Efficacy and safety of boceprevir-based triple therapy in HCV cirrhotic patients awaiting liver transplantation (ANRS HC29 BOCEPRETRANSPLANT)
Hélène Fontaine
(1, 2)
,
Marianne Maynard
(3)
,
Cécile Bouix
(3)
,
Maria Patrizia Carrieri
(4, 5)
,
Danielle Botta-Fridlund
(6)
,
Louis d'Alteroche
(7)
,
Antoine Conti
(8)
,
Georges-Philippe Pageaux
(9)
,
Vincent Leroy
(10)
,
Sophie Métivier
(11)
,
Rodolphe Anty
(12)
,
François Durand
(13)
,
Valérie Canva
(14)
,
Antoine Vilotitch
(4, 5)
,
Pascal Lebray
(15)
,
Laurent Alric
(16)
,
Christophe Duvoux
(17)
,
Ventzislava Petrov-Sanchez
(18, 19, 20)
,
Frédérik Beaulieux
(3)
,
Célia Wellems
(3)
,
Christelle Paul
(18, 19)
,
Anne-Marie Roque-Afonso
(21, 22)
,
Bruno Roche
(21, 22)
,
Pierre Pradat
(3)
,
Didier Samuel
(21, 22)
,
Jean-Charles Duclos-Vallée
(21, 22)
,
Bocepretransplant Study Group
1
Département d'hépatologie [CHU Cochin]
2 UPD5 - Université Paris Descartes - Paris 5
3 Service d'Hépatologie [Hôpital de la Croix-Rousse - HCL]
4 SESSTIM - U912 INSERM - Aix Marseille Univ - IRD - Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale
5 ORS PACA
6 LA CONCEPTION - Hôpital de la Conception [CHU - APHM]
7 Département d'Hépato-Gastroentérologie [Hôpital Trousseau, Tours]
8 CHU Saint-Antoine [AP-HP]
9 Fédération Médico-Chirurgicale des Maladies de l'Appareil Digestif
10 Département d'hépato-gastroentérologie
11 Pôle Maladies de l'appareil digestif [CHU Toulouse]
12 CHU Nice - Centre Hospitalier Universitaire de Nice
13 Service d’Hépatologie [Hôpital Beaujon]
14 Hôpital Claude Huriez [Lille]
15 CHU Pitié-Salpêtrière [AP-HP]
16 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
17 Service d'hépato-gastro-entérologie [APHP Henri Mondor]
18 ANRS France Recherche Nord & sud Sida-hiv hépatites
19 France REcherche Nord & sud Sida-hiv Hépatites (FRENSH)
20 Unit for Basic and Clinical research on Viral Hepatitis
21 CHB - Centre hépato-biliaire
22 Physiopathologie et traitement des maladies du foie
2 UPD5 - Université Paris Descartes - Paris 5
3 Service d'Hépatologie [Hôpital de la Croix-Rousse - HCL]
4 SESSTIM - U912 INSERM - Aix Marseille Univ - IRD - Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale
5 ORS PACA
6 LA CONCEPTION - Hôpital de la Conception [CHU - APHM]
7 Département d'Hépato-Gastroentérologie [Hôpital Trousseau, Tours]
8 CHU Saint-Antoine [AP-HP]
9 Fédération Médico-Chirurgicale des Maladies de l'Appareil Digestif
10 Département d'hépato-gastroentérologie
11 Pôle Maladies de l'appareil digestif [CHU Toulouse]
12 CHU Nice - Centre Hospitalier Universitaire de Nice
13 Service d’Hépatologie [Hôpital Beaujon]
14 Hôpital Claude Huriez [Lille]
15 CHU Pitié-Salpêtrière [AP-HP]
16 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
17 Service d'hépato-gastro-entérologie [APHP Henri Mondor]
18 ANRS France Recherche Nord & sud Sida-hiv hépatites
19 France REcherche Nord & sud Sida-hiv Hépatites (FRENSH)
20 Unit for Basic and Clinical research on Viral Hepatitis
21 CHB - Centre hépato-biliaire
22 Physiopathologie et traitement des maladies du foie
Hélène Fontaine
- Fonction : Auteur
- PersonId : 839376
Maria Patrizia Carrieri
- Fonction : Auteur
- PersonId : 21176
- IdHAL : patrizia-carrieri
- ORCID : 0000-0002-6794-4837
- IdRef : 144323036
Georges-Philippe Pageaux
- Fonction : Auteur
- PersonId : 762365
- ORCID : 0000-0003-1277-3054
- IdRef : 147413516
Rodolphe Anty
- Fonction : Auteur
- PersonId : 761750
- ORCID : 0000-0001-8194-9805
Laurent Alric
- Fonction : Auteur
- PersonId : 881462
- ORCID : 0000-0003-0676-7539
Bruno Roche
- Fonction : Auteur
- PersonId : 13013
- IdHAL : bruno-roche
- IdRef : 129757616
Bocepretransplant Study Group
- Fonction : Auteur
Résumé
BACKGROUND AND AIMS:
In this French multicentre, open-label study, we analyzed the efficacy, safety and patient-reported outcomes of a boceprevir-based triple therapy in HCV genotype 1 cirrhotic patients awaiting liver transplantation (LT).
METHODS:
Patients received PEG-IFN/ribavirin (RBV) for 48 weeks (W) and boceprevir from W4 to W48 or until LT.
RESULTS:
Fifty-one patients (80% males, median age: 56 years) were included. Fifty-seven percent had hepatocellular carcinoma and 43% end-stage liver disease. At enrolment, the median MELD score was 9 (range: 6-18); the Child-Pugh score was A in 65%, B in 35% and C in 2%. Therapy was discontinued because of severe adverse events (SAEs) in 39% of cases and virological inefficacy in 24%. 16% of patients had undetectable HCV RNA 24 weeks after the end of treatment (SVR24). LT was performed in 18 patients (35%). HCV RNA was undetectable in 16.6% at LT. Seven patients (14%) died and three deaths were attributed to treatment. SAEs (n=129) were observed in 84% of patients. Twenty-four percent of patients developed severe infections. Albumin<35g/L was independently associated with severe infection. Compared with baseline values, a significant decrease (P=0.02) of the physical dimension of health-related quality of life was observed between W4 and W24. The mean (95% CI) number of self-reported symptoms doubled during treatment (from 6.3 [4.8-7.7] to 11.8 [9.3-14.3]; P<0.001).
CONCLUSIONS:
The safety of the PEG-IFN/RBV/boceprevir combination is poor in patients awaiting LT, with a high risk of severe infection. Moreover, the limited efficacy confirms the indication for IFN-free combinations in these patients.