Antiviral activity of boceprevir monotherapy in treatment-naive subjects with chronic hepatitis C genotype 2/3

Background & Aims: To examine the antiviral activity of boceprevir, a hepatitis C virus (HCV) protease inhibitor, in HCV genotype (G) 2/3-infected patients. Methods: We assessed boceprevir and telaprevir activity against an HCV G2 and G3 isolates enzyme panel, in replicon, and in phenotypic cell-based assays. Additionally, a phase I study evaluated the antiviral activity of boceprevir monotherapy (200 mg BID, 400 mg BID, or 400 mg TID) vs. placebo for 14 days in HCV G2/3 treatment-naive patients. Results: Boceprevir and telaprevir similarly inhibited G1 and G2 NS3/4A enzymes and replication in Cl and G2 replicon and cell-based assays. However, telaprevir demonstrated lower potency than boceprevir against HCV G3a enzyme (K-i = 75 nM vs. 17 nM), in the G3a replicon assay (EC50 = 953 nM vs. 159 nM), and against HCV G3a NS3 isolates (IC50 = 3312 nM vs. 803 nM) in the cell-based assay. In HCV G2/3-infected patients, boceprevir (400 mg TID) resulted in a maximum mean decrease in HCV RNA of -1.60 log vs. -0.21 log with placebo. Conclusions: In vitro, boceprevir is more active than telaprevir against the HCV G3 NS3/4A enzyme in cell-based and biochemical assays and against G3 isolates in replicon assays. In HCV G2/3-infected treatment-naive patients, decreases in HCV RNA levels with boceprevir (400 mg TID) were comparable to those observed with the same dose in HCV treatment-experienced G1-infected patients. (C) 2013 Published by Elsevier B.V. on behalf of the European Association for the Study of the Liver.