High-dose peginterferon-alpha induction and prolongation of therapy may be an option to improve sustained virological response rates among Hepatitis C virus non-responders.
However, a higher and a longer dosing of peginterferon-alpha may intensify side effects.
|80% with a rapid virological response achieved sustained virological response |
Dr de Knegt and colleagues from the Netherlands randomized 53 patients who previously failed with standard interferon-alpha with or without ribavirin.
The patients received a high-dose induction and an extended regimen with peginterferon-alpha-2 beta at 3 µg/kg once weekly for 12 weeks, and a another 2 µg/kg q.w. for 12 weeks
A standard regimen of 1.5 µg/kg q.w. was given for 48 weeks.
All patients received daily weight-based ribavirin 800 to 1200 mg/day.
The short-form 36 health survey was used to evaluate health-related quality of life.
Intention-to-treat analysis showed no significant difference in sustained virological response rates between experimental and standard treatment.
The researchers found no significant difference in relapse rates between experimental and standard treatment.
Overall, 80% of the patients with rapid virological response, and Hepatitis C virus-RNA negativity at week 4 achieved sustained virological response.
The research team observed no significant dose-related differences in health-related quality of life between both groups.
At baseline, genotype 2 or 3, and increased γ-glutamyltransferase levels were significantly associated with sustained virological response.
Multivariate logistic regression at week 4 showed that baseline γ-glutamyltransferase 2 times the upper limit of normal was independently predictive of sustained virological response.
In addition, the team noted that rapid virological response was independently predictive for sustained virological response.
Dr de Knegt's team concluded, "Retreatment with peginterferon-alpha-2 beta and ribavirin for a minimum of 48 weeks should be considered in all patients unresponsive to previous interferon-based therapies."
"Baseline γ-glutamyltransferase values and rapid virological response are highly predictive for retreatment outcome."