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Poor Sustained Virological Response in a Multicenter Real-Life Cohort of Chronic Hepatitis C Patients Treated with Pegylated Interferon and Ribavirin plus Telaprevir or Boceprevir

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Abstract

Background

There are limited data analyzing the effectiveness of boceprevir (BOC) or telaprevir (TVR) in combination with pegylated interferon (PEG-IFN) plus ribavirin (RBV) in a real-life patient cohort.

Aims

In clinical trials, patients with chronic hepatitis C (CHC) treated with BOC or TVR plus PEG-IFN and RBV achieved sustained virological response (SVR) rates of 70 %. However, it is not clear whether similar results can be realized in routine practice. Our goal is to examine SVR rates of these triple regimens for CHC in a multicenter real-life patient cohort.

Methods

We retrospectively studied 200 consecutive CHC genotype 1 patients who were initiated on PEG-IFN, RBV, and either TVR (n = 113) or BOC (n = 87) from July 2011 to February 2014 at two US academic liver clinics, a Veterans Affairs liver clinic and a community gastroenterology clinic.

Results

Both BOC and TVR treatment groups were similar in regard to comorbidities, BMI, and HCV RNA levels. BOC patients were more likely to have cirrhosis than TVR patients (47 vs. 24 %, P = 0.001). SVR rates were low in both cohorts (40 % for BOC, 53 % for TVR, P = 0.05). On multivariate logistic regression, treatment adherence by the “80/80/80 rule,” diagnosis of cirrhosis, and use of erythropoietin were statistically significant predictors for SVR. Of these, treatment adherence was the strongest predictor (OR 4.43, 95 % CI 2.8–6.06, P < 0.001).

Conclusion

SVR was much lower in a real-life patient cohort than in clinical trials (53 % for TVR and 40 % for BOC, compared to 66–75 % in clinical trials).

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Abbreviations

HCV:

Hepatitis C virus

SVR:

Sustained virological response

PEG-IFN + RBV:

Pegylated interferon and ribavirin

RCT:

Randomized controlled trial

ITT:

Intention-to-treat

EVR:

Early virological response

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Conflict of interest

Kevin P. Vo, Philip Vutien, Matthew J. Akiyama, Vinh D. Vu, Nghiem B. Ha, Joy I. Piotrowski, and James Wantuck have none to declare. Marina M. Roytman is on Gilead speakers’ bureau and advisory board. Naoky Tsai discloses research grants with AbbVie, Janssen, Gilead Sciences, BMS, and Beckman. Naoky Tsai discloses he is on the Speaker’s bureau for AbbVie, Janssen, Gilead Sciences, BMS, Salix, and Bayer, and is also on the advisory board for Gilead Sciences and AbbVie. Ramsey Cheung discloses research grants with Gilead Sciences. Jiayi Li discloses he is a speaker for Gilead Sciences. Mindie H. Nguyen discloses she has received honoraria and research support from Bristol-Myers Squibb, Gilead Sciences, and Janssen Pharmaceuticals.

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Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, Stanford University Medical Center, 750 Welch Rd. Suite 210, Palo Alto, CA, 94304, USA

    Kevin P. Vo, Philip Vutien, Vinh D. Vu, Nghiem B. Ha, James Wantuck & Mindie H. Nguyen

  2. The Queens Medical Center, University of Hawaii, Liver Center POBIII #405, 550 S. Beretenia Street, Honolulu, HI, 96813, USA

    Joy I. Piotrowski, Marina M. Roytman & Naoky Tsai

  3. VA Palo Alto, 3801 Miranda Ave, Palo Alto, CA, 94304, USA

    Ramsey Cheung

  4. Palo Alto Medical Foundation Camino Division, 701 East El Camino Real, Mountain View, CA, 94040, USA

    Jiayi Li

  5. Division of Infectious Diseases, New York University School of Medicine, 16S 5-13 462 First Ave, New York, NY, USA

    Matthew J. Akiyama

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  1. Kevin P. Vo
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  2. Philip Vutien
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  4. Vinh D. Vu
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  7. James Wantuck
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  8. Marina M. Roytman
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  9. Naoky Tsai
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  10. Ramsey Cheung
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  11. Jiayi Li
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  12. Mindie H. Nguyen
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Corresponding author

Correspondence to Mindie H. Nguyen.

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Vo, K.P., Vutien, P., Akiyama, M.J. et al. Poor Sustained Virological Response in a Multicenter Real-Life Cohort of Chronic Hepatitis C Patients Treated with Pegylated Interferon and Ribavirin plus Telaprevir or Boceprevir. Dig Dis Sci 60, 1045–1051 (2015). https://doi.org/10.1007/s10620-015-3621-0

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  • DOI: https://doi.org/10.1007/s10620-015-3621-0

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