Clinical

Shorter interferon/ribavirin course effective for chronic hepatitis C types 2 and 3

Last Updated: 2003-10-27 17:02:51 -0400 (Reuters Health)

By Peggy Peck

BOSTON (Reuters Health) - Among patients with chronic hepatitis C (HCV) genotype 2 or 3 infection, 24 weeks of PEG-interferon alfa-2b plus ribavirin treatment is as effective as a 48-week regimen, according to results of a study presented at the 54th Annual Meeting of the American Association for the Study of Liver Diseases.

The shorter course has the added bonuses of lower cost and fewer side effects.

"Look at the response rates: 81% of patients achieved sustained viral response with just 24 weeks of treatment," said principle investigator Dr. Stefan Zeuzem of Saarland University Hospital, Homburg, Germany.

Two hundred twenty-four HCV patients (42 genotype 2, 182 genotype 3) were enrolled in the study in which they were treated with PEG-interferon alfa-2B 1.5�g/kg plus ribavirin 800-1000 mg/day. The results were compared with those achieved in historical controls treated with the same combination for 48 weeks.

In an interview with Reuters Health, Dr. Zeuzem said that HCV treatment is often compromised by "the side-effects that cause patients to reduce dose or discontinue therapy. But if you look at the historical data from studies of 48 weeks, what we see is a response at 24 weeks and then the side effects become evident during the second half of treatment. By shortening treatment, we are significantly reducing the depression, fatigue, headaches -- the side effects that make the treatment so difficult."

The end-of-treatment response rate with the shortened course was 94% (versus 95% among historical controls), and the estimated sustained virologic response rate at 48 weeks was 84%.

Dr. Zeuzem also pointed out that "standard 48-week treatment costs about 20,000 euros, so 24 weeks costs about 10,000 euros." He predicted similar reductions in cost in the U.S.

"Twenty-four weeks should now be considered the standard for patients with genotype 2 and 3," he said.

Dr. Zeuzem noted that the shortened treatment regimen is much better tolerated by patients as evidenced by improved compliance: only 5% of patients discontinued treatment, while the discontinuation rate in historical controls is 14%. Likewise, 22% of patients required dose reduction during the 24 weeks, while doses were reduced in 49% of historical controls.

The study was funded by Schering-Plough Research Institute, Kenilworth, NJ.