24-Week vs 48-Week Treatment with Pegasys Plus Ribavirin in HCV Genotype 1 Patients

[Guest guest]

24-Week vs 48-Week Treatment with Pegasys Plus Ribavirin in HCV Genotype 1 Patients

Pegylated interferon alfa plus ribavirin is the most effective therapy for chronic hepatitis C, but questions remain as to the optimal duration of therapy.

Brazilian researchers conducted a study to evaluate the effect of pegylated interferon alfa-2a (Pegasys) plus ribavirin on sustained virological response (SVR) when administered for 24 or 48 weeks to treatment-naïve patients with genotype 1 hepatitis C virus (HCV).

The study enrolled 117 participants being treated for hepatitis C for the first time. Genotype 1 patients were randomly assigned to receive treatment for 24 or 48 weeks; those with non-1 genotypes received treatment for 24 weeks. The researchers evaluated SVR (undetectable HCV RNA 24 weeks after the end of therapy) and treatment tolerability.

Results

The end-of-treatment response rates were:

59% for genotype 1 patients treated for 24 weeks; 80% for genotype 1 patients treated for 48 weeks; 92% for genotype non-1 patients treated for 24 weeks.

The SVR rates were:

19% for genotype 1 patients treated for 24 weeks (95% CI 7.2-36.4); 48% for genotype 1 patients treated for 48 weeks (95% CI 30.2-66.9; P = 0.0175).

76% for genotype non-1 patients (95% CI 62.3-86.5).

Safety profiles were acceptable, and there were no unexpected adverse side effects.

Conclusion

The authors concluded that almost half of genotype 1 patients achieved SVR after treatment for 48 weeks with Pegasys plus low-dose ribavirin (although the dose used was not specified in the abstract), confirming that 48-week treatment was superior to 24 weeks for this population.

Reference

C Brandão, A Barone, F Carrilho, and others.The results of a randomized trial looking at 24 weeks vs 48 weeks of treatment with peginterferon α-2a (40 kDa) and ribavirin combination therapy in patients with chronic hepatitis C genotype 1. Journal of Viral Hepatitis 13(8): 552-559. August 2006.

http://www.hivandhepatitis.com/2006roberts/hcv/080906_b.html