ACG MEETING: Adding Ribavirin To Interferon
Beneficial For Chronic Hepatitis C
BOSTON, MA -- Oct. 13, 1998 -- The addition of ribavirin to
standard interferon treatment for patients with chronic Hepatitis C
who have not responded to interferon treatment alone appears to be
beneficial according to two separate studies presented at the 63rd
annual scientific meeting of the American College of
Ribavirin is a new therapy recently approved by the United
States Food & Drug Administration.
At least half of patients with chronic Hepatitis C treated with
interferon are non-responders, unable to achieve complete viral
clearance. The combination of ribavirin with interferon in
non-responders achieved complete virologic response in 20 to 26
percent of patients who had not responded to prior treatments with
interferon alone, according to a study conducted by Mitchell
Shiffman, MD and the Virginia Hepatitis Treatment Group.
Dr. Shiffman randomly assigned 146 patients who were
non-responders to prior interferon treatment to three treatment
groups. Patients in Group A received interferon five million units
three times a week. Of these, 9.4 percent experienced complete
virologic response at three months and 11.1 percent at six months.
Patients in Group B were treated with interferon three million
units three times a week plus 600 mg ribavirin twice a day, with a
20.7 percent achieving a complete response at three months; and
21.1 percent at six months. The regimen for Group C was interferon
5 million units three times a week plus 600 mg ribavirin twice a
day. This group experienced a 14.7 percent response rate at three
months; and 26.1 percent at six months.
Dr. Shiffman's study concluded that 20 to 26 percent of patients
who were non-responders to interferon alone achieved response when
re-treated with the combination of ribavirin and interferon and
that the dose of five million units compared to three million units
of interferon appears no more effective in these patients.
In a study at Georgetown University Medical Center, James H.
Lewis, MD, FACG found that 31 percent of interferon non-responders
who were treated with combination therapy of interferon and
ribavirin experienced complete response at three months, and most
maintained this complete response at six months. However, among Dr.
Lewis's subjects who were non-responders at three months of
combined treatment, only two of 24 had a complete response after
three more months.
"The utility of continuing interferon plus ribavirin beyond
three months appears to be limited, but seems to benefit
non-responders who exhibit a significant fall in viral load and
normalising ALT after the initial three-month treatment," Dr. Lewis
Hepatitis C is a major cause of chronic liver disease in the
United States, with over four million Americans infected according
to the National Institutes of Health. Hepatitis C causes an
estimated 8,000 to 10,000 deaths each year. Chronic Hepatitis C
varies greatly in its course and outcome. At one end of the
spectrum are certain patients experiencing no symptoms and normal
liver enzymes, while at the other end are patients with severe
disease who, over a span of 10 to 20 years, may develop cirrhosis
and end-stage liver disease and account for approximately 20
percent of Hepatitis C patients. Those infected for 20 to 40 years
are at high risk for developing liver cancer.
SOURCE: Doctor's Guide to Medical News -
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