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Efficacy of interferon alpha‐2b induction therapy before retreatment for chronic hepatitis C
Author(s) -
Carr Catherine,
Blaine Hollinger F.,
Yoffe Boris,
Wakil Adil,
Phillips Jason,
Bzowej Natalie,
Leung Janet,
Mirro Katherine,
Poordad Fred,
Moore Dan H.,
Gish Robert G.
Publication year - 2007
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/j.1478-3231.2007.01535.x
Subject(s) - medicine , ribavirin , gastroenterology , pegylated interferon , alpha interferon , chronic hepatitis , induction therapy , hepatitis c , interferon , immunology , virus , chemotherapy
Background/Aims: Chronic hepatitis C (HCV) patients who have failed previous treatment have low sustained viral response (SVR) rates with repeat treatment. We evaluated whether interferon (IFN) induction during retreatment improves response rates. Methods: Two randomized, controlled trials were conducted in chronic HCV patients who failed IFN. In Study 1, patients received IFN 3 MU daily plus ribavirin (RBV) 1000 mg/day for 4 weeks, followed by IFN 3 MU TIW plus RBV 1000 mg/day for 44 weeks (induction; n =232), or IFN 3 MU TIW plus RBV 1000 mg/day for 48 weeks (non‐induction; n =237). In Study 2, patients received IFN 5 MU B.I.D. plus RBV 1000–1200 mg/day for 2 weeks, followed by pegylated IFN (PEG‐IFN) 75–150 μg weekly plus RBV 1000–1200 mg/day for 46 weeks (induction; n =201), or PEG‐IFN 75–150 μg weekly plus RBV 1000–1200 mg/day for 48 weeks (non‐induction; n =206). The primary end point for both trials was SVR. Results: Induction did not increase SVR compared with non‐induction, but did increase the on‐treatment response among genotype non‐1 patients in Study 2. By intention‐to‐treat (ITT) analysis, SVR in Study 1 was 13% for induction vs. 9% for non‐induction ( P =NS). In Study 2 (ITT), SVR was 20% for induction vs. 24% for non‐induction ( P =NS). However, by non‐ITT analysis of Study 2, genotype non‐1‐previous non‐responders showed significantly higher response rates with induction than non‐induction. Conclusion: For chronic HCV patients who have failed IFN, induction with retreatment does not improve SVR, but may be beneficial for patients with genotype non‐1 HCV.