Physicians are seeing more patients who have failed
treatment for hepatitis C virus (HCV) infection. And they are faced
with the difficult decision of what to do next for these people.
Since there are no ideal, uniformly effective treatments for the
disease, as more people are treated, more relapse or never respond
at all.
For previously untreated patients, the most commonly prescribed
therapy for chronic HCV in the United States is combination therapy
with interferon (Intron A, Schering) plus ribavirin. According to
Raymond Koff, MD, Chairman of Medicine at the University of
Massachusetts Medical School, treatment success was only 38% for
patients given combination therapy for 48 weeks, and 31% for 24
weeks. Success with interferon alone for 48 and 24 weeks was 13%
and 6%, respectively.
In a special symposium held during the recent Digestive Disease
Week (DDW) meeting in Orlando, Florida, leading hepatitis
researchers presented data to try to answer the question of "what
next?" One experimental strategy is to switch drugs, using
consensus interferon (Infergen, Amgen) for people who failed
combination therapy. UCLA's Dr. Paul Martin calls this approach one
of the "most promising." He calls retreatment with the same regimen
"generally futile."
Another strategy is to use drugs at higher doses or administered
more frequently, so-called "induction therapy." Tse-Ling Fong, MD
of Cedars-Sinai Medical Center in Los Angeles is conducting a study
using consensus interferon at higher doses to treat 300 patients
who failed previous interferon mono- or combination therapy. "The
goal of our study is to determine the efficacy and tolerability of
induction therapy – higher doses and increased frequency
– daily dosing over a twelve week regimen," Dr. Fong said. A
similar study headed by Dr. Maria Sjogren at Walter Reed Army
Medical Center in Washington, DC is now enrolling 400 patients.
Thousands of patients began combination therapy in October of
last year, when the treatment was approved for use. Dr. Koff
concluded the symposium saying, "By fall, we will be seeing people
who have completed a year of therapy," noting that "60% to 90% of
them are going to be non-responders or will have relapsed."
"So we're desperate for the information that will come out of
these trials," he said.
Highlights of these studies and several others from the DDW
meeting are available at http://www.highlights.wellweb.com.
Distributed by: Patients NewsWire
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