Side Effects of telaprevir: A Synthesis of Findings from 27 Studies

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Original Abstract of the Article

Major Research Findings

Telaprevir containing regimens have shown potential efficacy in treating genotype 1 HCV in HIV-HCV coinfected patients with liver cirrhosis, but close monitoring is necessary due to potential drug-related side effects. 3

Telaprevir, along with pegylated interferon and ribavirin, has shown high antiviral efficiency (75% SVR in genotype 1) with substantial side effects for the first generation protease inhibitors, which have obtained approval to market in 2011 (Telaprevir and Boceprevir) and recommendations of use in HCV mono-infected patients in 2012 and in HCV/HIV coinfected in 2013. 13

Direct-acting antivirals (DAAs) boceprevir and telaprevir for the treatment of chronic infection with hepatitis C virus (HCV) genotype 1 substantially increased the rates of sustained virologic response in the treatment of naive and experienced patients. However, triple therapy came with a burden of a new spectrum of side effects, which may lead to dose reduction and even discontinuation of therapy. 27

Telaprevir, along with pegylated interferon and ribavirin (triple therapy), has been approved in the treatment of chronic hepatitis C virus (HCV). Skin eruptions and isolated cases of severe cutaneous adverse reactions (SCAR) have been reported. 15

Telaprevir was reported as a side effect that resulted in skin eruption. 4

Telaprevir can activate severe skin reactions that can mimic an infectious disease, therefore early diagnosis and discontinuation of chronic hepatitis C treatment is mandatory. 12

The triple therapy with telaprevir seemed to be successful in HCV-infected patients who were candidates for renal transplantation. 11

Reasons for Side Effects

Side effects associated with telaprevir containing regimens may be caused by various factors, including the properties of the drug itself, interactions with other drugs, and the patient's underlying condition.

Common Side Effects

Anemia

Anemia is a common side effect of telaprevir containing regimens. 27 17 5 23 7

Skin Rash

Skin rash is a common side effect of telaprevir containing regimens. 17 10 4 12 15 23 16

Renal Dysfunction

Renal dysfunction is a side effect of telaprevir containing regimens. 14 18 7

Other Side Effects

The following symptoms may occur as side effects of telaprevir containing regimens. 27 17 5 23 7 11 14 16

  • Fever
  • Fatigue
  • Nausea
  • Loss of appetite
  • Headache
  • Muscle pain
  • Joint pain
  • Nausea
  • Vomiting
  • Diarrhea
  • Constipation
  • Dry mouth
  • Taste disturbance
  • Dyspnea
  • Chest pain
  • Dizziness
  • Impaired consciousness
  • Nervousness
  • Insomnia
  • Anxiety
  • Depression
  • Hallucinations
  • Auditory hallucinations
  • Dry skin
  • Discoloration of nails
  • Hair loss
  • Liver dysfunction
  • Pancreatitis
  • Heart failure

Measures to Counter Side Effects

Anemia

If anemia is observed, ribavirin may be reduced or additional therapies such as erythropoietin or blood transfusions may be administered. 27

Skin Rash

If skin rash is observed, topical medications such as steroid ointment or oral medications such as steroids may be used. 10 16

Renal Dysfunction

If renal dysfunction is observed, telaprevir may be reduced or discontinued, and interactions with other drugs need to be carefully monitored. 14 18

Other Side Effects

Appropriate treatment will be provided for other side effects according to the symptoms.

Comparison Between Studies

Commonalities Between Studies

Many studies have reported side effects such as anemia and skin rash in relation to telaprevir containing regimens. 27 17 10 4 12 15 5 23 7 11 14 16

Differences Between Studies

The incidence and severity of side effects may vary depending on the dosage of telaprevir, concomitant medications, and the patient's underlying condition. 27 17 10 4 12 15 5 23 7 11 14 16

Precautions for Application in Real Life

Treatment with telaprevir containing regimens is promising in terms of efficacy but also carries the risk of side effects. Consult with your doctor before starting treatment to fully understand the risks and benefits of treatment.

