Individualized treatment of genotype 1 Naïve patients: An Italian multicenter field practice experience

Alessandra Mangia, Giovanni Cenderello, Alessandra Orlandini, Valeria Piazzolla, Antonio Picciotto, Massimo Zuin, Alessia Ciancio, Giuseppina Brancaccio, Paolo Forte, Vito Carretta, Anna Linda Zignego, Nicola Minerva, Gaetano Brindicci, Massimo Marignani, Gianluca Svegliati Baroni, Gaetano Bertino, Giuseppe Cuccorese, Leonardo Mottola, Maria Ripoli, Mario Pirisi

Research output: Contribution to journalArticle

Abstract

Background: Triple therapy including Telaprevir or Boceprevir still represents in many European countries the standard of care for patients with Hepatitis C Virus genotype 1 infection. The number of patients who received this treatment resulted generally lower than expected. We investigated, among naïve patients, number and characteristics of treatment candidates who were started on triple or dual therapy in comparison to those who were deferred.

Patients and Methods: 621 naïve treatment candidates were prospectively evaluated at each center. Factors associated with decision to defer or treat with dual or triple therapy were investigated by univariate and multivariate analyses. Rates of Sustained Virological Response and safety profile were analysed.

Results: Of candidates to treatment, 33% did not received it. It was mostly due to high risk of Interferon-induced decompensation. Of 397 patients who were started on treatment, 266 (67%) received triple, 131 dual. Among patient receiving treatment, unfavorable IL28B, severe liver damage and higher albumin were independently associated with the physician decision to administer triple therapy. Sustained Virological Response after dual therapy was 66.4%, after triple 73.7% (p=0.14). 142 patients received Telaprevir. The choice of Telaprevir-based therapy was associated with higher Body Mass Index and advanced liver disease. Sustained Virological Response rates were 71.1% after Telaprevir and 76.6% after Boceprevir.

Conclusions: Individualizing treatment with available regimens allows to maximize Sustained Virological Response and to reduce the number of patients who remain untreated. High proportion of patients with severe liver damage urgently need Interferon free treatment.

Original languageEnglish
Article numbere110284
JournalPLoS One
Volume9
Issue number10
DOIs
Publication statusPublished - Oct 23 2014

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

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    Mangia, A., Cenderello, G., Orlandini, A., Piazzolla, V., Picciotto, A., Zuin, M., Ciancio, A., Brancaccio, G., Forte, P., Carretta, V., Zignego, A. L., Minerva, N., Brindicci, G., Marignani, M., Baroni, G. S., Bertino, G., Cuccorese, G., Mottola, L., Ripoli, M., & Pirisi, M. (2014). Individualized treatment of genotype 1 Naïve patients: An Italian multicenter field practice experience. PLoS One, 9(10), [e110284]. https://doi.org/10.1371/journal.pone.0110284