title: 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.
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.
  
  
  OBJECTIVE
  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).
  
  
  CONCLUSIONS
  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).
authors.affiliation: Division of Gastroenterology and Hepatology, Stanford University Medical Center, 750 Welch Rd. Suite 210, Palo Alto, CA, 94304, USA, vo.kevinp@gmail.com.
authors.forename: Kevin P
authors.initials: KP
authors.lastname: Vo
authors.forename: Philip
authors.initials: P
authors.lastname: Vutien
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Akiyama
authors.forename: Vinh D
authors.initials: VD
authors.lastname: Vu
authors.forename: Nghiem B
authors.initials: NB
authors.lastname: Ha
authors.forename: Joy I
authors.initials: JI
authors.lastname: Piotrowski
authors.forename: James
authors.initials: J
authors.lastname: Wantuck
authors.forename: Marina M
authors.initials: MM
authors.lastname: Roytman
authors.forename: Naoky
authors.initials: N
authors.lastname: Tsai
authors.forename: Ramsey
authors.initials: R
authors.lastname: Cheung
authors.forename: Jiayi
authors.initials: J
authors.lastname: Li
authors.forename: Mindie H
authors.initials: MH
authors.lastname: Nguyen
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D007372:Interferons / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009842:Oligopeptides / Q000627:therapeutic use*; D011392:Proline / Q000031:analogs & derivatives* / Q000627:therapeutic use; D012189:Retrospective Studies; D012254:Ribavirin / Q000627:therapeutic use; D016896:Treatment Outcome; D055815:Young Adult; D016903:Drug Monitoring
chemical_list: D000998:Antiviral Agents; D009842:Oligopeptides; 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; D007372:Interferons; D011392:Proline
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