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Reuters Health Information (2006-12-27): Peginterferon alfa-2b may be effective when standard HBV therapy fails


Peginterferon alfa-2b may be effective when standard HBV therapy fails

Last Updated: 2006-12-27 11:00:02 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Approximately one-third of patients with HBeAg-positive chronic hepatitis B who failed previous treatment with standard interferon (IFN) or lamivudine will respond to peginterferon alfa-2b (Peg-IFN alfa2b), research suggests.

High serum alanine aminotransferase (ALT) levels at the start of Peg-IFN alfa2b therapy is the best predictor of response in these patients, note researchers in the November American Journal of Gastroenterology.

Dr. Hajo J. Flink from Erasmus Medical Center, Rotterdam, The Netherlands, and an international team investigated the efficacy -- defined as loss of HBeAg at the end of follow up -- of Peg-IFN alfa2b in 76 previous non-responders to standard IFN or lamivudine. Thirty-seven had failed IFN, 17 had failed lamivudine, and 22 had failed both therapies.

All subjects received 52 weeks of Peg-IFN alfa2b (100 micrograms once weekly) combined with either 100 milligrams lamivudine daily or placebo. Subjects were followed for 26 weeks after the end of treatment.

Thirteen nonresponders to previous IFN (35%), 5 nonresponders to previous lamivudine therapy (29%), and 4 nonresponders to both drugs (22%) responded to treatment with Peg-IFN alfa2b, Dr. Flink and colleagues report.

The combination of Peg-IFN alfa2b and lamivudine did not lead to higher response rates relative to Peg-IFN alfa2b alone for any of the previous nonresponder groups, they note.

The best predictor of response to Peg-IFN alfa2b in previous nonresponders was a baseline ALT of greater than 4 times the upper limit of normal. Fifty-three percent of patients with this ALT level responded to Peg-IFN alfa2b compared with 20% of those with lower ALT levels at the start of treatment.

Am J Gastroenterol 2006;101:2523-2529.

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