Advances in Modern Medicine

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Advances in Modern Medicine introduces recent advanced medical practices performed at the Kure Medical Center and Chugoku Cancer Center (KMCCCC) - one of the leading hospitals in Japan - to those ...
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Impact of Dose Reduction on the Efficacy of Triple Therapy for Patients Infected with Genotype 1b and High Viral Loads

Pp. 287-295 (9)

Hiroshi Kohno, Hirotaka Kouno, Toshiki Yamaguchi, Atsushi Yamaguchi and Toshio Kuwai

Abstract

To examine the impact of dose reduction on the efficacy of pegylated interferon (PEG-IFN) plus ribavirin (RBV) plus telaprevir (TVR) triple therapy for patients infected with genotype 1b and high viral loads.

A total of 51 patients were recruited for this study. Patients were divided into groups receiving either 2,250 mg of TVR for 12 weeks and 600 – 1,200 mg of RBV for 24 weeks according to body weight (Group 1, N = 39) or 1,500 mg of TVR for 12 weeks and 400 mg of RBV for 24 weeks (Group 2, N = 13) plus 1.5 μg/Kg (range: 1.3 - 2.0 μg/Kg) of peg-IFN alpha-2b for 24 weeks. Patients of Group 1 were less than 65 years old or IL28 non T/T and over 65 to less than 70 years old. Patients of Group 2 were IL28B T/T and over 65 to less than 70 years old or over 70 years old.

Rapid virological response (RVR) rates were 66.7% in Group 1 and 84.2% in Group 2 (NS). Early virological response (RVR) rates were 79.5% in Group 1 and 91.7% in Group 2 (NS). End of treatment response (ETR) rates were 71.8% in Group 1 and 69.2% in Group 2 (NS). Sustained virological response (SVR) rates were 60.5% in Group 1 and 69.2% in Group 2 (NS). In multivariate analysis, significant contribution factors for SVR were IL28B (genotype TT; OR 1.83, P = 0.0032) and platelet counts (< 120,000; OR 2.14, P = 0.0140).

It was concluded that the treatment strategy of dose reduction based on patient background (age and IL28B SNP polymorphism) was proper in Japanese patients.

Keywords:

Dose reduction, Genotype 1b, HCV, Triple therapy, TVR.

Affiliation:

Department of Gastroenterology, National Hospital Organization, Kure Medical Center and Chugoku Cancer Center, 3-1 Aoyama-cho, Kure 737-0023, Japan.