Background No

Purpose To evaluate the prescription pattern and efficacy of telaprevir (TLP) and boceprevir (BOC) in the clinical management of chronic hepatitis C (HCV) infection in a region.

Material and methods Multicentre observational cohort study of HCV patients treated with protease-inhibitor triple therapy from September 20012 to April 2014. The information extracted from electronic health records was: age, gender, comorbidity and previous experience of HCV treatment. The virological response (VR) was assessed in patients who reached 24 and 48 weeks treatment; quick virological response rate (QVR) and discontinued treatment rates were also assessed.

Results 124 patients were included (TLP = 82; BOC = 42), 65% were male (63.4% treated with TVR and 69% with BOC p = 0.533). There was no difference between the selection of treatment according to comorbidity, with the exception of HIV co-infected patients (total: 8.9%; TVR: 13.6% vs. BOC: 0%; p = 0.012) or with mental illness (21.2%; 27.3% vs. 10.5%; p = 0.044). The distribution of patients according to previous experience was: treatment-naïve patients (total: 41.1%; TLP: 36.6% vs. BOC: 50%; p = 0.151), null responders (18.5%; 14.6% vs. 26.2%; p = 0.117), partial responders (12.9%; 11% vs. BOC = 16.7%; p = 0.371), relapsers (26.6%; 36.6% vs. 7.1%; p = 0.0001). At week 24, 83 patients achieved VR: 62.7%; (TLP = 66.7% BOC = 55.2%; p = 0.346). QVR rates were 53.1%; (62.2% vs.50.7%; p = 0.023). According the previous treatment experience, VR were: relapsers 81.8%, treatment-naïve patients 63.8%, partial responders: 58.3% and null responders: 37.5% (p = 0.048). At week 48, 61 patients achieved VR or 57.4% (TLP: 62.2% vs. BOC: 50%; p = 0.348). Discontinuation rate was 13.6% (TLP: 20% vs. BOC: 3.8%, p = 0.062).

Conclusion TLP was the preferred treatment in HIV co-infected patients, mentally ill patients or relapsers. The statistical trend shows higher efficacy and discontinued treatment rate with TLP, but the differences are statistically irrelevant. Both drugs showed worse results in clinical management than reported in clinical trials.

References and/or acknowledgements No conflict of interest.