Vaniprevir with pegylated interferon alpha-2a and ribavirin in treatment-naïve patients with chronic hepatitis C: A randomized phase II study

Michael P. Manns, Edward Gane, Maribel Rodriguez-Torres, Albrecht Stoehr, Chau Ting Yeh, Patrick Marcellin, Richard T. Wiedmann, Peggy M. Hwang, Luzelena Caro, Richard J.O. Barnard, Andrew W. Lee, Yacov Baruch, Yves Benhamou, Matthew Cave, Gary Davis, Shaban Faruqui, Michael Fried, Eliot Godofsky, Michael Gschwantler, Markus HeimMing Yang Lai, Eric Lawitz, Yoav Lurie, Darius Moradpour, Beat Müllhaupt, Francesco Negro, Court Pedersen, Ramón Planas Vila, Mark Russo, Rifaat Safadi, Alejandro Soza, Ulrich Spengler, Rudolf Stauber, Petr Urbanek, Elena Volchkova, Miroslava Volfova, Stefan Zeuzem

Research output: Contribution to journalArticlepeer-review

55 Scopus citations


Vaniprevir (MK-7009) is a macrocyclic hepatitis C virus (HCV) nonstructural protein 3/4A protease inhibitor. The aim of the present phase II study was to examine virologic response rates with vaniprevir in combination with pegylated interferon alpha-2a (Peg-IFN-α-2a) plus ribavirin (RBV). In this double-blind, placebo-controlled, dose-ranging study, treatment-naïve patients with HCV genotype 1 infection (n = 94) were randomized to receive open-label Peg-IFN-α-2a (180 μg/week) and RBV (1,000-1,200 mg/day) in combination with blinded placebo or vaniprevir (300 mg twice-daily [BID], 600 mg BID, 600 mg once-daily [QD], or 800 mg QD) for 28 days, then open-label Peg-IFN-α-2a and RBV for an additional 44 weeks. The primary efficacy endpoint was rapid viral response (RVR), defined as undetectable plasma HCV RNA at week 4. Across all doses, vaniprevir was associated with a rapid two-phase decline in viral load, with HCV RNA levels approximately 3log10 IU/mL lower in vaniprevir-treated patients, compared to placebo recipients. Rates of RVR were significantly higher in each of the vaniprevir dose groups, compared to the control regimen (68.8%-83.3% versus 5.6%; P < 0.001 for all comparisons). There were numerically higher, but not statistically significant, early and sustained virologic response rates with vaniprevir, as compared to placebo. Resistance profile was predictable, with variants at R155 and D168 detected in a small number of patients. No relationship between interleukin-28B genotype and treatment outcomes was demonstrated in this study. The incidence of adverse events was generally comparable between vaniprevir and placebo recipients; however, vomiting appeared to be more common at higher vaniprevir doses. Conclusion: Vaniprevir is a potent HCV protease inhibitor with a predictable resistance profile and favorable safety profile that is suitable for QD or BID administration.

Original languageEnglish (US)
Pages (from-to)884-893
Number of pages10
Issue number3
StatePublished - Sep 2012

ASJC Scopus subject areas

  • Hepatology


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