Document Detail


Efficacy of interferon alpha-2b induction therapy before retreatment for chronic hepatitis C.
MedLine Citation:
PMID:  17845540     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND/AIMS: Chronic hepatitis C (HCV) patients who have failed previous treatment have low sustained viral response (SVR) rates with repeat treatment. We evaluated whether interferon (IFN) induction during retreatment improves response rates. METHODS: Two randomized, controlled trials were conducted in chronic HCV patients who failed IFN. In Study 1, patients received IFN 3 MU daily plus ribavirin (RBV) 1000 mg/day for 4 weeks, followed by IFN 3 MU TIW plus RBV 1000 mg/day for 44 weeks (induction; n=232), or IFN 3 MU TIW plus RBV 1000 mg/day for 48 weeks (non-induction; n=237). In Study 2, patients received IFN 5 MU B.I.D. plus RBV 1000-1200 mg/day for 2 weeks, followed by pegylated IFN (PEG-IFN) 75-150 mug weekly plus RBV 1000-1200 mg/day for 46 weeks (induction; n=201), or PEG-IFN 75-150 mug weekly plus RBV 1000-1200 mg/day for 48 weeks (non-induction; n=206). The primary end point for both trials was SVR. RESULTS: Induction did not increase SVR compared with non-induction, but did increase the on-treatment response among genotype non-1 patients in Study 2. By intention-to-treat (ITT) analysis, SVR in Study 1 was 13% for induction vs. 9% for non-induction (P=NS). In Study 2 (ITT), SVR was 20% for induction vs. 24% for non-induction (P=NS). However, by non-ITT analysis of Study 2, genotype non-1-previous non-responders showed significantly higher response rates with induction than non-induction. CONCLUSION: For chronic HCV patients who have failed IFN, induction with retreatment does not improve SVR, but may be beneficial for patients with genotype non-1 HCV.
Authors:
Catherine Carr; F Blaine Hollinger; Boris Yoffe; Adil Wakil; Jason Phillips; Natalie Bzowej; Janet Leung; Katherine Mirro; Fred Poordad; Dan H Moore; Robert G Gish
Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial    
Journal Detail:
Title:  Liver international : official journal of the International Association for the Study of the Liver     Volume:  27     ISSN:  1478-3223     ISO Abbreviation:  Liver Int.     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-09-11     Completed Date:  2007-12-20     Revised Date:  2009-11-19    
Medline Journal Info:
Nlm Unique ID:  101160857     Medline TA:  Liver Int     Country:  England    
Other Details:
Languages:  eng     Pagination:  1111-8     Citation Subset:  IM    
Affiliation:
Departments of Medicine and Transplantation, California Pacific Medical Center, San Francisco, CA, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Antiviral Agents / adverse effects,  therapeutic use*
DNA, Viral / analysis
Drug Therapy, Combination
Female
Genotype
Hepacivirus / genetics
Hepatitis C, Chronic / drug therapy*,  ethnology,  genetics,  pathology
Humans
Interferon Alfa-2b / adverse effects,  therapeutic use*
Interferons / adverse effects,  therapeutic use*
Liver / drug effects,  pathology,  virology
Male
Middle Aged
Patient Selection
Polyethylene Glycols
RNA, Viral / blood
Ribavirin / adverse effects,  therapeutic use*
Sex Factors
Time Factors
Treatment Failure
United States
Viral Load
Chemical
Reg. No./Substance:
0/Antiviral Agents; 0/DNA, Viral; 0/Polyethylene Glycols; 0/RNA, Viral; 0/peginterferon alfa-2b; 36791-04-5/Ribavirin; 9008-11-1/Interferons; 99210-65-8/Interferon Alfa-2b

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


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