tailieunhanh - hepatology 2010_part6

Đại lý cho điều trị viêm gan C được chọn để xác định việc xử lý sơ bộ với PEG-IFN a-2 và ribavirin có thể tránh được sự phát triển của kháng thuốc trong khi có tác động tích cực về hiệu quả kháng virus. | New agents for treating hepatitis C chosen to determine whether pretreatment with PEG-IFN a-2 and ribavirin could avoid the development of resistance while have positive effects on antiviral efficacy. The control group was treated with PEG-IFN a-2b and ribavirin for 48 weeks. SVR rates after 28 weeks of triple therapy were 54 and 56 after 24 weeks with an additional 4 weeks of pretreatment lead-in with PEG-IFN a-2 and ribavirin Figure 8 . SVR rates after 48 weeks of triple treatment were 67 and 75 after 44 weeks with an additional 4 weeks of pretreatment lead in with PEG-IFN a-2 and ribavirin. After 4 weeks of triple therapy with boceprevir PEG-IFN and ribavirin 38 of patients achieved a rapid virologic response. The most common side-effects related to boceprevir were anemia nausea vomiting and dysgeusia. In general SPRINT-1 has shown a higher antiviral efficacy of combination therapies with boceprevir in comparison to the standard of care with slightly better results with the 4 week lead-in phase especially for the long treatment duration of 48 weeks. However with 38 RVR rates boceprevir triple therapy seems to be less potent then telaprevir triple therapy with an RVR rate of approximately 70 . A phase III clinical trial SPRINT-2 evaluating boceprevir in treatment-naive patients was recently initiated. RBN RBN -24 weeks boc PEG-IFN RBV -44 weeks boc PEG-IFN RBV Premature treatment termination 28 boceprevir 14 standard Resistance 5-11 TVR 0 standard Figure 8. Results of SPRINT-1. Combination therapy of boceprevir and PEG-IFN a-2b ribavirin RBV in treatment-naive genotype 1 patients. Non-responder and relapser phase II studies In a complex study of genotype 1 non-responders the addition of boceprevir to PEG-IFN a-2b and ribavirin resulted in only slightly increased SVR rates compared to standard treatment 14 vs. 2 Schiff 2008 . A phase III clinical trial RESPOND-2 evaluating boceprevir in relapsers and partial non-responders was initiated recently. This is trial .