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 23 February 2018

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News

Shorter treatment duration less effective in Hep C?

Today's issue of the New England Journal of Medicine assessed treatment with peginterferon and ribavirin for 16 weeks vs the standard 24-week regimen in Hep C genotype 2 or 3.

News image

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Patients infected with Hepatitis C virus genotype 2 or 3 have sustained virologic response rates of approximately 80% after receiving treatment with peginterferon and ribavirin for 24 weeks.

Dr Mitchell Shiffman and colleagues from Virginia, USA determined whether similar efficacy could be achieved with only 16 weeks of treatment with peginterferon alfa-2a and ribavirin.

The research team conducted a large, randomized, multinational, noninferiority trial.

The team evaluated 1469 patients with Hepatitis C virus genotype 2 or 3.

The patients were randomly assigned the patients to 180 µg of peginterferon alfa-2a weekly, plus 800 mg of ribavirin daily, for either 16 or 24 weeks.

A sustained virologic response was defined as an undetectable serum Hepatitis C virus RNA level 24 weeks after the end of treatment.

The sustained virologic response rate was significantly lower in patients treated for 16 weeks than in patients treated for 24 weeks
New England Journal of Medicine

The researchers did not find that the 16-week regimen was noninferior to the 24-week regimen.

The sustained virologic response rate was significantly lower in patients treated for 16 weeks than in patients treated for 24 weeks.

In addition, the team noted that the rate of relapse was 31% in the 16-week group vs 18% in the 24-week group.

The sustained virologic response rates with a pretreatment serum Hepatitis C RNA level of 400,000 IU per milliliter or less was 82% with the 16-week regimen.

The team observed that a sustained virologic response rate with the same pre-treatment serum Hepatitis RNA levels was 81% with the 24-week regimen.

Among patients with a rapid virologic response, sustained virologic response rates were 79% in the 16-week group and 85% in the 24-week group.

Dr Shiffman's team comments, "Treatment with peginterferon and ribavirin for 16 weeks in patients infected with Hepatitis C virus genotype 2 or 3 results in a lower overall sustained virologic response rate than treatment with the standard 24-week regimen."

NEJM 2007: 35(2):124-34
12 July 2007

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