INFO:Improved combination drug treatment for hepatitis C

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Improved combination drug treatment for hepatitis

C

Lancet 2001; 358 (9286): 958

Manns and colleagues from Hannover Medical

University, Germany, assessed whether

peginterferon alfa-2b plus ribavirin could be more

effective than interferon alfa-2b plus ribavirin.

A total of 1530 chronic hepatitis C patients, from

Europe, Argentina, USA, and Canada, were assigned

one of three treatments.

The first regimen option was interferon alfa-2b (3

MU subcutaneously, 3 times per week) plus oral

ribavirin 1000-1200 mg/day. The second was

peginterferon alfa-2b (1.5 µg/kg each week) plus

800 mg/day ribavirin. The third treatment option

was peginterferon alfa-2b (1.5 µg/kg per week, for

4 weeks, then 0.5 µg/kg per week) plus ribavirin

1000-1200 mg/day for 48 weeks.

The primary endpoint was the proportion of

patients with a sustained viral response (SVR;

undetectable hepatitis C virus [HCV] RNA in blood)

at 24-week follow-up.

Peginterferon alfa-2b plus ribavirin will replace

current standard therapy for chronic HCV.

The SVR rate was greater in the higher-dose

peginterferon group (274 out of 511, 54%) than in

the lower-dose peginterferon (244 out of 514, 47%)

or interferon (235 out of 505, 47%) groups.

Among patients with the more serious HCV

genotype-1 infection, the corresponding SVR rates

were 42% (145/348), 34% (118/349), and 33%

(114/343).

The rate for patients with genotype-2 and 3

infections was about 80% for all treatment groups.

Manns comments, " The most effective

therapy for the initial treatment of suitable

patients with chronic hepatitis C, according to

this study, is the combination of 1.5 µg/kg per

week of peginterferon alfa-2b with ribavirin. "

He adds, " Because of the improved response rate

and more convenient once-weekly administration

schedule, this regimen will replace the current

standard of interferon alfa-2b plus ribavirin. "