Telaprevir: evidence and guidance for use in clinical practice

Heather Lewis, Graham Foster

Hepatitis C virus (HCV) is the leading cause of chronic liver disease and liver

transplantation worldwide, with an estimated 170 million people chronically infected. Pegylated

interferon and ribavirin (PR) have been the mainstay of treatment for the past 10 years with

sustained viral response rates of 41–82%. The use of PR is limited by its side-effect profile, the

prolonged treatment course required and its relatively low efficacy. Recently, two new therapies

have been approved for the treatment of chronic genotype 1 HCV in combination with PR, the

first-generation protease inhibitors telaprevir (TVR) and boceprevir. Phase III clinical trials show

that triple therapy with these agents significantly improves sustained viral response rates over

PR, but with an increase in adverse events. In this article, we discuss the development of TVR,

the current evidence supporting its use in genotype 1 HCV and give practical guidance on the

use of TVR in clinical practice.

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