Latest Treatment for HCV May Not Be Best


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Latest Treatment for Hepatitis C May Not Be Best, According to Patients NewsWire; Consensus Interferon Effective for Many Patients Who Have Failed Rebetron

PHILADELPHIA, Oct. 27 /PRNewswire/ -- The newest combination drug therapy may not be best for every hepatitis C patient. Many do not respond to Intron A (interferon alfa-2b) with ribavirin, and others may see viral counts lowered but relapse once treatment stops. Consensus interferon (Infergen from Amgen) is worth a closer look for these patients.

A study in the April issue of Hepatology showed that 58 percent of relapsers and 13-17 percent of non-responders achieved a sustained response after 48 weeks of treatment with high dose consensus interferon (15 micrograms three times a week).

Interferons comprise a family of natural proteins produced by the body in response to viral infections. Consensus interferon is a man-made combination of parts of various interferon molecules that has five to ten times the biological activity of natural interferons in the laboratory.

Doctors are pioneering ways to maximize Infergen's effectiveness by modifying the dosing regimen approved by the FDA. Dr. William Boyd, Clinical Associate Professor of Medicine at South Florida School of Medicine and a hepatologist in private practice, uses Infergen with relapsers and with non- responders. "Infergen is particularly successful with relapsers," says Boyd. "Based on the Hepatology study, they have a 55-60 percent chance of success if they have relapsed after treatment with Intron A."

For non-responders, Boyd prescribes 15 micrograms of Infergen three times a week, either initially or after acclimating the patient with 9 micrograms three times a week. "After three or four months at the higher dose without a dramatic drop in the viral load, we discuss increasing to 15 micrograms of Infergen daily."

Long-term therapy for patients with significant liver fibrosis is a new concept. "In the past, we considered hepatitis a viral illness," says Boyd. "If the virus didn't decrease after three or four months of treatment, we'd try something different or wait for better medicines. Now, the goal for patients with significant fibrosis is broader than alleviating the virus. The medicine may slow or even reverse fibrosis, so we plan on a year of treatment, even if the viral load doesn't decrease."

Doctors individualize therapy by weighing several factors: how the patient tolerates the medicine, how motivated the patient is, amount of fibrosis, and what has happened to the viral load. "We may arrive at different dosing schedules for different patients. We don't prescribe by cookbook as we did five years ago," says Boyd.

Dr. Boyd recommends patients find a doctor to spend time with them examining their viral load and biopsy results, their age, their tolerance of side effects, and their expected length of treatment before making treatment decisions. "Working with such a doctor is critical to developing commitment -- no treatment works if the patient doesn't refill the prescription," he says.

Link to "Re-treatment of Chronic Hepatitis C with Consensus Interferon," Hepatology, April 1998, p.1136-1143, Vol. 27, No. 4:

SOURCE Patients NewsWire ; CO: Patients NewsWire; ST: Pennsylvania; IN: MTC HEA; SU:; 10/27/98 13:09 EST

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