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Boceprevir: Effective in Previous Non-Responders

By Sean R. Hosein

December 23, 2010

In the past, some HCV-positive people may have undergone treatment with standard therapy but did not recover from this infection. Researchers refer to such people as "non-responders." People with HCV genotype 1 are traditionally the least responsive to therapy.

In the Respond 2 study, researchers compared two strategies for trying to increase recovery from HCV infection. Participants were divided into the following three groups:

The average profile of participants who entered the Respond 2 study was as follows:

Boceprevir was taken at a dose of 800 mg three times daily.


Results -- Sustained Virologic Response (SVR)

Overall, SVRs were distributed among the three treatment groups as follows:


Results -- SVR According to the HCV Detectability at Week 8

Overall, boceprevir increased the chances of participants achieving an SVR.


Results -- According to Response to Prior Therapy

Among non-responders to previous peginterferon + ribavirin, here is the proportion who achieved an SVR in the present study:

Among people who relapsed when previously treated with peginterferon + ribavirin, here is the proportion who achieved an SVR in the present study:

Results -- According to Changes in HCV Viral Load at Week 4

In boceprevir studies, including the present one, for the first four weeks of therapy participants received peginterferon + ribavirin. The purpose of this lead-in phase of peginterferon is to assess participants' ability to respond to peginterferon and assess any changes in HCV viral load. Among participants in the present study whose HCV viral loads fell by at least one log after the first four weeks of therapy (in other words, who had a significant response to peginterferon), SVRs were as follows:


Results -- Safety

One death occurred during the Respond 2 study in a person who received boceprevir.

Most side effects were evenly distributed across all three groups, except for these which were more common among boceprevir users:

Anemia occurred as follows:

Altered sense of taste occurred in the following proportion of participants:


Summary

The use of boceprevir significantly increased the changes of SVR even in participants who had not previously responded to peginterferon therapy. Both strategies of boceprevir use (response-guided and taking it for 44 weeks) seemed equally effective in people whose previous treatment with peginterferon + ribavirin had failed.

As in other studies, boceprevir was associated with an increased risk of anemia and altered sense of taste in the present study.


Reference

  1. Bacon BR, Gordon SC, Lawitz E, et al. HCV Respond-2 Final Results: High sustained virologic response among genotype 1 previous non-responders and relapsers to peginterferon/ribavirin when re-treated with boceprevir plus Pegintron (peginterferon alfa-2b)/ribavirin. In: Program and abstracts of the 61st Annual Meeting of the American Association for the Study of Liver Diseases, 29 October - 2 November, 2010, Boston, MA.




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