| Hyporesponsiveness to PegIFNα2B plus ribavirin in patients with hepatitis C-related advanced fibrosis. | |
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MedLine Citation:
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PMID: 21756847 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND & AIMS: The success of pegylated-interferon (PegIFN)/ribavirin (Rbv) therapy of chronic hepatitis C is compromised by liver fibrosis. Whether fibrosis equally affects the two PegIFNα-based therapies is unknown. To assess the response to the two PegIFN regimens in patients with different degree of liver fibrosis. METHODS: A sub-analysis of the MIST study: 431 consecutive naïve patients randomly assigned, based on HCV genotype, to receive either (A) PegIFNα2a 180 μg/wk plus daily Rbv 800-1200 mg or (B) PegIFNα2b 1.5 μg/kg/week plus daily Rbv 800-1200 mg, were stratified according to Ishak staging (S) into mild (S0-S2) or moderate (S3, S4) fibrosis and cirrhosis (S5, S6). RESULTS: In A the sustained virological response (SVR) rates were not significantly influenced by fibrosis stage (71% in S0-S2, 66% in S3, S4, 53% in S5, S6, p=0.12), compared to B where the SVR rates differed according to fibrosis stage (65%, 46%, and 38%, p=0.004, respectively). This was even more so in HCV-1/4 patients treated with PegIFNα2b where the SVR rates were twice as many in S0-S2 vs. S≥3 (44% vs. 22%, p=0.02), while in A the SVR rates were similar between the two fibrosis subgroups (S0-S2: 47% vs. S≥3: 48%, p=0.8). By logistic regression analysis genotype 1/4 and lack of rapid virological response were independent predictors of treatment failure in both treatment groups, while S≥3 fibrosis was associated to PegIFNα2b treatment failure, only (OR 2.83, 95% CI 1.4-5.68, p=0.004). CONCLUSIONS: Liver fibrosis was an independent moderator of treatment outcome in patients receiving PegIFNα2b, not in those receiving PegIFNα2a. |
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Authors:
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Gian Maria Prati; Alessio Aghemo; Maria Grazia Rumi; Roberta D'Ambrosio; Stella De Nicola; Maria Francesca Donato; Elisabetta Degasperi; Massimo Colombo |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial Date: 2011-07-12 |
Journal Detail:
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Title: Journal of hepatology Volume: 56 ISSN: 1600-0641 ISO Abbreviation: J. Hepatol. Publication Date: 2012 Feb |
Date Detail:
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Created Date: 2012-01-18 Completed Date: 2012-05-24 Revised Date: 2012-10-15 |
Medline Journal Info:
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Nlm Unique ID: 8503886 Medline TA: J Hepatol Country: England |
Other Details:
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Languages: eng Pagination: 341-7 Citation Subset: IM |
Copyright Information:
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Copyright © 2011 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved. |
Affiliation:
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A.M. Migliavacca Center for Liver Disease, 1st Division of Gastroenterology, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy. |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Antiviral Agents / administration & dosage* Female Hepacivirus / classification, genetics Hepatitis C, Chronic / complications*, drug therapy*, virology Humans Interferon-alpha / administration & dosage* Liver Cirrhosis / classification, etiology*, pathology Male Middle Aged Polyethylene Glycols / administration & dosage* Recombinant Proteins / administration & dosage Ribavirin / administration & dosage* Treatment Outcome Viral Load / drug effects |
| Chemical | |
Reg. No./Substance:
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0/Antiviral Agents; 0/Interferon-alpha; 0/Polyethylene Glycols; 0/Recombinant Proteins; 0/peginterferon alfa-2a; 0/peginterferon alfa-2b; 36791-04-5/Ribavirin |
| Comments/Corrections | |
Comment In:
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J Hepatol. 2012 Jul;57(1):226-8; author reply 229
[PMID:
22390901
]
J Hepatol. 2012 Sep;57(3):704-5 [PMID: 22510262 ] J Hepatol. 2012 Feb;56(2):303-4 [PMID: 22015961 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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