Limitations of Current Research

Research on telaprevir containing regimens is not yet fully comprehensive. Further research is needed, particularly on long-term side effects and safety and efficacy in various patient populations.

Future Directions for Research

Future research should focus on evaluating the long-term safety and efficacy of telaprevir containing regimens, evaluating safety and efficacy in various patient populations, and elucidating the mechanisms of side effects.

Conclusion

Treatment with telaprevir containing regimens shows potential efficacy for genotype 1 HCV, but carries the risk of side effects. Consult with your doctor before starting treatment to fully understand the risks and benefits of treatment. Research on telaprevir containing regimens is not yet fully comprehensive. Further research is needed, particularly on long-term side effects and safety and efficacy in various patient populations.

Literature analysis of 27 papers
Positive Content
23
Neutral Content
3
Negative Content
1
Article Type
0
0
0
5
25
1.

Emerging therapeutic options for the management of hepatitis C infection.

Author: ThompsonJ Richard

Hepatitis C treatment
Toxicity

This paper reviews agents in late-phase development for the future treatment of hepatitis C. These agents offer improved sustained virological response (SVR) rates compared to traditional therapies, and some are being developed for oral administration once daily.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

2.

Response-guided therapy in patients with genotype 1 hepatitis C virus: current status and future prospects.

Author: LawitzEric J, MembrenoFernando E

Treatment success
Viral eradication
Side-effects
Viral load

Treatment of hepatitis C has evolved significantly with the introduction of direct-acting antiviral agents (DAAs). Response-guided therapy has successfully shortened treatment durations and reduced side effects. With promising new DAAs, interferon-free regimens might become the standard of care.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

3.

Efficacy and tolerability after 24 weeks of treatment with telaprevir, pegylated interferon and ribavirin in cirrhotic HIV-HCV coinfected subjects.

Author: GenebatMiguel, VeraFrancisco, Hernández-QueroJosé, DomingoPere, GuardiolaJosé M, Martínez-MadridOnofre, MartínezLorena, de la LlanaFrancisco García, Sánchez-VillegasJorge, AlvarezHortensia, MariñoAna, LluchJosé F, Martínez-PérezMaría A, MarínJorge, Ruiz-MateosEzequiel, LealManuel

HCV-RNA undetectability
Drug-related side effects
Virological rebound

Telaprevir-based triple therapy for genotype 1 hepatitis C in HIV-coinfected patients with cirrhosis showed a 71.9% success rate after 24 weeks. However, 15.6% of patients experienced treatment failure due to side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

4.

Cutaneous Eruption due to Telaprevir.

Author: FalcãoEduardo Mastrangelo Marinho, TropeBeatriz Moritz, GodinhoMariana Marteleto, CarneiroLeonardo Hoehl, de Araujo-NetoJoão Marcello, NogueiraCristiane Alves Villela, Ramos-E-SilvaMarcia

HCV treatment
Skin rash

Telaprevir, a treatment for hepatitis C, can cause skin reactions requiring interruption of the treatment.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.

Language : English

5.

Feasibility of telaprevir-based triple therapy in liver transplant patients with hepatitis C virus: SVR 24 results.

Author: WernerChristoph R, EgetemeyrDaniel P, LauerUlrich M, NadalinSilvio, KönigsrainerAlfred, MalekNisar P, BergChristoph P

Antiviral efficacy
Increased SVR 24
Hematological side effects

Telaprevir-based triple therapy showed efficacy in liver transplant patients with recurrent hepatitis C genotype 1, with a 5/9 SVR24 rate. However, two-thirds of patients experienced side effects requiring treatment modifications.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

7.

Patients treated with first-generation HCV protease inhibitors exhibit high ribavirin concentrations.

Author: BodeauSandra, Nguyen-KhacEric, SolasCaroline, BennisYoussef, CapronDominique, DuverlieGilles, BrochotEtienne

Anemia reduction
Anemia
Kidney dysfunction

Triple therapy for Hepatitis C (PEG-IFN, RBV, and telaprevir/boceprevir) can increase ribavirin levels, leading to increased anemia risk. Lowering the ribavirin dose may help mitigate this effect.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

8.

Medicinal plants against hepatitis C virus.

