Daily Combination Therapy Better Than Thrice Weekly for Previously Treated HCV Patients
- Daily Combination Therapy Better than Thrice Weekly
for Previously Treated HCV Patients
Preliminary results of a study examining daily dosing
of combination therapy for previously treated chronic
hepatitis C patients show improved results compared to
three times a week dosing.
In a study conducted from September 1997 to March
1998, 25 HCV patients who had previously relapsed or
failed to respond to interferon monotherapy were given
daily doses of interferon afa-2b at 3 million units
plus ribavirin at 1000-1200 milligrams for twelve
"There is no consensus about dose and duration of
combination therapy," says Zeki Karasu, M.D., lead
investigator and research fellow, Oklahoma
Transplantation Institute, Oklahoma City, Oklahoma.
"When interferon was first approved, it was for three
times a week, but later, some viral kinetic studies
showed that daily use of that drug may produce better
results. Based on this information, we tried daily use
of these drugs in combination, and we did get better
After 12 weeks, 57% (12/21) showed no serum HCV
(HVC-RNA negative) but 43% (9/21) remained HCV-RNA
positive. Four of the 25 dropped out of the study. Of
the ten relapsers to previous interferon monotherapy,
9 (90%) responded to the regimen in this study. Of the
11 previous non-responders, 3 (27%) showed HCV RNA
The response rate for non-responding or relapsing
patients is usually quite low, Dr. Karasu says. "Our
results for daily use of these two drugs show much
At three months, the side effects from daily dosing of
combination therapy "were comparable to three times a
week dosing [of combination therapy]" Dr. Karasu says.
Dose reductions were necessary for 12 patients, mainly
because of anemia and fatigue. And he notes the need
for close patient monitoring because of the likelihood
of these complications from the ribavirin component of
the combination therapy.
The study is continuing, but Dr. Karasu noted that
patients who respond in 3 months of treatment tend to
have a sustained response. "If the patient doesn't
respond after three months time, they usually don't
respond after that."
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