| Telaprevir (Incivo in Europe and Incivek in the USA) is for patients with Genotype 1. It is a protease inhibitor that helps target the virus and is added to the current treatment of Interferon and Ribavirin. It will mean the patient will be taking a combination of 3 drugs. Telaprevir can boost the success rate of clearing the virus from 50% to 80% and in some cases will shorten the time that a patient needs to be on treatment.
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If a patient has never done treatment before (Treatment Naive) or has done treatment before but relapsed after first responding and completing treatment, then it is estimated that over 50% will only have to do 24 weeks treatment. However, all those who have done treatment before but not responded well (partial or null responders) will still do 48 weeks.
Treatment time is calculated using a system called response guided therapy (RGT). This means that tests are done at various weeks into treatment that can tell how well a patient is responding to the treatment. This can help ensure that the patient does not stay on treatment longer than necessary.
Side effects
Telaprevir does not reduce the side effects that can be caused by Interferon and Ribavirin. However there is an increased risk of developing a rash in many patients. Rash symptoms are monitored throughout treatment and are graded from 1 to 4. However, only 10% of cases are severe and treatment will then be stopped for these patients. More information on the rash symptoms can be found in the Telaprevir summary document at the bottom of this page.
How to take it
All patients will take Telaprevir for the first 12 weeks of treatment. It will be taken alongside Interferon and Ribavirin making a total of 3 drugs to be taken. Patients will then continue with Interferon and Ribavirin for the rest of their treatment.
- Interferon
- Ribavirin
- Telaprevir
For more information on Interferon and Ribavirin click here.
Telaprevir tablets will be taken 3 times a day with a meal. This will mean taking 2 tablets orally at 8 hour intervals. Virus levels will then be measured at week 4 and week 12 to determine the length of treatment required.
The diagram below shows the duration of therapy using Response Guided Therapy (RGT) guidelines. We have composed a simple explanation of this diagram below it.
Treatment Naive patients – those who have never tried treatment before
Prior relapse patients – those who have previously responded to treatment but then relapsed
If the virus is undetectable at week 4 and also undetectable at week 12:
- The total duration of treatment will be 24 weeks
- Interferon, Ribavarin and Telaprevir will be taken up until week 12
- Interferon and Ribavarin will be taken for a further 12 weeks
If the virus is detectable at week 4 or week 12:
- The total duration of treatment will be 48 weeks
- Interferon, Ribavarin and Telaprevir will be taken up until week 12
- Interferon and Ribavarin will be taken for a further 36 weeks
Prior partial and null responders – those who have done treatment before but not responded well
- The total duration of treatment will be 48 weeks
- Interferon, Ribavarin and Telaprevir will be taken up until week 12
- Interferon and Ribavarin will be taken for a further 36 weeks
Stopping treatment altogether is also recommended for patients who are not responding well at week 4 or 12 or those with detectable levels of virus at 24 weeks.
