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Interferon Therapies in Hepatitis C

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    Aggressive Interferon Therapies, Combination Therapies and Newer Longer-Acting Interferons in Hepatitis C Treatment with standard interferon alpha 3MU three
    Message 1 of 1 , Jan 10, 2000
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      Aggressive Interferon Therapies, Combination Therapies and Newer
      Longer-Acting Interferons in Hepatitis C

      Treatment with standard interferon alpha 3MU three times weekly for 6-12
      months produces long term sustained virological response in only 15-20% of
      patients with chronic hepatitis C. In an attempt to improve the number of
      patients who achieve viral eradication various alternative strategies have
      been employed. Overall, numerous studies have shown that these aggressive
      interferon regimens may improve end-of-treatment response rates. It is
      likely that this improved response is reflected in the more intensive
      antiviral pressure that these regimens provide relative to standard
      interferon dosing. However, although end-of-treatment viral response was
      generally improved significantly, the effect on sustained virologic response
      was less consistent.
      In contrast, regimens combining interferon with ribavirin have achieved
      significantly better treatment success than standard interferon in both
      na�ve patients and relapsers. Sustained response rates approaching 40% have
      been achieved in previously untreated patients. Response rates are also
      improved in patients who relapse following interferon monotherapy; one
      recent study showed that the proportion of sustained responders was
      substantially higher with combination therapy than with interferon
      monotherapy (49% vs 5%; p < 0.001). Combination therapy also improved
      biochemical and histological end points to a greater degree than interferon
      therapy alone.
      In an effort to achieve a more consistent and sustained antiviral pressure,
      longer-acting interferons have been developed. New treatments such as
      peginterferon alfa-2a, a 40kD pegylated interferon with a prolonged action
      (as a result of slower absorption and longer elimination half-life) relative
      to standard interferon alfa, are encouraging. A phase II study in
      previously untreated patients showed significantly higher sustained
      virological response rates following 48 weeks� treatment with once-weekly
      peginterferon alfa-2a 90�g and 180�g, than with standard interferon alfa 3MU
      three times weekly. In another phase II study, combination therapy with
      peginterferon alfa-2a 180�g weekly and ribavirin for 24 to 48 weeks produced
      an initial virological response in 16 of 19 (84%) treatment-na�ve patients
      with chronic hepatitis C. From these preliminary results, peginterferon
      alfa-2a, alone or in combination with ribavirin, appears to be a promising
      alternative to standard interferon regimens.
      (With inputs from AASLD)

      Dr Sharat C Misra MD, DM
      Consultant Gastroenterologist & Hepatologist
      Each morning is the doorway to a new world,
      A beginning of infinite possibilities.

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