Nine patients (15.0%) receiving telaprevir 2250 mg/day and 32 cases (53.3%) receiving 1500 mg/day underwent RBV dose reduction at the beginning of treatment. In other words, the group receiving telaprevir

Smoothened Agonist 1500 mg/day had a significantly lower initial dose of telaprevir and RBV dose than did the group receiving 2250 mg/day (Table 2). However, in the present study, HCV RNA became undetectable during the 12 weeks of treatment at similar or higher rates in the telaprevir 1500 mg/day group than in the 2250 mg/day group (Fig. 1). In the IL28B TT genotype, the early virological response of the telaprevir 1500 mg/day group was significantly higher than that of the 2250 mg/day group. Although we assessed baseline factors, drug adherence and drug discontinuation rates only in the IL28B TT genotype, there were no significant differences between both groups, except for lower telaprevir adherence up to 12 weeks and a greater number of cases of PEG IFN and RBV dose reductions at the beginning of treatment in the telaprevir 1500 mg/day group. Therefore, the reason for significant differences selleck screening library in the early virological response between both groups is unclear. However, we considered that these results did not affect the SVR rate because

HCV RNA became undetectable in all patients in both groups at 8 weeks after the start of triple therapy. In all cases, IL28B TT cases and non-TT cases, there were no significant differences in SVR rates after triple therapy between those receiving telaprevir 2250 and 1500 mg/day (Figs 3, 4). By examining the detailed course of drug administration from 12–24 weeks (Table 2), we found that the group receiving telaprevir 1500 mg/day had a lower discontinuation rate of telaprevir and higher adherence to RBV and PEG IFN up to 24 weeks in spite of the low initial RBV dose. Furthermore,

hemoglobin levels showed greater reductions during triple therapy with telaprevir 2250 mg/day than with telaprevir 1500 mg/day, and the group receiving telaprevir 2250 mg/day had a significantly higher discontinuation rate of telaprevir due to anemia than did the group receiving telaprevir C-X-C chemokine receptor type 7 (CXCR-7) 1500 mg/day (Fig. 2). Therefore, telaprevir 1500 mg/day may be a safe option as part of triple therapy, while maintaining PEG IFN and RBV adherence. Viral breakthrough or relapse can occur during telaprevir monotherapy or telaprevir plus PEG IFN dual therapy (without RBV) because of the development of mutations that confer resistance to telaprevir.[14, 27-29] Furthermore, in a Japanese phase III trial of triple therapy in relapsers and non-responders who had not achieved SVR to a previously administrated IFN-based regimen, SVR rates increased as RBV adherence increased, particularly in previous non-responders.