Administration of low‐dose epoetin‐alpha facilitates adherence to ribavirin in triple therapy with pegylated interferon‐alpha‐2b and telaprevir

Abstract

EPO can be a favorable alternative to reduction of RBV to facilitate the adherence of patients on TVR-based triple therapy.

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)

“…A previous trial of triple therapy with telaprevir for 24 weeks revealed SVR rates of 84% in patients with a TT allele of IL‐28B‐related gene SNP (rs8099917), while the SVR rates were 50% and 12% in those showing non‐TT alleles with genotype 1b wild and mutant HCV strains, respectively, at a.a.70 in the core region . Also, in this trial, when the comparison was made in patients with a previous history of PEG IFN plus ribavirin therapy, the SVR rates differed between patients who showed or did not show RVR; the rates were 91.8% and 54.5% in relapsers showing RVR and non‐RVR, respectively, and 39.1% and 22.2% in non‐responders showing RVR and non‐RVR, respectively . Moreover, the adherence rates to both PEG IFN‐α‐2b and ribavirin were shown to be crucial for achieving SVR in treatment‐naive patients as well as in relapsers and non‐responders .…”

“…6 Also, in this trial, when the comparison was made in patients with a previous history of PEG IFN plus ribavirin therapy, the SVR rates differed between patients who showed or did not show RVR; the rates were 91.8% and 54.5% in relapsers showing RVR and non-RVR, respectively, and 39.1% and 22.2% in nonresponders showing RVR and non-RVR, respectively. 12 Moreover, the adherence rates to both PEG IFN-α-2b and ribavirin were shown to be crucial for achieving SVR in treatment-naive patients as well as in relapsers and nonresponders. 11,12 In the case of the non-responders, none of the patients with an adherence rate to PEG IFN-α-2b of less than 80% showed SVR, while all of the patients with adherence rates of 80% or more achieved SVR.…”

“…11,12 In the case of the non-responders, none of the patients with an adherence rate to PEG IFN-α-2b of less than 80% showed SVR, while all of the patients with adherence rates of 80% or more achieved SVR. 12 Also, the SVR rates were 91.7% and 72.7% in treatment-naive patients showing RVR with adherence rates to ribavirin of 80% or more and less than 80%, respectively, and 100% and 56.3% in treatment-naive patients failing to achieve RVR with adherence rates to ribavirin of 80% or more and less than 80%, respectively. 11 To overcome these limitations of triple therapy with telaprevir, the duration of administration of PEG IFN-α-2b and ribavirin was prolonged up to 48 or 72 weeks depending on the adherence rates to the two drugs until 12 weeks of the therapies, using cut-off values of 80% for each drug, IL-28B-related gene polymorphism and viral response during the therapy.…”

“…The response‐guided approach was shown to be effective for achieving high SVR rates after triple therapy with telaprevir, as well as after combined PEG IFN plus ribavirin therapy . Also, the adherence rate to both ribavirin and PEG IFN, and the IL‐28B‐related gene alleles, were identified as predictors of high SVR rates after triple therapy with telaprevir for 24 weeks.…”

Adjuvant epoetin‐β with peginterferon‐α and ribavirin in Japanese ribavirin‐intolerant relapsed patients with chronic hepatitis C genotype 2

“…Erythropoietic growth factor, erythropoietin, is widely used in the USA and some Western countries to increase hemoglobin level, maintain the doses of RBV and improve treatment compliance. [11][12][13][14][15][16][17][18][19][20][21] However, the adjuvant use of erythropoietin in the setting of anti-HCV therapy has not been approved in Japan. 22 In addition, the impact of erythropoietin administration on SVR remains unclear.…”