title: Impact of Telaprevir in HCV Patients with Cirrhosis and RVR: Real-Life Data from Boceprevir or Telaprevir based "Triple Therapy" Experience in Southern Italy.
abstract: Background and Rationale of Study: The real-life data of triple therapy-based treatment in patients with chronic hepatitis C were investigated in this survey of 12 clinical centers of southern Italy. This retrospective study analyzed data from 176 consecutive patients.
  
  
  
  125 (70%) patients were treated with telaprevir, and 51(30%) with boceprevir. There were no differences in demographic characteristics between the groups. The degree of Liver Fibrosis (LF) was evaluated according to Liver Biopsy (LB) and/or Transient Elastography (TE). 53/176 patients (30%) had liver cirrhosis. Sixteen patients (9%) were treatment naïve, and the remaining were not: 92 were non-responders (52, 84%), 63 relapsed (35,79%), and 5 discontinued treatment (2, 8%).
  
  
  
  Overall, the rapid Virological Response (RVR) rate was 67.6%. Of the 103 patients who had follow-up for at least 12 weeks after the end of treatment, 61 (59, 2%) achieved a Sustained Virological Response (SVR). According to multivariate analysis for SVR, RVR was the only independent predictive factor of SVR, irrespective of the degree of LF and the type of response to previous treatments. In telaprevir-treated patients, the rate of RVR was similar in patients with F0-F2, F3 and F4 fibrosis (85%, 84%, 78%, respectively), and the SVR rates among RVR patients was similar irrespective of LF.
  
  
  
  Data from this real-life study confirm the efficacy reported in clinical trials, although cirrhosis appears to play a smaller role in influencing treatment efficacy. Moreover, RVR is the only independent predictive factor of response regardless of cirrhosis. Based on RVR and for patients with cirrhosis, a shorter therapy might be considered, at least with telaprevir-based therapy.
authors.forename: Filomena
authors.initials: F
authors.lastname: Morisco
authors.forename: Mario
authors.initials: M
authors.lastname: Masarone
authors.forename: Valerio
authors.initials: V
authors.lastname: Rosato
authors.forename: Silvia
authors.initials: S
authors.lastname: Camera
authors.forename: Rocco
authors.initials: R
authors.lastname: Granata
authors.forename: Maria T
authors.initials: MT
authors.lastname: Tartaglione
authors.forename: Carmine
authors.initials: C
authors.lastname: Coppola
authors.forename: Nicola
authors.initials: N
authors.lastname: Coppola
authors.forename: Angelo
authors.initials: A
authors.lastname: Salomone-Megna
authors.forename: Ivan
authors.initials: I
authors.lastname: Gentile
authors.forename: Antonio
authors.initials: A
authors.lastname: De Luna
authors.forename: Alessandro
authors.initials: A
authors.lastname: Federico
authors.forename: Davide
authors.initials: D
authors.lastname: Precone
authors.forename: Ernesto
authors.initials: E
authors.lastname: Claar
authors.forename: Ludovico
authors.initials: L
authors.lastname: Abenavoli
authors.affiliation: Salerno University of Medicine, Internal Medicine and Hepatology Unit, Salerno, Italy.
authors.forename: Marcello
authors.initials: M
authors.lastname: Persico
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005838:Genotype; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D016898:Interferon-alpha; D007558:Italy; D008103:Liver Cirrhosis / Q000188:drug therapy*; D009842:Oligopeptides / Q000627:therapeutic use*; D012189:Retrospective Studies; D012254:Ribavirin; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D009842:Oligopeptides; D012254:Ribavirin; C486464:telaprevir