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TITLE:

TELAPREVIR COMBINATION RESPONSE-GUIDED HEPATITIS C INFECTION MANAGEMENT

AUTHORS:

Dr Aiman Maghfoor, Dr. Shifa Sajjad, Dr Huda Iftikhar

ABSTRACT:

Aim: Patients with interminable disease with hepatitis C infection genotype 1 frequently need 48 weeks of peg interferon–ribavirin treatment for a supported virologic reaction. We structured a no inferiority preliminary (no inferiority edge, −11.6%) to look at rates of continued virologic reaction among patients getting two treatment terms. Methods: We recruited patients with a long-lasting disease with HCV genotype 1 who had not yet received treatment. All patients received telaprevir 750 mg every 8 hours, peg interferon alfa-2a 180 μg weekly, and ribavirin 1000 to 1200 mg daily for 12 weeks followed by peginterferon-ribavirin. Our current research was conducted at Jinnah Hospital, Lahore from May 2019 to April 2020. Patients who had a rapid overall virology response (HCV RNA levels imperceptible at weeks 4 and 12) were arbitrarily excluded after week 20 to receive dual therapy for an additional 4 weeks (T12PR24) or 28 additional weeks (T12PR48). Patients with no overall rapid virology response were treated with T12PR48. Results: Of the 540 patients, 356 (67%) had an overall rapid virology response. The overall rate of sustained virology response was 73%. Of the 35 patients with an overall rapid virology reaction who were randomized to a review meeting, 148 (93%) in T12PR24 and 150 (89%) in T12PR48 had a sustained virology reaction (full distinction, 4 concentration levels; 95% certainty interval, -2 to 11), establishing no inferiority. Unfriendly cases included rash (in 37% of patients, severe in 6%) and pallor (in 39%, extreme in 6%). Termination of all investigational drugs was dependent on antagonistic opportunities in 19% of patients overall, as well as in 1% of patients (each arbitrarily assigned) in the T12PR24 pool and 12% of patients arbitrarily assigned to the T12PR48 pool (P<0.002). Conclusion: For the first 12 weeks, a peginterferone-ribavirin 24-week regimen was no lower than a comparable regimen 48 week with an extensive, rapid biological reaction in close to 67% of patients including patients with incessant HCV disease who had not already undergone treatment with telaprevir. Keywords: Telaprevir Combination, Response-Guided, Hepatitis C Infection.

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