24-Week vs 48-Week Treatment with Pegasys Plus Ribavirin in HCV Genotype 1 Patients

Pegylated interferon alfa plus ribavirin is the most effective therapy for chronic hepatitis C, but questions remain as to the optimal duration of therapy.

Brazilian researchers conducted a study to evaluate the effect of pegylated interferon alfa-2a (Pegasys) plus ribavirin on sustained virological response (SVR) when administered for 24 or 48 weeks to treatment-naïve patients with genotype 1 hepatitis C virus (HCV).

The study enrolled 117 participants being treated for hepatitis C for the first time. Genotype 1 patients were randomly assigned to receive treatment for 24 or 48 weeks; those with non-1 genotypes received treatment for 24 weeks. The researchers evaluated SVR (undetectable HCV RNA 24 weeks after the end of therapy) and treatment tolerability.

Results

• The end-of-treatment response rates were:
• 59% for genotype 1 patients treated for 24 weeks;
• 80% for genotype 1 patients treated for 48 weeks;
• 92% for genotype non-1 patients treated for 24 weeks.
• The SVR rates were:
• 19% for genotype 1 patients treated for 24 weeks (95% CI 7.2-36.4);
• 48% for genotype 1 patients treated for 48 weeks (95% CI 30.2-66.9; P = 0.0175).
• 76% for genotype non-1 patients (95% CI 62.3-86.5).
• Safety profiles were acceptable, and there were no unexpected adverse side effects.

Conclusion

The authors concluded that almost half of genotype 1 patients achieved SVR after treatment for 48 weeks with Pegasys plus low-dose ribavirin (although the dose used was not specified in the abstract), confirming that 48-week treatment was superior to 24 weeks for this population.

Reference