Efficacy
of Ribavirin Monotherapy Following Combination Therapy with
Interferon Alfa-2b (Intron A) and Ribavirin in Patients with
Chronic Hepatitis C
Reappearance
of HCV RNA followed by exacerbation of biochemical parameters
after combination therapy consisting of [standard] interferon
and ribavirin is an obstacle to achieving a sustained
response (SVR) and improving long-term prognosis.
In
the current study, Japanese researchers hypothesized that
ribavirin
monotherapy after 6 months of combination therapy
might improve sustained viral and biochemical responses.
They
conducted a prospective, randomized and controlled study.
Thirty-eight patients with chronic hepatitis C treated with
combination therapy for 6 months and who at end of treatment
had no detectable serum HCV RNA were enrolled and allocated
into two arms.
Group
I (n = 19) was continuously administered
oral ribavirin for an additional 6 months, and group II (n = 19)
was followed up without any further treatment.
Results
· At
the end of the trial, HCV RNA negativity was 11/19 (58%) in
group I, and 6/19 (32%) in group II (p = 0.191).
Multivariate analysis demonstrated that ribavirin monotherapy
was not a predictor for the eradication
of HCV RNA.
· In
cases without sustained
viral responses, serum ALT levels at baseline and
at the end of 48 weeks’ trial were 54.6 and 44.4 in group
I (p = 0.237).
· A
significant reduction in ALT
levels following ribavirin monotherapy was not
observed.
The
authors conclude, “Ribavirin monotherapy following combination
therapy fails to improve sustained viral response as well
as biochemical response.”
The
outcome of this trial is a reminder that for best results,
relapsers and nonresponders to standard interferon plus ribavirin
should be retreated with peginterferon monotherapy or peginterferon/ribavirin.
Teikyo University School of Medicine;
Ankoh Medical Center; Akabane Central Hospital; and Tokyo
Musashino Hospital, Tokyo, Japan.
06/10/05
Reference
R
Nagayama. Efficacy of ribavirin monotherapy following combination
therapy with interferon alfa-2b and ribavirin for patients
with chronic hepatitis C. Hepatology Research. Posted
online May
3, 2005.
|
