Document Detail


Comparison of high initial and fixed-dose regimens of interferon-alpha2a in chronic hepatitis C: a randomized controlled trial. French Multicenter Interferon Study Group.
MedLine Citation:
PMID:  9493517     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The efficacy of a high-dose de-escalating treatment regimen versus the standard, fixed-treatment regimen of interferon-alpha2a (IFN; Roferon-A) in chronic hepatitis C was evaluated in 291 patients who had elevated alanine aminotransferase (ALT) levels, for at least 6 months prior to the study, and histologically proven chronic hepatitis. Patients were randomized into two groups: 142 patients received IFN at a fixed dose (3 million international units (MIU) three times a week for 6 months) and 149 patients received 6 MIU three times a week for 3 months followed by 3 MIU three times a week for the next 3 months. The groups did not differ significantly with respect to age, gender or percentage of patients with cirrhosis. Response was evaluated by monitoring ALT levels monthly during treatment and during the 6 months post-treatment follow-up. Sixty-one per cent and 66% of the patients in the fixed and de-escalating treatment groups had a primary response (serum ALT normalization) during the treatment period; sustained-response rates at the end of follow-up were 20% and 29%, respectively (not significant). In non-cirrhotic patients, a primary response was recorded in 65% and 70% of the patients in the fixed and de-escalating groups; sustained-response rates were 22% and 33%, respectively. Overall, 62% of patients with a sustained response showed histological improvement. In univariate analysis, patients with sustained response tended to be non-cirrhotic and had lower initial serum gamma-glutamyl transpeptidase and ferritin levels. Multivariate analysis indicated that only ALT activity assessed at month 1 (P < 0.01) was a significant predictor of sustained response. These findings suggest that although the difference in the response rates between the de-escalating (6 MIU three times a week for 3 months; 3 MIU three times a week for 3 months) and fixed (3 MIU three times a week for 6 months) treatment regimens did not reach statistical significance, there was a clear trend towards higher response with the 6 MIU induction dose in patients without cirrhosis.
Authors:
D Ouzan; G Babany; D Valla; P Opolon
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Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of viral hepatitis     Volume:  5     ISSN:  1352-0504     ISO Abbreviation:  J. Viral Hepat.     Publication Date:  1998 Jan 
Date Detail:
Created Date:  1998-04-13     Completed Date:  1998-04-13     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9435672     Medline TA:  J Viral Hepat     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  53-9     Citation Subset:  IM    
Affiliation:
Institut Arnault-Tzanck, Saint-Laurent-du-Var, France.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Alanine Transaminase / analysis,  blood,  metabolism*
Antiviral Agents / administration & dosage*,  therapeutic use*
Biopsy
Female
Ferritins / analysis,  blood,  metabolism
Hepatitis C, Chronic / blood,  drug therapy*,  metabolism
Humans
Interferon Alfa-2a / administration & dosage*,  therapeutic use*
Liver / pathology
Liver Cirrhosis / complications,  metabolism,  virology
Male
Middle Aged
Multivariate Analysis
Predictive Value of Tests
Prospective Studies
gamma-Glutamyltransferase / analysis,  blood,  metabolism
Chemical
Reg. No./Substance:
0/Antiviral Agents; 76543-88-9/Interferon Alfa-2a; 9007-73-2/Ferritins; EC 2.3.2.2/gamma-Glutamyltransferase; EC 2.6.1.2/Alanine Transaminase

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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