Hepatitis C: Difference between revisions

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imported>Robert Badgett
(Added 4 RCTs)
imported>Robert Badgett
(→‎Treatment: evidence table)
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==Treatment==
==Treatment==
Two protease inhibitors, [[telaprevir]] and [[boceprevir]] may add benefit to standard therapy of peginterferon and ribavirin.  [[Telaprevir]] adds to peginterferon and ribavirin for previously treated<ref name="pmid21696308">{{cite journal| author=Zeuzem S, Andreone P, Pol S, Lawitz E, Diago M, Roberts S et al.| title=Telaprevir for retreatment of HCV infection. | journal=N Engl J Med | year= 2011 | volume= 364 | issue= 25 | pages= 2417-28 | pmid=21696308 | doi=10.1056/NEJMoa1013086 | pmc= | url= }} </ref> and untreated<ref name="pmid21696307">{{cite journal| author=Jacobson IM, McHutchison JG, Dusheiko G, Di Bisceglie AM, Reddy KR, Bzowej NH et al.| title=Telaprevir for previously untreated chronic hepatitis C virus infection. | journal=N Engl J Med | year= 2011 | volume= 364 | issue= 25 | pages= 2405-16 | pmid=21696307 | doi=10.1056/NEJMoa1012912 | pmc= | url= }} </ref> patients. [[Boceprevir]] adds to peginterferon and ribavirin for previously treated<ref name="pmid21449784">{{cite journal| author=Bacon BR, Gordon SC, Lawitz E, Marcellin P, Vierling JM, Zeuzem S et al.| title=Boceprevir for previously treated chronic HCV genotype 1 infection. | journal=N Engl J Med | year= 2011 | volume= 364 | issue= 13 | pages= 1207-17 | pmid=21449784 | doi=10.1056/NEJMoa1009482 | pmc= | url= }} </ref> and untreated<ref name="pmid21449783">{{cite journal| author=Poordad F, McCone J, Bacon BR, Bruno S, Manns MP, Sulkowski MS et al.| title=Boceprevir for untreated chronic HCV genotype 1 infection. | journal=N Engl J Med | year= 2011 | volume= 364 | issue= 13 | pages= 1195-206 | pmid=21449783 | doi=10.1056/NEJMoa1010494 | pmc= | url= }} </ref> patients.
{| class="wikitable"
|+ [[Randomized controlled trial]]s of [[protease inhibitors]] for hepatitis C genotype 1 infection.
<ref name="pmid21696308">{{cite journal| author=Zeuzem S, Andreone P, Pol S, Lawitz E, Diago M, Roberts S et al.| title=Telaprevir for retreatment of HCV infection. | journal=N Engl J Med | year= 2011 | volume= 364 | issue= 25 | pages= 2417-28 | pmid=21696308 | doi=10.1056/NEJMoa1013086 | pmc= | url= }} </ref>
<ref name="pmid21696307">{{cite journal| author=Jacobson IM, McHutchison JG, Dusheiko G, Di Bisceglie AM, Reddy KR, Bzowej NH et al.| title=Telaprevir for previously untreated chronic hepatitis C virus infection. | journal=N Engl J Med | year= 2011 | volume= 364 | issue= 25 | pages= 2405-16 | pmid=21696307 | doi=10.1056/NEJMoa1012912 | pmc= | url= }} </ref>
<ref name="pmid21449783">{{cite journal| author=Poordad F, McCone J, Bacon BR, Bruno S, Manns MP, Sulkowski MS et al.| title=Boceprevir for untreated chronic HCV genotype 1 infection. | journal=N Engl J Med | year= 2011 | volume= 364 | issue= 13 | pages= 1195-206 | pmid=21449783 | doi=10.1056/NEJMoa1010494 | pmc= | url= }} </ref>
<ref name="pmid21449784">{{cite journal| author=Bacon BR, Gordon SC, Lawitz E, Marcellin P, Vierling JM, Zeuzem S et al.| title=Boceprevir for previously treated chronic HCV genotype 1 infection. | journal=N Engl J Med | year= 2011 | volume= 364 | issue= 13 | pages= 1207-17 | pmid=21449784 | doi=10.1056/NEJMoa1009482 | pmc= | url= }} </ref>
! rowspan="2"|Trial!!rowspan="2"| Patients!!rowspan="2"| Intervention!!rowspan="2"|Comparison !!rowspan="2"|Outcome!!colspan="2"|Results
|-<br/>
! Intervention!!Control
|-
| ADVANCE Study<ref name="pmid21696308"/><br/>2011|| Previously untreated patients|| telaprevir||peginterferon-ribavirin|| HCV RNA 24 weeks after last treatment|| 69% to 75%|| 44%
|-
| REALIZE Study<ref name="pmid21696307"/><br/>2011 || Previously treated patients|| telaprevir||peginterferon-ribavirin|| HCV RNA 24 weeks after last treatment||  83% to 88% (prior reponse)<br/>54% to 59% (prior partial response)<br/>29% to 33% (prior non-response)
|| 24% (prior reponse)<br/>15% (prior partial response)<br/>5% (prior non-response)
|-
| SPRINT-2 study<ref name="pmid21449783"/><br/>2011 || Previously untreated patients|| boceprevir||peginterferon-ribavirin|| HCV RNA level|| 59% to 66%|| 21%
|-
| HCV RESPOND-2 study<ref name="pmid21449784"/><br/>2011 || Previously treated patients|| boceprevir||peginterferon-ribavirin|| HCV RNA level|| 67% to 68% (nonblack patients)<br/>42% to 53% (black patients)
|| 40% (nonblack patients)<br/>23% (black patients)
|-
|}
 
