Boceprevir as an adjunct to standard therapy in Chronic Hepatitis C patients

Chronic Hepatitis C affects approximately 25 million individuals in the UK. Despite being infected, a considerable number of people remain asymptomatic for long periods resulting in a delay in diagnosis. Therefore, it is sometimes referred to as the silent epidemic. An average general practitioner (GP), or primary care physician will typically have 8-20 hepatitis C infected patients in his/her patient pool of around 1,800 patients.

A blood-borne virus causes Hepatitis C that can lead to inflammation of the liver followed by scarring (fibrosis) of liver tissue, and can eventually progress to liver cirrhosis and cancer.

The virus has varied genotypes (strains). Nearly 40 to 50% of infected individuals in the UK are affected by Genotype 1, which is the hardest strain to clear. While SVR rates for genotypes 2, 3, and 9 are nearly 80%, the SVR rate for Genotype 1 on current treatment is 40%.

The effect of administering Boceprevir as an adjunct to standard therapy was investigated by means of 2 crucial Phase III studies: HCV RESPOND-2 and HCV SPRINT-2. Nearly 403 patients who had not responded to prior therapy and 1,097 untreated patients were recruited for the study. A response guided therapy arm used to reduce treatment duration was a part of both studies. Instead of the 48 weeks of standard therapy alone, some of the previously untreated patients could have stopped at 28 weeks.

While current standard therapy works by eliciting an enhanced immune response from the patient, Boceprevir acts by inhibiting a key enzyme in the Hep C virus thereby interfering with its ability to replicate.

Anemia, dysgeusia (metallic taste), headache, nausea, and fatigue are some of the most common adverse events associated with boceprevir use, although, side effects are said to be manageable.