie Adda; Adrian M Di Bisceglie Journal: N Engl J Med Date: 2010-04-08 Impact factor: 91.245
Authors: Stanislas Pol; Reem H Ghalib; Vinod K Rustgi; Claudia Martorell; Greg T Everson; Harvey A Tatum; Christophe Hézode; Joseph K Lim; Jean-Pierre Bronowicki; Gary A Abrams; Norbert Bräu; David W Morris; Paul J Thuluvath; Robert W Reindollar; Philip D Yin; Ulysses Diva; Robert Hindes; Fiona McPhee; Dennis Hernandez; Megan Wind-Rotolo; Eric A Hughes; Steven Schnittman Journal: Lancet Infect Dis Date: 2012-06-18 Impact factor: 25.071
Authors: Ira M Jacobson; John G McHutchison; Geoffrey Dusheiko; Adrian M Di Bisceglie; K Rajender Reddy; Natalie H Bzowej; Patrick Marcellin; Andrew J Muir; Peter Ferenci; Robert Flisiak; Jacob George; Mario Rizzetto; Daniel Shouval; Ricard Sola; Ruben A Terg; Eric M Yoshida; Nathalie Adda; Leif Bengtsson; Abdul J Sankoh; Tara L Kieffer; Shelley George; Robert S Kauffman; Stefan Zeuzem Journal: N Engl J Med Date: 2011-06-23 Impact factor: 91.245
Authors: John G McHutchison; Gregory T Everson; Stuart C Gordon; Ira M Jacobson; Mark Sulkowski; Robert Kauffman; Lindsay McNair; John Alam; Andrew J Muir Journal: N Engl J Med Date: 2009-04-30 Impact factor: 91.245
Authors: Eric Lawitz; Alessandra Mangia; David Wyles; Maribel Rodriguez-Torres; Tarek Hassanein; Stuart C Gordon; Michael Schultz; Mitchell N Davis; Zeid Kayali; K Rajender Reddy; Ira M Jacobson; Kris V Kowdley; Lisa Nyberg; G Mani Subramanian; Robert H Hyland; Sarah Arterburn; Deyuan Jiang; John McNally; Diana Brainard; William T Symonds; John G McHutchison; Aasim M Sheikh; Zobair Younossi; Edward J Gane Journal: N Engl J Med Date: 2013-04-23 Impact factor: 91.245
Authors: Ira M Jacobson; Stuart C Gordon; Kris V Kowdley; Eric M Yoshida; Maribel Rodriguez-Torres; Mark S Sulkowski; Mitchell L Shiffman; Eric Lawitz; Gregory Everson; Michael Bennett; Eugene Schiff; M Tarek Al-Assi; G Mani Subramanian; Di An; Ming Lin; John McNally; Diana Brainard; William T Symonds; John G McHutchison; Keyur Patel; Jordan Feld; Stephen Pianko; David R Nelson Journal: N Engl J Med Date: 2013-04-23 Impact factor: 91.245
Authors: Edward J Gane; Catherine A Stedman; Robert H Hyland; Xiao Ding; Evguenia Svarovskaia; William T Symonds; Robert G Hindes; M Michelle Berrey Journal: N Engl J Med Date: 2013-01-03 Impact factor: 91.245