title: UK consensus guidelines for the use of the protease inhibitors boceprevir and telaprevir in genotype 1 chronic hepatitis C infected patients.
abstract: BACKGROUND
  The nonstructural 3 serine protease inhibitors (PIs), boceprevir and telaprevir, represent the first in a new generation of directly acting antivirals against genotype 1 hepatitis C (HCV) infection. When used in combination with pegylated interferon and ribavirin, these drugs greatly improve sustained virological response rates in both treatment-naïve patients and patients who have had previous virological failure on treatment. However, the addition of these new agents will increase the complexity of therapeutic regimens, the rates of side-effects and costs.
  
  
  OBJECTIVE
  To review concisely the current evidence and to suggest current best practice, for the use of telaprevir and boceprevir in the management of chronic genotype 1 HCV infection.
  
  
  METHODS
  These guidelines for the use of boceprevir and telaprevir have been formulated following extensive review of the current literature, are based on the consensus opinion of a panel of national experts, and have been openly discussed and debated at a national meeting of HCV care providers.
  
  
  RESULTS
  We have made recommendations on a number of the key practical issues facing HCV care providers: (i) Which patients to treat?; (ii) Standards for the provision of care; (iii) Pre-treatment considerations; (iv) Which treatment regimens to use?; (v) Stopping rules; and (vi) Management of adverse effects. Finally, we have produced suggested algorithms for the assessment and treatment of these patients.
  
  
  CONCLUSIONS
  These UK Consensus guidelines indicate the current best practice for the use of boceprevir and telaprevir in the management of genotype 1 chronic HCV infection.
authors.affiliation: Department of Gastroenterology, Aberdeen Royal Infirmary, Aberdeen, UK. p_ramachandran@yahoo.com
authors.forename: P
authors.initials: P
authors.lastname: Ramachandran
authors.forename: A
authors.initials: A
authors.lastname: Fraser
authors.forename: K
authors.initials: K
authors.lastname: Agarwal
authors.forename: A
authors.initials: A
authors.lastname: Austin
authors.forename: A
authors.initials: A
authors.lastname: Brown
authors.forename: G R
authors.initials: GR
authors.lastname: Foster
authors.forename: R
authors.initials: R
authors.lastname: Fox
authors.forename: P C
authors.initials: PC
authors.lastname: Hayes
authors.forename: C
authors.initials: C
authors.lastname: Leen
authors.forename: P R
authors.initials: PR
authors.lastname: Mills
authors.forename: D J
authors.initials: DJ
authors.lastname: Mutimer
authors.forename: S D
authors.initials: SD
authors.lastname: Ryder
authors.forename: J F
authors.initials: JF
authors.lastname: Dillon
mesh_terms: D000465:Algorithms; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics*; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000235:genetics; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000009:adverse effects / Q000627:therapeutic use; D009842:Oligopeptides / Q000009:adverse effects / Q000627:therapeutic use*; D018579:Patient Selection; D011092:Polyethylene Glycols / Q000009:adverse effects / Q000627:therapeutic use; D011392:Proline / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D011994:Recombinant Proteins / Q000009:adverse effects / Q000627:therapeutic use; D012254:Ribavirin / Q000009:adverse effects / Q000627:therapeutic use; D015842:Serine Proteinase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D006113:United Kingdom; D019562:Viral Load
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D009842:Oligopeptides; D011994:Recombinant Proteins; D015842:Serine Proteinase Inhibitors; D011092:Polyethylene Glycols; D012254:Ribavirin; C486464:telaprevir; C512204:N-(3-amino-1-(cyclobutylmethyl)-2,3-dioxopropyl)-3-(2-((((1,1-dimethylethyl)amino)carbonyl)amino)-3,3-dimethyl-1-oxobutyl)-6,6-dimethyl-3-azabicyclo(3.1.0)hexan-2-carboxamide; D011392:Proline; C417083:peginterferon alfa-2b; C100416:peginterferon alfa-2a