Currently,
there are limited therapeutic options for chronic hepatitis C patients who fail
treatment with pegylated interferon alpha
plus ribavirin, write researchers from the Mayo Clinic (Scottsdale, AZ) in
the March 2007 issue of Digestive Diseases and Sciences. For such non-responders,
one possibility is re-treatment with a second course of pegylated interferon/ribavirin.
The investigators
evaluated outcomes of a cohort of patients with chronic hepatitis C virus (HCV)
infection who achieved sustained virological
response (SVR) when re-treated with pegylated interferon/ribavirin, after
failing to respond to an initial course of the same therapy. Non-response was
defined as failure to achieve an early virological response by week 12 or presence
of detectable HCV RNA 24 weeks after completion of therapy.
Results
•
20 patients (12 men; 8 women)
were re-treated with pegylated interferon alpha-2a (Pegasys) or pegylated interferon
alpha-2b (PegIntron) plus ribavirin.
•
The mean age was 50 years,
85% were white, 95% had genotype 1 HCV, and 35% had liver cirrhosis.
•
Prior to the first course
of pegylated interferon/ribavirin, 12 of 20 patients (60%) had received no prior
treatment for hepatitis C.
•
After the second course of
pegylated interferon/ribavirin, 2 of 20 patients (10%) achieved SVR.
Conclusion
In
conclusion, the authors wrote, "These results suggest marginal benefit of
re-treatment of patients with chronic HCV with another course of pegylated interferon
plus ribavirin after they have not responded to an initial course of pegylated
interferon plus ribavirin."
Thus,
optimal treatment of non-responders to pegylated interferon/ribavirin remains
uncertain, but researchers are investigating the use of different forms of interferon
as well as novel antiviral agents currently in the drug development pipeline.
02/20/07
Reference R
Cheruvattath, M J Rosati, M Gautam, and others. Pegylated Interferon and Ribavirin
Failures: Is Retreatment an Option? Digestive Diseases and Sciences 52(3).
March 2007.