Author: AshfaqUsman A, IdreesSobia

HCV treatment

This review summarizes medicinal plants and their phytochemicals that inhibit different stages of the hepatitis C virus (HCV) life cycle. These natural compounds have potential for use in HCV therapy, especially as current treatment options have limitations in effectiveness and side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

9.

Virologic response and haematologic toxicity of boceprevir- and telaprevir-containing regimens in actual clinical settings.

Author: ButtA A, YanP, ShaikhO S, FreibergM S, Lo ReV, JusticeA C, ShermanK E,

HCV treatment efficacy
Hematologic adverse effects

Boceprevir and telaprevir are more effective than pegylated interferon/ribavirin in treating Hepatitis C, achieving higher sustained virologic response rates. However, hematologic side effects like anemia and thrombocytopenia are common.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

11.

Evaluation of telaprevir-containing triple therapy in the treatment of chronic hepatitis C in hemodialysed patients.

Author: KayaSafak, AksozSelcuk, BaysalBirol, AyNurettin, DanisRamazan

HCV eradication
Kidney transplant
Anemia
Nausea
Vomiting
Weakness

Telaprevir-based triple therapy shows promise in treating Hepatitis C in kidney transplant candidates with end-stage renal disease. However, side effects like nausea, vomiting, and anemia can occur.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

12.

A rare and severe cutaneous adverse effect of telaprevir: drug rash with eosinophilia and systemic symptoms.

Author: CengizFatma P, SuOzlem, EmirogluNazan, Biyik OzkayaDilek, BahaliAnil G, OnsunNahide

Telaprevir side effects

Telaprevir, a drug used to treat Hepatitis C, can cause a severe adverse reaction called DRESS (drug reaction with eosinophilia and systemic symptoms), which involves skin rashes, fever, and organ involvement. Early diagnosis and discontinuation of the drug are crucial when these symptoms appear.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

13.

[Treatment of hepatitis C: current status and perspectives].

Author: PolStanislas, CorougeMarion

HCV cure rates
Side effects

Hepatitis C treatment has significantly advanced over the past two decades. This abstract reviews the progression from interferon/ribavirin combinations to direct-acting antiviral agents (DAAs), highlighting improved sustained virologic response (SVR) rates and reduced side effects.

English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : French

14.

Efficacy and safety of telaprevir-based antiviral treatment for elderly patients with hepatitis C virus.

Author: TakitaMasahiro, HagiwaraSatoru, KudoMasatoshi, KounoMasashi, ChishinaHirokazu, ArizumiTadaaki, KitaiSatoshi, YadaNorihisa, InoueTatsuo, MinamiYasunori, UeshimaKazuomi

HCV treatment
Side effects

Telaprevir-based therapy for hepatitis C genotype 1 can cause side effects like skin rashes, anemia, and kidney problems, leading to dose reductions or treatment discontinuation in some patients. This is particularly important to consider in older patients.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

15.

[Cutaneous adverse events of telaprevir/peginterferon/ribavirin therapy for chronic hepatitis C: A multicenter prospective cohort study].

Author: LorcyS, Gaudy-MarquesteC, BottaD, PortalI, QuilesN, OuliesV, ManciniJ, GrobJ-J, RichardM-A

Hepatitis C virus treatment
Severe cutaneous adverse reactions
Skin eruption

This prospective observational study of 48 patients assessed the incidence of skin eruption and clinical characteristics of mucocutaneous adverse events associated with telaprevir treatment. The incidence of skin eruption was 58.4%, but most cases were mild. Telaprevir was discontinued in 6% of patients due to severe rash.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Observational StudyResearch that observes and collects data on participants' behavior and outcomes in their natural state, without intervention.

Language : French

16.

First case of drug rash eosinophilia and systemic symptoms due to boceprevir.

Author: SamainAgnès, Duval-ModesteAnne-Bénédicte, JolyPascal, LeblancCéline, MassyNathalie, CourvillePhilippe, GoriaOdile, RiachiGhassan

Hepatitis C treatment
Drug rash
Eosinophilia
Systemic symptoms

This case report describes a patient who developed drug rash with eosinophilia and systemic symptoms (DRESS) due to boceprevir, an antiviral drug used to treat hepatitis C.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

18.

