en
Professional article
English

The CUPIC algorithm: an accurate model for the prediction of sustained viral response under telaprevir or boceprevir triple therapy in cirrhotic patients

CollaboratorsNegro, Francesco
Published inJournal of Viral Hepatitis, vol. 22, no. 12, p. 1002-1010
Publication date2015
Abstract

Triple therapy using boceprevir or telaprevir remains the reference treatment for genotype 1 chronic hepatitis C in countries where new interferon-free regimens have not yet become available. Antiviral treatment is highly required in cirrhotic patients, but they represent a difficult-to-treat population. We aimed to develop a simple algorithm for the prediction of sustained viral response (SVR) in cirrhotic patients treated with triple therapy. A total of 484 cirrhotic patients from the ANRS CO20 CUPIC cohort treated with triple therapy were randomly distributed into derivation and validation sets. A total of 52.1% of patients achieved SVR. In the derivation set, a D0 score for the prediction of SVR before treatment initiation included the following independent predictors collected at day 0: prior treatment response, gamma-GT, platelets, telaprevir treatment, viral load. To refine the prediction at the early phase of the treatment, a W4 score included as additional parameter the viral load collected at week 4. The D0 and W4 scores were combined in the CUPIC algorithm defining three subgroups: 'no treatment initiation or early stop at week 4', 'undetermined' and 'SVR highly probable'. In the validation set, the rates of SVR in these three subgroups were, respectively, 11.1%, 50.0% and 82.2% (P < 0.001). By replacing the variable 'prior treatment response' with 'IL28B genotype', another algorithm was derived for treatment-naïve patients with similar results. The CUPIC algorithm is an easy-to-use tool that helps physicians weigh their decision between immediately treating cirrhotic patients using boceprevir/telaprevir triple therapy or waiting for new drugs to become available in their country.

Keywords
  • Algorithms
  • Antiviral Agents/therapeutic use
  • Drug Therapy
  • Combination
  • Female
  • Hepacivirus/drug effects
  • Hepatitis C
  • Chronic/drug therapy
  • Humans
  • Interferon-alpha/therapeutic use
  • Liver Cirrhosis/drug therapy/virology
  • Male
  • Middle Aged
  • Models
  • Theoretical
  • Oligopeptides/therapeutic use
  • Polyethylene Glycols/therapeutic use
  • Proline/analogs & derivatives/therapeutic use
  • Random Allocation
  • Ribavirin/therapeutic use
  • Treatment Outcome
  • Viral Load/drug effects
Citation (ISO format)
BOURSIER, J et al. The CUPIC algorithm: an accurate model for the prediction of sustained viral response under telaprevir or boceprevir triple therapy in cirrhotic patients. In: Journal of Viral Hepatitis, 2015, vol. 22, n° 12, p. 1002–1010. doi: 10.1111/jvh.12433
Main files (1)
Article (Published version)
accessLevelRestricted
Secondary files (1)
Identifiers
ISSN of the journal1352-0504
230views
0downloads

Technical informations

Creation11/15/2019 4:25:00 PM
First validation11/15/2019 4:25:00 PM
Update time03/15/2023 6:23:46 PM
Status update03/15/2023 6:23:44 PM
Last indexation01/17/2024 8:13:20 AM
All rights reserved by Archive ouverte UNIGE and the University of GenevaunigeBlack