December 15, 2013

Does telaprevir possess a direct antidiabetic effect?

Liver International

Accepted Article (Accepted, unedited articles published online and citable. The final edited and typeset version of record will appear in future.)

Case Reports

Paulino Tall√≥n de Lara1, Thomas Himschoot1, Jean-Louis Frossard1,  Francesco Negro1,2,*

DOI: 10.1111/liv.12440

This article is protected by copyright. All rights reserved.

Publication History
Accepted manuscript online: 14 DEC 2013 03:48AM EST
Manuscript Accepted: 7 DEC 2013
Manuscript Revised: 30 OCT 2013
Manuscript Received: 15 AUG 2013

This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1111/liv.12440

Keywords: hepatitis C; insulin resistance;  protease inhibitor;  type 2 diabetes

Abstract

Hepatitis C virus (HCV) induces insulin resistance, which improves upon viral clearance. Telaprevir is a protease inhibitor effective against HCV genotype 1. We report a case whose history suggests that telaprevir may induce some antidiabetic effect independently of its suppression of HCV. A 56-year old woman with obesity, type 2 diabetes treated with sitagliptin and metformin, and HCV-related cirrhosis was given triple therapy with pegylated interferon-alpha, ribavirin and telaprevir. After two weeks of treatment, HCV RNA was no longer detectable but the patient described a pronounced drop in the capillary glucose levels and episodes of hypoglycemia that compelled her to stop all antidiabetic treatment. One month after stopping telaprevir, she had to resume her antidiabetic treatment, despite a persisting virological response. Despite reaching a sustained virological response, her diabetes progressed. Although the suppression of HCV replication may have played a role in reducing glucose intolerance, the fact that this patient resumed her prior antidiabetic treatment upon completing the telaprevir treatment, while still aviremic, suggests that telaprevir may have an additional antidiabetic effect. Further evidence about the possible role and mechanisms of telaprevir as antidiabetic agent is warranted.

This article is protected by copyright. All rights reserved.

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