The Pharmaceutical Journal
Vol 276 No 7399 p527
6 May 2006

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Studies address length of treatment for hepatitis C

Data from studies addressing treatment duration for hepatitis C infection were presented at the annual meeting of the European Association for the Study of the Liver held in Vienna last week.

One study, involving 1,469 patients with chronic hepatitis C (HCV) genotypes 2 and 3, showed that 24 weeks of peginterferon alfa-2a (180µg once weekly) combined with ribavirin (800mg daily) achieves higher cure rates than 16 weeks of treatment. Sustained virological response was observed in 76 per cent of those who received 24 weeks of treatment compared with 65 per cent of those who received the shorter treatment.

Lead investigator Mitchell Shiffman of Virginia Commonwealth University medical centre, Richmond, Virginia, commented: “Although three small studies have suggested that treating these patients for a shorter duration may be effective and some physicians have already adopted this approach, this large study has clearly demonstrated that patients with HCV genotypes 2 and 3, including those with a rapid virological response, really do need 24 weeks of treatment.”

The study was supported by Roche.

A second study, examining treatment outcome for peginterferon alfa-2b (1.5µg/kg weekly) with ribavirin (800mg daily or a weight-based dose up to 1,400mg daily) in 1,829 patients with HCV genotypes 2 and 3, showed that 24 weeks of therapy was as effective as 48 weeks.

The shorter 24-week regimen was associated with a relapse rate of 5 per cent in genotype 2 patients and 10 per cent in genotype 3 patients compared with 5 per cent and 12 per cent, respectively, in the longer 48-week regimen. In the 24-week arm, patients with genotype 2 also had a higher sustained virological response than those with genotype 3 (72 per cent versus 59 per cent). The investigators conclude that higher, weight-based doses of ribavirin appear to be necessary to achieve similar response rates in genotype 3 patients.

The study was supported by Schering-Plough.