Weight loss during telaprevir-based triple therapy due to telaprevir-induced appetite loss

The sustained virological response (SVR) rate has improved to >70% for patients with hepatitis C virus genotype 1 treated with the triple therapy of telaprevir (TVR), pegylated interferon (PEG-IFN)-α, and ribavirin (RBV). However, this therapy has various adverse effects, although there have been no reports of it decreasing body weight.

A total of 175 patients with chronic hepatitis C received one of three IFN-based regimens (35 received the PEG-IFN/RBV/TVR (PRT) regimen, 70 received the PEG-IFN/RBV (PR) regimen, and 70 received the IFN-β/RBV (FR) regimen) and body weight was followed for 12 weeks.

Decreases in body weight up to week 12 were significantly greater in the PRT group than in the PR or FR groups (p<0.001). The proportion of patients who experienced weight loss ≥5.0 kg by week 12 in the PRT group was significantly higher than in the PR or FR groups (p<0.001) regardless of baseline ghrelin level. The question 18 score (appetite) of the Beck Depression Inventory-II at week 12 was significantly higher in the PRT group than in the PR or FR groups (p<0.001). A multivariate analysis revealed PRT, the ghrelin level before treatment (<7.0 fmol/mL), and the question 18 score in week 12 (2 or 3) to be independent factors associated with a decrease in body weight ≥5.0 kg from week 0 to week 12.

PEG-IFN/RBV/TVR therapy yielded high SVR rates, but it was associated with a decreased body weight due to TVR-induced appetite loss.