SAN FRANCISCO, November 5, 2011 /PRNewswire/ --
Data presented at AASLD 2011 highlights efficacy in typically hard to treat patients
NOT INTENDED FOR US JOURNALISTS
Janssen Pharmaceutica NV (Janssen), today presented new data for INCIVO(R) (telaprevir) at the American Association for the Society of Liver Disease (AASLD) Annual Meeting, highlighting the safety and efficacy of a telaprevir based regimen in cirrhotic patients who had previously failed treatment. Results from a sub-analysis of the REALIZE Phase 3 study showed that telaprevir, in combination with peginterferon alfa and ribavirin (PR), was associated with cure rates (defined as a sustained virologic response (SVR)) significantly higher than PR alone in patients with genotype-1 chronic HCV and cirrhosis (47 percent vs 10 percent respectively).[1] HCV is a curable condition in the majority of cases, however, if left untreated can result in serious long-term health problems including cirrhosis. Cirrhosis causes permanent scarring of the liver which can eventually lead to liver failure and mortality.
Results showed that cirrhotic patients experienced significantly higher cure rates following treatment with a telaprevir-based regimen compared with PR alone. Overall, cirrhotic patients had lower cure rates than those without cirrhosis (except previous treatment relapsers), however, treatment with a telaprevir-based regimen cured nearly half of all patients with cirrhosis.[1]
"This year has seen significant advances in the treatment of HCV with the availability of direct-acting antivirals (DAAs), including telaprevir. This is even more important for those patients who are experiencing the potentially devastating effects of HCV, such as cirrhosis. The REALIZE sub-analysis demonstrates that telaprevir maintains superior efficacy compared to PR alone in a group of patients that is typically hard to treat." said Prof. Stanislas Pol, Lead Study Investigator, Université Paris Descartes, Inserm U-1016 and Liver Department, Hôpital Cochin, Paris, France.
REALIZE was a randomised, double-blind, placebo-controlled Phase 3 trial to compare the efficacy, safety and tolerability of telaprevir in 662 patients with chronic genotype-1 HCV who failed prior treatment with PR. Patients received 48 weeks total treatment with PR alone or one of two telaprevir-based regimens (T/PR): 12 weeks T/PR plus 36 weeks PR alone, or 4 weeks PR alone followed by 12 weeks T/PR and 32 weeks PR alone.[2] In this sub-analysis, efficacy and safety variables were reanalysed for 662 patients with and without baseline cirrhosis.[1]
Adverse events were consistent with those reported in the Phase 3 studies. Rash, pruritus and anemia (Hb <10 g/dL) were more frequent in cirrhotic patients receiving telaprevir (42%, 53% and 39% respectively) than PR alone. Adverse events led to discontinuation of telaprevir in 15% of cirrhotic and 12% of non-cirrhotic patients.[1]
Telaprevir was approved by the European Commission for the treatment of genotype-1 chronic HCV in previously untreated and treatment-experienced patients in combination with peginterferon alfa and ribavirin in September 2011. The approval was based on the results of three Phase 3 studies in 2,290 patients: ADVANCE, ILLUMINATE and REALIZE.[3,4,2]
Additional telaprevir data being presented at AASLD include:
- Further analysis of the REALIZE study confirms that prior response to treatment may be a more accurate predictor of achieving a cure with telaprevir than response to a 4 week lead in. Prior relapsers or partial responders who had a poor response after 4-week lead-in phase with PR achieved substantially higher cure rates in response to the telaprevir based regimen than prior null responders, despite similar responses at this time point.[5] This study highlights the value of prior response categorisation to predict response to telaprevir. - An interim analysis of the EXTEND study highlighted that 99% of patients who achieved a cure after receiving telaprevir maintained undetectable HCV RNA at a median follow-up of 21 months.[6] One patient had a late relapse 44 weeks after early study dosing discontinuation. Among patients not achieving a cure, variants associated with telaprevir resistance were no longer observed in 83% of patients at a median follow up of 29 months.[6]
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