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News

Discontinuation of pegylated interferon plus ribavirin therapy

Early discontinuation of 'ineffective' anti-viral therapy is unpopular with patients, reports the most recent issue of Alimentary Pharmacology and Therapeutics and further education regarding the cost-effectiveness will be needed if early discontinuation is to be accepted.

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Current therapy for chronic hepatitis C infection involves a course of pegylated interferon and ribavirin.

Patients who do not show a virological response after 12 weeks of therapy have a low probability of sustained virological response and it is therefore recommended that such patients stop treatment.

Dr D'Souza and colleagues from London undertook a study in order to assess patients' views of early treatment cessation.

The researchers conducted a open-labelled study in 3 UK centres, using patients with biopsy-proven chronic hepatitis C requiring therapy.

The research team offered the participants the choice of a full course of therapy with 40 kDa pegylated interferon- 2a plus ribavirin (24 or 48 weeks depending on viral genotype) or early cessation if therapy had failed after 12 weeks.

4% of patients did not achieve an early virological response with the 40-kDa pegylated interferon- 2a plus ribavirin
Alimentary Pharmacology and Therapeutics

The researchers enrolled 95 participants in total and the majority (69%) did not wish to discontinue therapy even if it had low probability of success.

In this unselected UK population, the researchers found that very few patients (4%) did not achieve an early virological response with the 40-kDa pegylated interferon- 2a plus ribavirin.

In addition, the research team noted that 2 of the 4 early virological non-responders decided to continue therapy.

Dr R. D'Souza concluded, "Early discontinuation of 'ineffective' anti-viral therapy may prove less popular with patients than with health care providers."

"Further patient-directed education regarding the cost-effectiveness of therapy will be needed if early discontinuation of unsuccessful therapy is to be accepted by patients."

Alimentary Pharmacology & Therapeutics; 2005: 21: (1): 43
17 January 2005

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