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Virologic Response To Pegasys With Genotype 4 in Small Study Group

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  • claudine intexas
    Virologic Response To Pegasys With Genotype 4 in Small Study Group Morris Sherman from Toronto General Hospital reported at I think AASLD November 2000
    Message 1 of 1 , Apr 6, 2001
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      Virologic Response To Pegasys With Genotype 4 in Small
      Study Group

      Morris Sherman from Toronto General Hospital reported
      at I think AASLD
      November 2000 response to Pegasys and regular
      Interferon a-2a for
      individuals
      with chronic HCV and genotype 4.

      It has been reported that treatment with standard IFN
      is less effective
      in
      patients with genotypes 1 and 4 than in patients with
      genotypes 2 and
      3. The
      purpose of this retrospective analysis was to compare
      the effectiveness
      of
      Pegasys (40 kDa) IFN a-2a once weekly with IFN a-2a
      taken 3 times
      weekly in
      patients chronically infected with hepatitis C with
      the difficult to
      treat
      genotype 4. The investigators looked at a database
      consisting of 1208
      patients from large randomized phase II and III
      studies comparing three
      times
      weekly injections of IFN a-2a (3 MIU or 6 MIU) to
      treatment with once
      weekly
      Pegasys IFN a-2a (180 ug). Effectiveness was evaluated
      in a subset of
      patients infected with genotype 4.

      Sixteen patients were found to have genotype 4. Five
      patients received
      treatment with IFN a-2a three times weekly and 11 were
      treated with 180
      ug
      Pegasys IFN a-2a once weekly for up to 48 weeks.
      Patients were
      predominantly
      male (63%), with baseline viral loads ranging from
      8,000 to >12 million
      copies/ml (COBAS Amplicor Monitor HCV, version 2.0).
      Four patients
      (25%) had
      cirrhosis. End-of-treatment (week 48) virologic
      responses (COBAS
      Amplicor HCV
      Test version 2.0 with lower limit of detection of 100
      copies/ml) were
      0% in
      the standard IFN a-2a patients and 73% in the Pegasys
      group. Sustained
      virologic response (week 72) was obtained on 0% of
      patients receiving
      standard IFN and 45% in Pegasys treated patients. All
      patients that
      were
      sustained virologic responders were also sustained
      biochemical
      responders.
      Paired biopsies (pre and post treatment) were obtained
      for 8 patients
      treated
      with Pegasys and histologic response (improved liver
      condition)
      measured by a
      >2 point decrease in Histology Activity Index (HAI)
      was found in 5 of
      these
      patients (63%). Histologic response was observed in
      2/3 patiented with
      paired
      biopsies and treated with standard IFN.

      The authors concluded that the number of patients with
      genotype 4 found
      to
      respond well to Pegasys was small, but the data are
      encoraging and
      indicate
      that further larger studies should be conducted in
      genotype 4 patients.

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