Does elevation of serum creatinine in patients with chronic hepatitis C under therapy of telaprevir mean renal impairment?

Author: MatsuiKatsuomi, Kamijo-IkemoriAtsuko, SugayaTakeshi, IkedaHiroki, OkuseChiaki, ShibagakiYugo, YasudaTakashi, KimuraKenjiro

HCV treatment
SCr elevation

Elevation of SCr levels with TVR therapy may not suggest renal impairment.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Observational StudyResearch that observes and collects data on participants' behavior and outcomes in their natural state, without intervention.

Language : English

20.

Inhibitory effects of Pycnogenol® on hepatitis C virus replication.

Author: EzzikouriSayeh, NishimuraTomohiro, KoharaMichinori, BenjellounSoumaya, KinoYoichiro, InoueKazuaki, MatsumoriAkira, Tsukiyama-KoharaKyoko

HCV treatment

Pycnogenol, a natural extract, showed antiviral effects against hepatitis C virus (HCV) in cell and animal models. It also showed synergy with interferon-alpha and ribavirin, suggesting a potential role in improving existing HCV treatments.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

21.

Hepatitis C treatment in the elderly: New possibilities and controversies towards interferon-free regimens.

Author: Vespasiani-GentilucciUmberto, GalatiGiovanni, GalloPaolo, De VincentisAntonio, RivaElisabetta, PicardiAntonio

HCV treatment
Viral eradication
Drug interactions
Side effects

The management of hepatitis C in older adults is becoming increasingly important due to the aging of the infected population. Newer, interferon-free treatments offer hope for a cure, but potential drug interactions with other medications need to be considered.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

22.

Miliary tuberculosis infection during hepatitis C treatment with sofosbuvir and ledipasvir plus ribavirin.

Author: Ballester-FerréMaria Pilar, MartínezFernando, Garcia-GimenoNatalia, MoraFrancisco, SerraMiguel A

HCV treatment
Miliary tuberculosis

This case report describes an HCV-infected patient who developed miliary tuberculosis after completing treatment with sofosbuvir/ledipasvir plus ribavirin. This highlights the importance of considering opportunistic infections, particularly TB, in patients undergoing HCV therapy.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.

Language : English

23.

[Incidence, management and costs of adverse effects in chronic hepatitis C patients on triple therapy with telaprevir or boceprevir: first 12 weeks of treatment].

Author: Guglieri-LópezBeatriz, Ventura-CerdáJosé Manuel, Gómez-ÁlvarezSandra, Climente-MartíMónica

Hepatitis C treatment
Dermatological AE
Hematological AE
Increased cost
Treatment discontinuation

The addition of telaprevir (TVR) or boceprevir (BOC) to conventional hepatitis C treatment leads to a higher incidence of hematological adverse effects (AEs) in patients, requiring supportive care and increasing treatment costs.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Observational StudyResearch that observes and collects data on participants' behavior and outcomes in their natural state, without intervention.

Language : Spanish

24.

"Fighting an uphill battle": experience with the HCV triple therapy: a qualitative thematic analysis.

Author: RasiManuela, Künzler-HeulePatrizia, SchmidPatrick, SemelaDavid, BruggmannPhilip, FehrJan, SaxerSusi, NiccaDunja

HCV treatment efficacy
Side effects

Protease inhibitor-based triple therapy for hepatitis C genotype 1 is highly effective but can cause side effects and require complex management. This study aims to understand how patients manage the therapy in daily life and their support needs.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

26.

The Changing Face of Hepatitis C: Recent Advances on HCV Inhibitors Targeting NS5A

Author: RaiDiwakar, WangLiu, JiangXuemei, ZhanPeng, JiaHaiyong, De ClercqErik, LiuXinyong

HCV treatment
Drug resistance
Side effects

Direct-acting antivirals (DAAs) are used to treat Hepatitis C, but side effects, resistance, cost, and pill burden limit their use. NS5A inhibitors are being developed to improve treatment options.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

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