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Hepatitis Interferon Dosing

October 5, 2004

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More Effective Interferon Dosing For HCV Genotype 1 This new trial result is very revealing. Especially given the fact that 70% of chronic Hepatitis c patients in the USA have genotype 1. Note the success rates (along with the failure rates). Apparently with this “improved” method of dosing they got up to 41%. and the drop out rate was only 19%. Now take a closer look at the rates they compare against. These are for the currently accepted standard dosing.

More Effective Interferon Dosing For HCV Genotype 1

This new trial result is very revealing. Especially given the fact that 70% of chronic Hepatitis c patients in the USA have genotype 1. Note the success rates (along with the failure rates). Apparently with this “improved” method of dosing they got up to 41%. and the drop out rate was only 19%. Now take a closer look at the rates they compare against. These are for the currently accepted standard dosing.

What happened to the 50% success rate that doctors keep talking about? 29% is much lower than that. And look the drop out rate. This is something that is seldom mentioned. 31% discontinue with current therapy because it is intolerable? Wow! So, only a 41% success rate after 31% drop out. Hmmm…

I’m no mathematician, but the final result for people who started the therapy and actually finished successfully seems like it is reduced by 31% first and THEN it’s a 41% success rate of those left. Isn’t that actually a much lower success rate than 41%?

If you are genotype 1, like me, it seems like these are very important numbers to be armed with when speaking with your doctor about current medical treatment options.

An Induction Dose of Peginterferon Is a More Effective and Better-tolerated Treatment for Patients with Genotype 1 Than Combination Therapy with High Dose Standard Interferon

In this randomized, controlled, multicenter trial, researchers assessed the effectiveness and safety of an induction dose of peginterferon alfa-2b/ PEG-IFN (Peg-Intron) plus ribavirin for initial treatment of patients with genotype 1 chronic HCV infection.

Three hundred and eleven naïve patients infected with genotype 1 and chronic hepatitis were randomly assigned to 48-week treatment with PEG-IFN once weekly (80–100 μg depending on body weight for 8 weeks, followed by 50 μg for the next 40 weeks), or standard interferon alfa-2b/ IFN (Intron A) 6 million units on alternate days, both in combination with ribavirin (1000–1200 mg/day).

Results

PEG-IFN plus ribavirin significantly increased sustained virological response (SVR) compared with IFN plus ribavirin (41.1 vs. 29.3% respectively, P=0.030). Fewer patients discontinued PEG-IFN than IFN (19 vs. 31%, P=0.010).

By logistic regression, SVR in the PEG-IFN group was independently associated with age less than 50 years, and mild fibrosis at liver biopsy.

Conclusions

Combination therapy with an induction dose of PEG-IFN was a more effective and better-tolerated treatment for treatment-naïve patients with genotype 1 than combination therapy with high dose standard IFN.

In patients aged less than 50 years with mild fibrosis, this schedule achieves a very high rate of SVR.

10-08-04

Reference
S Bruno and others. Peginterferon alfa-2b plus ribavirin for naïve patients with genotype 1 chronic hepatitis C: a randomized controlled trial. Journal of Hepatology 41(3): 474-481. September 2004.

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