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Treatment length: Is an "A la carte" Combination Interferon alfa-2b....

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  • claudine intexas
    (Note: this is the old combo, not peg) Clinical Trials Is an A la carte Combination Interferon alfa-2b Plus Ribavirin Regimen Possible for the First Line
    Message 1 of 1 , Mar 2, 2002
      (Note: this is the old combo, not peg)

      Clinical Trials
      Is an "A la carte" Combination Interferon alfa-2b
      Plus Ribavirin Regimen Possible for the First Line
      Treatment in Patients With Chronic Hepatitis C? The
      ALGOVIRC Project Group
      Poynard T, McHutchison J, Goodman Z, Ling MH, Albrecht
      J
      Hepatology 2000 Jan;31(1):211-8
      Randomized trials have shown the enhancement of
      efficacy with interferon alfa-2b and ribavirin (IFN-R)
      in comparison with interferon monotherapy (IFN) as
      first line treatment of chronic hepatitis C. Further
      definition of response based on disease, patient, and
      treatment characteristics is needed to determine the
      degree of benefit for the various patient subgroups.
      The aim of this study was to answer this question by
      analyzing the data from 1,744 naive patients included
      in trials that compared 24- or 48-week IFN-R
      treatment. Response factors were identified by
      logistic regression and receiver operating
      characteristics curves. Five independent
      characteristics were associated with a sustained loss
      of hepatitis C virus (HCV) RNA (<100 copies/mL) 24
      weeks after the end of treatment: genotype 2 or 3,
      baseline viral load less than 3.5 million copies/mL,
      no or portal fibrosis, female gender, and age younger
      than 40 years. There was a significant advantage for
      IFN-R in comparison with IFN alone whatever the
      combination of factors. The most efficient strategy is
      to treat all patients for 24 weeks. If the 24-week
      polymerase chain reaction (PCR) is positive, treatment
      can be stopped. If the 24-week PCR is negative,
      patients with fewer than 4 favorable factors should be
      treated for an additional 24 weeks. Conclusion: The
      combination of IFN-R is better as first line treatment
      than IFN monotherapy. For patients who are PCR
      negative after 24 weeks of treatment, genotyping and
      baseline viral load, fibrosis stage, gender, and age
      are useful predictive factors in determining whether
      to continue an additional 24 weeks of treatment.


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