Consensus Interferon (Infergen) and Ribavirin in Nonresponders to Prior Therapy with Either Standard Interferon Alfa and Ribavirin or Pegylated Interferon and Ribavirin

Currently, there are no FDA-approved treatment options for individuals who fail to achieve a sustained virological response (SVR) to the standard of care—peginterferon plus ribavirin combination therapy. In the present review, investigators at 3 midwestern medical centers describe their experience using consensus interferon (CIFN) (Infergen) [aka interferon alfacon-1] plus ribavirin (RBV) in nonresponders (NR) to peginterferon + ribavirin

All patients were treated initially with IFN alfa-2a (Pegasys) monotherapy or Peg IFN + RBV. Those who failed to achieve undetectable HCV RNA were classified as NR and were then retreated with CIFN + weight-based RBV (800 mg-1200 mg/day) for at least 48 weeks.

Pretreatment liver biopsy, HCV genotype, viral load and various demographic information were collected for all subjects. Patients on CIFN + RBV retreatment were allowed to use growth factors to continue with their treatment on an as needed basis.

All patients received CIFN at a starting dose of 15 mcg/daily with weight-based RBV. Doses were adjusted as necessary for hematological side effects.

Results

• 79 patients were screened and 76 patients were treated with CIFN and RBV (65% Caucasian, 16% African American, 4% Hispanic, 15% other);
• 49 male and 27 female; age ranged from 20-76 years (Mean: 61 (80%) had HCV genotype 1;
• 36 (47%) had Metavir fibrosis F3/F4.
• At the end of treatment (week 48), 55 (72%) patients were HCV RNA negative.
• At week 72, 38 (50%) achieved an SVR.
• One patient on treatment underwent liver transplantation and stopped treatment. At that time, his viral load had dropped to 1,830 copies/mL. 

Table

Conclusions
According to the authors, “These data suggest that IFN alfacon-1 and weight-based RBV are a potential alternative in Peg IFN plus RBV NR HCV patients. In addition, NR patients with advanced disease (F3/F4) tolerated this therapy well and should be candidates for retreatment with IFN alfacon-1 and RBV.”

“Further study is warranted to confirm these findings.”

11/28/05

Reference
K Chen and others. Consensus interferon and ribavirin in patients with chronic hepatitis C who were nonresponders to prior therapy with either interferon alfa and ribavirin or pegylated interferon and ribavirin. Abstract 1203. 56th annual meeting of the American Association for the Study of Liver Diseases. November 11-15, 2005. San Francisco, CA.