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Safety of Telaprevir for Chronic Hepatitis C Virus Infection

A Meta-Analysis of Randomized Controlled Trials

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Abstract

Background: Previous studies have reported telaprevir is effective for chronic hepatitis C virus infection, but the safety of a telaprevir-based regimen remains uncertain.

Objective: A meta-analysis was performed to assess the safety of the addition of telaprevir to a standard regimen of pegylated interferon (peginterferon) plus ribavirin (combination telaprevir with peginterferon plus ribavirin, the TPR group) compared with the standard regimen group (peginterferon plus ribavirin, the PR group).

Methods and Results: Seven randomized controlled trials involving a total of 2808 patients were included in the meta-analysis. The addition of telaprevir to the standard regimen was associated with a significantly increased risk of serious adverse events compared with the standard PR group (relative risk [RR]=1.56; 95% confidence interval [CI] 1.21, 2.03; p = 0.0007; I2 = 0%). Telaprevir was also associated with increased risk of treatment discontinuation (RR = 2.10; 95% CI 1.56, 2.83; p<0.0001; I2=42%). In addition, telaprevir was more likely to cause nausea (RR= 1.39; p < 0.0001), diarrhoea (RR = 1.32; p = 0.004), pruritus (RR = 1.56; p = 0.0006), rash (RR = 1.60; p < 0.0001) and anaemia (RR = 1.55; p = 0.007). There was no difference in the other kinds of adverse events between the two groups. Sensitivity analysis further validated the credibility of the above outcomes.

Conclusion: Our meta-analysis raises safety concerns about the potential for an increased risk of serious adverse events associated with the use of telaprevir among patients with chronic hepatitis C virus infection, and cautious use of telaprevir is warranted.

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Acknowledgements

The authors have no conflicts of interest that are directly relevant to this study. No external funding was received for the conduct of this study.

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Authors and Affiliations

  1. Department of Infectious Diseases, The First College of Clinical Medical Science, China Three Gorges University, Yichang, Hubei Province, China

    Huimin Qin MD, Xiaolin Zhou, Fang Feng, Yanbing Shen, Hongku Tan, Feng Ye & Yingchun Xie

  2. Department of Infectious Diseases, Yichang Central People’s Hospital, No.183 of Yiling Avenue, Wujiagang District, Yichang City, Hubei Province, 443003, China

    Huimin Qin MD, Xiaolin Zhou, Fang Feng, Yanbing Shen, Hongku Tan, Feng Ye & Yingchun Xie

  3. Department of Oncology, Fengxian Branch of People’s 6th Hospital, Shanghai, Hubei Province, China

    Hongtao Li

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  1. Huimin Qin MD
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Correspondence to Huimin Qin MD.

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Qin, H., Li, H., Zhou, X. et al. Safety of Telaprevir for Chronic Hepatitis C Virus Infection. Clin Drug Investig 32, 665–672 (2012). https://doi.org/10.1007/BF03261920

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