Document Detail


Hyporesponsiveness to PegIFNα2B plus ribavirin in patients with hepatitis C-related advanced fibrosis.
MedLine Citation:
PMID:  21756847     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Journal Article; Randomized Controlled Trial     Date:  2011-07-12
Journal Detail:
Title:  Journal of hepatology     Volume:  56     ISSN:  1600-0641     ISO Abbreviation:  J. Hepatol.     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-01-18     Completed Date:  2012-05-24     Revised Date:  2012-10-15    
Medline Journal Info:
Nlm Unique ID:  8503886     Medline TA:  J Hepatol     Country:  England    
Other Details:
Languages:  eng     Pagination:  341-7     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
Affiliation:
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:
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:
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:
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 ]

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