title: Multicenter prospective study to optimize the efficacy of triple therapy with telaprevir in patients with genotype 1b hepatitis C virus infection according to an algorithm based on the drug Adherence, IL-28B Gene Allele and Viral Response Trial (AG & RGT).
abstract: OBJECTIVE
  To optimize the therapeutic efficacy of NS3/4A protease inhibitors, a multicenter prospective study was performed according to an algorithm based on the Adherence, IL-28B Gene Allele and Viral Response Trial (AG & RGT).
  
  
  METHODS
  A total of 340 patients with genotype 1b hepatitis C virus (HCV) showing serum RNA levels of >5 log were enrolled. The duration of ribavirin/pegylated interferon (PEG IFN)-α-2b therapy was prolonged to 48 weeks in patients with unfavorable IL28B alleles showing adherence rates of less than 80% for either drug during the first 12 weeks even if RVR had been achieved, and in those in whom cEVR, but not RVR, was achieved; furthermore, to 72 weeks in those showing partial early viral response.
  
  
  RESULTS
  The therapeutic outcomes were assessed in 282 patients, and the therapy was set to complete at 24 weeks in 181 patients (64%) and to prolong to 48 weeks or 72 weeks in 71 patients (25%). The former group showed a SVR rate of 84%, while the latter group showed an SVR rate of 69% with a relapse rate of 7%. The SVR rate was 33% in the 30 patients (11%) in whom the therapy had to be discontinued in less than 12 weeks. Thus, the results of intention-to-treat analysis revealed an overall SVR rate of 75%. Multivariate analysis identified prolongation of the duration of therapy as a significant factor associated with SVR.
  
  
  CONCLUSIONS
  Triple therapy yielded a high SVR rate in the AG & RGT trial via attenuation of viral relapse by prolonged ribavirin/PEG IFN-α-2b administration. © 2015 The Japan Society of Hepatology.
authors.affiliation: Department of Gastroenterology and Hepatology, Saitama Medical University Hospital, Saitama Medical University, Saitama.
authors.forename: Kayoko
authors.initials: K
authors.lastname: Sugawara
authors.affiliation: Department of Gastroenterology, Saitama Red Cross Hospital, Saitama.
authors.forename: Youhei
authors.initials: Y
authors.lastname: Koushima
authors.affiliation: Department of Gastroenterology and Hepatology, Saitama Medical University Hospital, Saitama Medical University, Saitama.
authors.forename: Mie
authors.initials: M
authors.lastname: Inao
authors.affiliation: Department of Gastroenterology and Hepatology, Saitama Medical University Hospital, Saitama Medical University, Saitama.
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Nakayama
authors.affiliation: Department of Gastroenterology and Hepatology, Saitama Medical Center, Saitama Medical University, Saitama.
authors.forename: Sumiko
authors.initials: S
authors.lastname: Nagoshi
authors.affiliation: Department of Gastroenterology and Hepatology, Saitama Medical Center, Saitama Medical University, Saitama.
authors.forename: Koji
authors.initials: K
authors.lastname: Yakabi
authors.affiliation: Department of Gastroenterology, Dokkyo Medical University Koshigaya Hospital, Saitama.
authors.forename: Masaya
authors.initials: M
authors.lastname: Tamano
authors.affiliation: Department of Gastroenterology, Saitama Medical Center, Jichi Medical University, Saitama.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Asabe
authors.affiliation: Department of Gastroenterology Ageo Central General Hospital, Saitama.
authors.forename: Ko
authors.initials: K
authors.lastname: Nishikawa
authors.affiliation: Department of Gastroenterology Todachuo General Hospital, Saitama.
authors.forename: Youji
authors.initials: Y
authors.lastname: Harada
authors.affiliation: Saiseikai Kawaguchi General Hospital, Saitama.
authors.forename: Chuichi
authors.initials: C
authors.lastname: Sekine
authors.affiliation: Saiseikai Kurihashi General Hospital, Saitama.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Fukuya
authors.affiliation: Chichibu Hospital, Saitama.
authors.forename: Junji
authors.initials: J
authors.lastname: Funyu
authors.affiliation: Hakusei-Kai Aoki Hospital, Saitama, Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Hashimoto
authors.affiliation: Department of Gastroenterology and Hepatology, Saitama Medical University Hospital, Saitama Medical University, Saitama.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Mochida
keywords: adherence; interleukin-28B; pegylated interferon; response-guided therapy; ribavirin; telaprevir