NEVŞEHİR İLİNDE KRONİK HEPATİT C HASTALARINDA BOCEPREVİR VE TELAPREVİR KOMBİNASYON TEDAVİSİ SONUÇLARI
Kronik hepatit C infeksiyonu Türkiyede önemli bir sağlık sorunudur. Türkiyede en sık görülen hepatitis C virüs (HCV) genotipi 1bdir. Hepatit C tedavisinde önemli gelişmelerden biri proteaz inhibitörleri boceprevir (BOC) ve telaprevirin (TVR) kullanıma girmesidir. Hepatit C genotip 1 ile infekte hastalarda pegile interferon-alfa ve ribavirin (PegIFN/RBV) ile beraber BOC ve TVR kullanımı kalıcı virolojik cevap (KVC) oranlarını belirgin olarak artırmıştır. Bu çalışmada kompanse karaciğer hastalığı olan HCV genotip 1 ile infekte, daha önce PegIFN/RBV tedavisi almış ama KVC elde edilememiş hastalar- da yeniden tedavide PegIFN/RBV kombinasyonuna eklenen BOC ve TVR etkinliği ve yan etkileri değerlendirmek amaçlan- mıştır. Toplam 22 hastanın 14ünde (% 63.6) KVC elde edilmiştir. BOC grubunda en sık gözlenen yan etkiler halsizlik, kuru cilt, bulantı, anemi, nötropeni ve TVR grubunda ise anemi, kuru cilt, bulantı ve halsizlik olmuştur. PegIFN/RBV ile beraber BOC ve TVR kullanımı ile KVC yüksek oranda saptanmıştır. Yan etkilerin sıklığına rağmen kombinasyon tedavisinin kesilme oranı düşük olmuştur.
Results of Boceprevir and Telaprevir Combination Therapy in Chronic Hepatitis C Patients in Nevşehir Province
Chronic Hepatitis C infection is an important health problem in Turkey. The most frequently observed hepatitis C virus (HCV) genotype in Turkey is genotype 1b. Protease inhibitor antiviral agents boceprevir (BOC) and telaprevir (TVR) for HCV infection are one of the major advances in its medical treatment. The combination of BOC and TVR with pegylated interferon- alpha and ribavirin (PegIFN/RBV) for the treatment of patients infected with HCV genotype 1 has caused significantly inc- reased rates of sustained virologic response (SVR). In this study, we aimed to evaluate the efficacy and adverse effects of BOC and TVR with PegIFN/RBV for the retreatment of patients infected with HCV genotype 1 who have compensated liver dise- ase and who have previously received PegIFN/RBV therapy but could not achieve SVR. Sustained virologic response was achieved in 14 (63.6 %) of the 22 patients. The most observed adverse effects were anaemia, dry skin, nausea, fatigue at TVR group and fatigue, dry skin, nausea, anaemia and neutropenia at BOC group. Sustained virologic response rates were high with the combination of BOC and TVR with PegIFN/RBV. Although adverse effects were frequently observed, the discontinuation rate of combination therapy was low.
___
- 1. Aygen B, Yıldız O, Akhan S, Çelen MK ve ark. Retreatment of chronic hepatitis C infection with telaprevir: preliminary results in Turkey, Balkan Med J 2015;32(3):266-72. http://dx.doi.org/10.5152/balkanmedj.2015.15366
- 2. Bacon BR, Gordon SC, Lawitz E et al. Boceprevir for previously treated chronic HCV genotype 1 infection (HCV RESPOND-2 trial), N Engl J Med 2011;364(13):1207-17. http://dx.doi.org/10.1056/NEJMoa1009482
- 3. Bertino G, Ardiri A, Proiti M et al. Chronic hepati- tis C: this and the new era of treatment, World J Hepatol 2016;8(2):92-106. http://dx.doi.org/10.4254/wjh.v8.i2.92
- 4. Borcak D, Çağır Ü, Yalçıner A. Nevşehir ilinde hepatit C virus genotip dağılımı ile serum alanin aminotransferaz ve kantitatif serum HCV RNA düzeyleri ilişkisi, ANKEM Derg 2015;29(1):36-40.
