12 Weeks of Pegylated Interferon Works as Well as 48 Weeks in Selected Patients with HBeAg Positive Chronic Hepatitis B

Past research has shown that 48 weeks of treatment with pegylated interferon is effective in about one-third of patients with hepatitis B "e" antigen (HBeAg) positive chronic hepatitis B. However, there is insufficient data to show whether a shorter course of therapy would be equally effective.

As reported at the 58th Annual Meeting of the American Association for the Study of Liver Diseases (AASLD) in Boston (November 2-6, 2007), researchers from Argentina conducted a study to compare the efficacy of 48 versus 24 weeks of pegylated interferon alfa-2a (Pegasys) in patients with chronic hepatitis B who had predictors of good response.

The study included 35 participants with high baseline alanine transaminase (ALT) levels (> 3 x upper limit of normal) and low HBV DNA viral load (< 109 copies/mL). About half (n = 19) were treated with 180 mcg/week pegylated interferon alfa-2a for 48 weeks, while 16 patients received the same regimen for 24 weeks.

All participants were followed for 24 weeks after completion of therapy. Virological, biochemical, and serological responses in the 2 groups were compared.

Results

› At the end of follow-up, HBeAg seroconversion was observed in 7 of 19 patients (36.8%) treated for 48 weeks compared with 6 of 16 (37.5%) treated for 24 weeks (not a statistically significant difference).

› Patients treated for 48 weeks experienced a significantly greater decrease in HBV DNA at the end of therapy compared with those treated for 24 weeks (-4.8 logs vs -3.6 logs, respectively; P < 0.05).

› The percentage of patients with HBV DNA < 100,000 copies/mL was similar in both groups at the end of follow-up (42.1% vs 43.7%; not a statistically significant difference).

› No significant differences were noted between the 2 groups with regard to ALT normalization, hepatitis B surface antigen (HBsAg) loss, or HBsAg seroconversion.

› 1 patient in each group experienced a serious adverse event.

Conclusion

"The results from this study indicate that 24 weeks of therapy with peginterferon alfa-2a is similar to 48 weeks therapy in patients with HBeAg positive chronic hepatitis B who have good predictors of response," the investigators concluded.

11/02/07

Reference
L Rezzonico, O Galdame, B Frider, and others. Twenty-four weeks therapy with Peginterferon alfa-2a is similar to 48 weeks therapy in patients with HBeAg positive chronic hepatitis B and good predictors of response. 58th Annual Meeting of the American Association for the Study of Liver Diseases. Boston. November 2-6, 2007. Abstract 978.