Two [[protease inhibitor]]s, [[telaprevir]] and [[boceprevir]] may add benefit to standard therapy of genotype 1 infection  with peginterferon and ribavirin.  [[Telaprevir]] adds to peginterferon and ribavirin for previously treated<ref name="pmid21696308">{{cite journal| author=Zeuzem S, Andreone P, Pol S, Lawitz E, Diago M, Roberts S et al.| title=Telaprevir for retreatment of HCV infection. | journal=N Engl J Med | year= 2011 | volume= 364 | issue= 25 | pages= 2417-28 | pmid=21696308 | doi=10.1056/NEJMoa1013086 | pmc= | url= }} </ref> and untreated<ref name="pmid21696307">{{cite journal| author=Jacobson IM, McHutchison JG, Dusheiko G, Di Bisceglie AM, Reddy KR, Bzowej NH et al.| title=Telaprevir for previously untreated chronic hepatitis C virus infection. | journal=N Engl J Med | year= 2011 | volume= 364 | issue= 25 | pages= 2405-16 | pmid=21696307 | doi=10.1056/NEJMoa1012912 | pmc= | url= }} </ref> patients. [[Boceprevir]] adds to peginterferon and ribavirin for previously treated<ref name="pmid21449784">{{cite journal| author=Bacon BR, Gordon SC, Lawitz E, Marcellin P, Vierling JM, Zeuzem S et al.| title=Boceprevir for previously treated chronic HCV genotype 1 infection. | journal=N Engl J Med | year= 2011 | volume= 364 | issue= 13 | pages= 1207-17 | pmid=21449784 | doi=10.1056/NEJMoa1009482 | pmc= | url= }} </ref> and untreated<ref name="pmid21449783">{{cite journal| author=Poordad F, McCone J, Bacon BR, Bruno S, Manns MP, Sulkowski MS et al.| title=Boceprevir for untreated chronic HCV genotype 1 infection. | journal=N Engl J Med | year= 2011 | volume= 364 | issue= 13 | pages= 1195-206 | pmid=21449783 | doi=10.1056/NEJMoa1010494 | pmc= | url= }} </ref> patients.


==References==
==References==
<references/>
<references/>

Revision as of 12:20, 8 July 2011

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Main Article
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Hepatitis C is "inflammation of the liver in humans caused by hepatitis c virus, a single-stranded RNA virus. Its incubation period is 30-90 days. Hepatitis C is transmitted primarily by contaminated blood parenterally, and is often associated with transfusion and intravenous drug abuse. However, in a significant number of cases, the source of hepatitis C infection is unknown."[1]

Treatment

Randomized controlled trials of protease inhibitors for hepatitis C genotype 1 infection. [2] [3] [4] [5]
Trial Patients Intervention Comparison Outcome Results
Intervention Control
ADVANCE Study[2]
2011
Previously untreated patients telaprevir peginterferon-ribavirin HCV RNA 24 weeks after last treatment 69% to 75% 44%
REALIZE Study[3]
2011
Previously treated patients telaprevir peginterferon-ribavirin HCV RNA 24 weeks after last treatment 83% to 88% (prior reponse)
54% to 59% (prior partial response)
29% to 33% (prior non-response)
24% (prior reponse)
15% (prior partial response)
5% (prior non-response)
SPRINT-2 study[4]
2011
Previously untreated patients boceprevir peginterferon-ribavirin HCV RNA level 59% to 66% 21%
HCV RESPOND-2 study[5]
2011
Previously treated patients boceprevir peginterferon-ribavirin HCV RNA level 67% to 68% (nonblack patients)
42% to 53% (black patients)
40% (nonblack patients)
23% (black patients)

Two protease inhibitors, telaprevir and boceprevir may add benefit to standard therapy of genotype 1 infection with peginterferon and ribavirin. Telaprevir adds to peginterferon and ribavirin for previously treated[2] and untreated[3] patients. Boceprevir adds to peginterferon and ribavirin for previously treated[5] and untreated[4] patients.

References

  1. Anonymous (2024), Hepatitis C (English). Medical Subject Headings. U.S. National Library of Medicine.
  2. 2.0 2.1 2.2 Zeuzem S, Andreone P, Pol S, Lawitz E, Diago M, Roberts S et al. (2011). "Telaprevir for retreatment of HCV infection.". N Engl J Med 364 (25): 2417-28. DOI:10.1056/NEJMoa1013086. PMID 21696308. Research Blogging.
  3. 3.0 3.1 3.2 Jacobson IM, McHutchison JG, Dusheiko G, Di Bisceglie AM, Reddy KR, Bzowej NH et al. (2011). "Telaprevir for previously untreated chronic hepatitis C virus infection.". N Engl J Med 364 (25): 2405-16. DOI:10.1056/NEJMoa1012912. PMID 21696307. Research Blogging.
  4. 4.0 4.1 4.2 Poordad F, McCone J, Bacon BR, Bruno S, Manns MP, Sulkowski MS et al. (2011). "Boceprevir for untreated chronic HCV genotype 1 infection.". N Engl J Med 364 (13): 1195-206. DOI:10.1056/NEJMoa1010494. PMID 21449783. Research Blogging.
  5. 5.0 5.1 5.2 Bacon BR, Gordon SC, Lawitz E, Marcellin P, Vierling JM, Zeuzem S et al. (2011). "Boceprevir for previously treated chronic HCV genotype 1 infection.". N Engl J Med 364 (13): 1207-17. DOI:10.1056/NEJMoa1009482. PMID 21449784. Research Blogging.