- 5. Bozdayi AM, Aslan N, Bozdayi G et al. Molecular epidemiology of hepatitis B, C and D viruses in Turkish patients, Arch Virol 2004;149:2115-29. http://dx.doi.org/10.1007/s00705-004-0363-2
- 6. Cooper C, Lester R, Thorlund K et al. Direct- acting antiviral therapies for hepatitis C genotype 1 infection: a multiple treatment comparison meta- analysis, QJM 2013;106(2):153-63. http://dx.doi.org/10.1093/qjmed/hcs214
- 7. Cooper C, Druyts E, Thorlund K et al. Boceprevir and telaprevir for the treatment of chronic hepati- tis C genotype 1 infection: an indirect comparison meta-analysis, Ther Clin Risk Manag 2012;8:105- 30.
- 8. Cunningham M, Foster GR. Efficacy and safety of telaprevir in patients with genotype 1 hepatitis C infection, Therap Adv Gastroenterol 2012;5(2):139- 51. http://dx.doi.org/10.1177/1756283X11426895
- 9. Çakaloğlu Y. Kronik C hepatitis tedavisi 2012, direk etkili antiviral ajanlarla sağlananlar, ANKEM Derg 2012;26(Ek 2):135-43.
- 10. European Association for the Study of the Liver. EASL clinical practice guidelines: management of hepatitis C virus infection, J Hepatol 2014;60:392- 420. http://dx.doi.org/10.1016/j.jhep.2013.11.003
- 11. European Association for the Study of the Liver. Recommendations on treatment of hepatitis C 2015, J Hepatol 2015;63:199-236. http://dx.doi.org/10.1016/j.jhep.2015.03.025
- 12. Ghany MG, Nelson DR, Strader DB et al. An update on treatment of genotype 1 chronic hepati- tis C virus infection: 2011 practice guideline by the American Association for the Study of Liver Diseases, Hepatol 2011;54(4):1433-44. http://dx.doi.org/10.1002/hep.24641
- 13. González-Grande R, Jiménez-Pérez M, González Arjona C, Mostazo Torres J. New approaches in the treatment of hepatitis C, World J Gastroenterol 2016;22(4):1421-32. http://dx.doi.org/10.3748/wjg.v22.i4.1421
- 14. Habersetzer F, Leboeuf C, Doffoël M, Baumert TF. Boceprevir and personalized medicine in hepatitis C virus infection, Pharmgenomics Pers Med 2012; 5:125-37.
- 15. Hepatitis C guidance. AASLD-IDSA recommen- dations for testing, managing, and treating adults infected with hepatitis C virus, J Hepatol 2015; 62(3):932-54. http://dx.doi.org/10.1002/hep.27950
- 16. Hézode C, Fontaine H, Dorival C et al. Effectiveness of telaprevir or boceprevir in treatment-experien- ced patients with HCV genotype 1 Infection and Cirrhosis, Gastroenterol 2014;147(1):132-42. http://dx.doi.org/10.1053/j.gastro.2014.03.051
- 17. Hofmann WP, Zeuzem S. A new standard of care for the treatment of chronic HCV infection, Nat Rev Gastroenterol Hepatol 2011;8(5):257-64. http://dx.doi.org/10.1038/nrgastro.2011.49
- 18. Jacobson IM, McHutchison JG, Dusheiko G et al. Telaprevir for previously untreated chronic hepa- titis C virus infection (ADVANCE atudy), N Engl J Med 2011;364(25):2405-16. http://dx.doi.org/10.1056/NEJMoa1012912
- 19. Kabaçam G, Önder FÖ. Hepatit C enfeksiyonu tedavisinin bugünü ve yarını, Güncel Gastroen- teroloji 2013;17(3):225-31.
- 20. Kłujszo CE , Parcheta P, Zarëbska-Michaluk D. Dermatologic adverse events of protease inhibitor- based combination therapy in patients with chro- nic hepatitis C, J Dermatol Case Rep 2014 31;8(4):95- 102.
