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Telaprevir in the treatment of hepatitis C infection: evidence from the ADVANCE, ILLUMINATE and REALIZE studies

Joseph Ahn, Steven Flamm

Treatment of chronic hepatitis C (HCV) infection with PEGylated IFN-α and ribavirin is suboptimal, resulting in a growing number of treatment-failure patients who are left with limited treatment options. Telaprevir, a NS3/4A HCV protease inhibitor, was shown in Phase II studies to be efficacious and safe in treatment-naive and treatment-experienced genotype 1 patients. This article reviews the results of the recently reported Phase III studies: ADVANCE, ILLUMINATE and REALIZE, which reported sustained virological response as high as 75% in treatment-naive patients and 88% in prior relapse patients. Response-guided therapy using extended rapid virological response resulted in sustained virological response rates as high as 92% in treatment-naive patients with a short course of therapy. The addition of telaprevir to the therapeutic regimen for HCV genotype 1 represents a major advance in the management of chronic HCV.