A second study in the New England Journal of Medicine
has shown that weekly administration of peginterferon is also more
effective in treating chronic hepatitis C patients with cirrhosis.
The efficacy and safety of peginterferon alfa-2a in patients
with HCV-related cirrhosis or bridging fibrosis was examined by an
international team.
271 patients with cirrhosis or bridging fibrosis were randomly
assigned to receive subcutaneous treatment with 3 million units of
interferon alfa-2a three times weekly (88 patients), 90
µg of peginterferon alfa-2a once weekly (96), or 180
µg of peginterferon alfa-2a once weekly (87).
Treatment lasted 48 weeks and was followed by a 24-week
follow-up period.
Efficacy was assessed by measuring HCV RNA and alanine
aminotransferase and by evaluating liver-biopsy specimens. A
histologic response was defined as a decrease of at least 2 points
on the 22-point Histological Activity Index.
In an intention-to-treat analysis, HCV RNA was found to be
undetectable at week 72 in 8 per cent, 15 per cent, and 30 per cent
of the patients treated with interferon alfa-2a and with 90
µg and 180 µg of peginterferon alfa-2a,
respectively. At week 72, alanine aminotransferase concentrations
had normalized in 15 per cent, 20 per cent, and 34 per cent of
patients, respectively.
In the subgroup of 184 patients with paired liver-biopsy
specimens, the rates of histologic response at week 72 were 31 per
cent, 44 per cent, and 54 per cent, respectively. All three
treatments were similarly tolerated.
Dr Jenny Heathcote concluded on behalf of the group that, "In
patients with chronic hepatitis C and cirrhosis or bridging
fibrosis, 180 µg of peginterferon alfa-2a administered
once weekly is significantly more effective than 3 million units of
standard interferon alfa-2a administered three times weekly."
<<P> N Engl J Med 2000; 343: 1673-80
07 December 2000
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