Authors' recommendations: There is currently no available evidence for switching a patient with CHC infection from one protease inhibitor to the other midway through completion of the original PR-protease inhibitor therapy. There is evidence that initiating boceprevir after a 4-week lead-in period with PR leads to a higher response rate than continuing on PR alone. There is also evidence that in treatment-experienced patients, initiating telaprevir 4 weeks into a PR regimen is as efficacious and safe as starting patients on telaprevir-PR. There is no evidence for initiating a protease inhibitor after four weeks of PR therapy. There is also no evidence comparing the addition of a PI to PR at 4 weeks with continuation of PR alone in patients who achieve rapid virological response (undetectable HCV at 4 weeks); such patients demonstrate high SVR rates with 24 weeks of PR alone, therefore the benefit of PI-PR therapy is uncertain. There is evidence that extending treatment duration with PR from 48 to 72 weeks leads to a statistically significant increase in the rate of sustained virologic response (SVR). However, given the availability of the protease inhibitors, it is perhaps unlikely that PR regimens longer than 48 weeks would be considered for most patients exhibiting slow virological response.

Project Status: Completed

Year Published: 2012

URL for published report: http://www.cadth.ca/media/pdf/htis/mar-2012/RC0327-001%20Extended%20Therapy%20Final.pdf

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Canada

Organisation Name: Canadian Agency for Drugs and Technologies in Health

Contact Address: 600-865 Carling Avenue, Ottawa, ON K1S 5S8 Canada. Tel: +1 613 226 2553; Fax: +1 613 226 5392;

Contact Name: requests@cadth.ca

Contact Email: requests@cadth.ca

Copyright: Canadian Agency for Drugs and Technologies in Health (CADTH)