December 28, 2010

Current antiviral combination therapy for chronic hepatitis C patients who failed to interferon alfa-based treatment

Journal of Clinical Pharmacy and Therapeutics
Early View (Articles online in advance of print)

M. Trapero-Marugán MD1, J. Mendoza MD1, J. A. Moreno Monteagudo MD1, M. Chaparro MD1, L. García-Buey MD1, L. González-Moreno MD2, M. J. Borque BSc3, R. Moreno-Otero MD1

Article first published online: 22 DEC 2010
DOI: 10.1111/j.1365-2710.2010.01231.x

Abstract

Keywords:chronic hepatitis C; non-response;peginterferon; relapse; ribavirin; sustained virological response

Summary

What is known and Objective:  Interferon-alfa-based therapy is effective in the treatment of Hepatitis C. However, some patients fail to respond and others relapse, after initially responding. Our objective was to assess the efficacy, safety and predictive factors for sustained virological response (SVR) to peginterferon plus ribavirin in chronic hepatitis C patients who failed to interferon-alfa (IFNα)-based therapy.

Methods:  Seventy-five consecutive patients who failed to IFNα-based therapy were retreated with peginterferon plus ribavirin. Of these patients, 85% were infected by genotype 1. The primary endpoint was SVR.

Results and Discussion:  Of 75 non-responder (n = 54) or relapser patients (n = 21), 50 were previously treated with IFNα-monotherapy and 25 with IFNα plus ribavirin. Global SVR rate was 41·3%: for patients re-treated with IFNα the response was 48% whilst for those retreated with IFNα plus ribavirin, it was 28%. For previous non-responders the SVR rate was 37% and for relapsers it was 52·4%.

What is new and Conclusion:  Retreatment with peginterferon plus ribavirin is an effective option for some chronic hepatitis C non-responder or relapser patients. Higher SVR rate was achieved in relapsers and in those patients who received IFNα monotherapy previously.

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