- 21. Kömür S, Kurtaran B, Inal AS et al. Telaprevir experience from Turkey, Hepat Mon 2015;15(2): e25639. http://dx.doi.org/10.5812/hepatmon.25639
- 22. Manns MP, McHutchison JG, Gordon SC et al. Peginterferon alfa-2b plus ribavirin compared with interferon alfa-2b plus ribavirin for initial treatment of chronic hepatitis C: a randomised trial, Lancet 2001;358(9286):958-65. http://dx.doi.org/10.1016/S0140-6736(01)06102-5
- 23. McHutchison JG, Everson GT, Gordon SC et al and PROVE1 study team. Telaprevir with pegin- terferon and ribavirin for chronic HCV genotype 1 infection, N Engl J Med 2009;360(18):1827-38. http://dx.doi.org/10.1056/NEJMoa0806104
- 24. McHutchison JG, Lawitz EJ, Shiffman ML et al. Peginterferon alfa-2b or alfa-2a with ribavirin for treatment of hepatitis C infection, N Engl J Med 2009;361(6):580-93. http://dx.doi.org/10.1056/NEJMoa0808010
- 25. McHutchison JG, Manns MP, Muir AJ et al. Telaprevir for previously treated chronic HCV infection, N Engl J Med 2010;362(14):1292-303. http://dx.doi.org/10.1056/NEJMoa0908014
- 26. Park C, Jiang S, Lawson KA. Efficacy and safety of telaprevir and boceprevir in patients with hepati- tis C genotype 1: a meta-analysis, J Clin Pharm Ther 2014;39(1):14-24. http://dx.doi.org/10.1111/jcpt.12106
- 27. Poordad F, McCone J Jr, Bacon BR et al. Boceprevir for untreated chronic HCV genotype 1 infection (SPRINT-2 trial), N Engl J Med 2011;364(13):1195- 206. http://dx.doi.org/10.1056/NEJMoa1010494
- 28. Poynard T, Colombo M, Bruix J et al. Peginterferon alfa-2b and ribavirin: effective in patients with hepatitis C who failed interferon alfa/ribavirin therapy, Gastroenterol 2009;136(5):1618-28. http://dx.doi.org/10.1053/j.gastro.2009.01.039
- 29. Roujeau JC, Mockenhaupt M, Tahan SR et al. Telaprevir-related dermatitis, JAMA Dermatol 2013;149:152-8. http://dx.doi.org/10.1001/jamadermatol.2013.938
- 30. Smith DB, Bukh J, Kuiken C et al. Expanded classification of hepatitis C virus into 7 genotypes and 67 subtypes: updated criteria and genotype assignment web resource, J Hepatol 2014;59(1): 318-27. http://dx.doi.org/10.1002/hep.26744
- 31. Thompson A, Patel K, Tillman H, McHutchison JG. Directly acting antivirals for the treatment of patients with hepatitis C infection: a clinical deve- lopment update addressing key future challenges, J Hepatol 2009;50(1):184-94. http://dx.doi.org/10.1016/j.jhep.2008.10.011
- 32. Zeuzem S, Andreone P, Pol S et al. Telaprevir for retreatment of HCV infection (REALIZE study), N Engl J Med 2011;364(25):2417-28. http://dx.doi.org/10.1056/NEJMoa1013086
- ISSN: 1301-3114
- Yayın Aralığı: Yılda 3 Sayı
- Başlangıç: 1986
- Yayıncı: Antibiyotik ve Kemoterapi Derneği
Sayıdaki Diğer Makaleler
AYŞE İSTANBULLU TOSUN, Mehmet Demirci, Mesut YILMAZ, Hatice ŞEN, Leyla SİREKBASAN, Ezgi GÖZÜN ŞAYLAN, Cemile GÖKÇEAĞAÇLI, AHMET ZEKİ ŞENGİL
NURULLAH ÇİFTÇİ, HATİCE TÜRK DAĞI, ASLIHAN DEMİRCAN, İnci TUNCER
Meltem ZENCİR, Alpay ARI, Nisel YILMAZ, Meltem AVCI, Şebnem ÇALIK, Ayten S. COŞKUNER, Fatma BAL, Neval AĞUŞ
TÜBERKÜLOZ PERİTONİT: İKİ OLGU SUNUMU
Şükran KÖSE, Sabri ATALAY, Ufuk SÖNMEZ, Didem ÇELİK, Ayşe ÖZKAN, Hazal ALBAYRAK
GÜLŞEN HAZIROLAN, Dilek KANYILMAZ, İpek MUMCUOĞLU, Hürrem BODUR, MELTEM ARZU YETKİN, Neriman AKSU