Clinical

Pegylated interferon alfa-2b effective for chronic hepatitis B

Last Updated: 2005-01-06 18:30:27 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Approximately one third of patients with chronic hepatitis B become negative for hepatitis B e antigen (HBeAg) when treated with pegylated interferon alfa-2b (PegIntron, Schering-Plough), a multinational research team reports in the January 8th issue of The Lancet. However, combination treatment with lamivudine is no more effective than monotherapy.

Dr. Harry L. A. Janssen, at University Medical Center Rotterdam and his colleagues randomly assigned 166 patients to combination therapy with weekly doses of PegIntron 100 micrograms and daily lamivudine 100 mg, or PegIntron monotherapy. PegIntron dose was lowered to 50 micrograms/week after 32 weeks.

At the end of week 52, serum HBeAg loss was documented in 44% in the combination group and 29% in the monotherapy group. But at the end of follow-up (week 78), sustained response was noted in 35% and 36%, respectively.

HBV DNA suppression to below 200,000 copies per mL showed similar results: 74% versus 29%, respectively, at week 52, and 32% versus 27% at week 78.

HBeAg loss rates at the end of follow-up were dependent on HBV genotype, with those in group A (47%) and B (44%) having higher responses than those in group C (28%) and D (25%).

Dr. Janssen's group points out that long-term therapy with lamivudine is not considered an option because of the development of high rates of drug resistance.

"Rates of sustained clearance of serum HBeAg and reduction of viral load are as high as or higher than those that have previously been reported for any other therapy in this indication," the authors conclude.

Lancet 2005;365:123-129.