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 21 February 2018

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News

Improving outcomes in Hep C with difficult-to-treat characteristics

A study in the latest issue of Hepatology examines higher doses of peg interferon-2a and ribavirin in improving Hep C with difficult-to-treat characteristics.

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Treatment response remains suboptimal for many patients with chronic Hepatitis C, particularly those with genotype 1 and high levels of viremia.

Dr Michael Fried and colleagues from North Carolina, USA compared the efficacy of high-dose regimens of peginterferon alfa-2a and ribavirin with conventional dose regimens in patients with features predicting poor treatment responses.

The research team evaluated eligible treatment-naïve adults with genotype 1 infection, Hepatitis C virus RNA over 800,000 IU/mL, and body weight more than 85 kg.

The patients were randomized to double-blind treatment with peginterferon alfa-2a at 180 or 270 g/week plus ribavirin at 1200 or 1600 mg/day for 48 weeks.

Higher fixed doses of ribavirin may increase sustained virologic response rates
Hepatology

The primary endpoint was viral kinetics during the first 24 weeks of therapy.

Among patients receiving peginterferon alfa-2a the magnitude of Hepatitis C RNA reduction was greater than for patients randomized to the conventional dose of peginterferon alfa-2a (180 g/week) for the pairwise comparison for ribavirin at 1600 mg/day.

Patients randomized to the highest doses of peginterferon alfa-2a (270 g/week) and ribavirin (1600 mg/day) experienced the numerically highest rates of sustained virologic response, and the lowest relapse rates.

The team noted that the arm with the higher doses of both drugs was less well-tolerated than the other regimens.

Dr Fried’s team commented, “Higher fixed doses of peginterferon alfa-2a (270 g/week) and ribavirin (1600 mg/day) may increase sustained virologic response rates compared with lower doses of both drugs in patients with a cluster of difficult-to-treat characteristics.”

Hepatology 2008: 48(4): 1033-43


22 October 2008

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