Twice a Week Administration of PEG-Intron Plus Ribavirin in Obtaining SVR Among Patients with HCV Genotype 1
Once a week administration of peginterferon alfa-2b (PEG-Intron) produces an exponential decrease of serum drug's level to almost undetectable at days 6 and 7. The aim of this Italian study was to evaluate whether twice a week administration may improve sustained virological response (SVR) in hepatitis C patients.
Sixty five patients (38 men/27 women, age range 20-65) with chronic hepatits C were subsequently enrolled among outpatients.
Twenty-two (7 genotype 2, 15 genotype 1) received PEG-Intron 1.5 mcg/kg once a week (group A), and 43 (17 genotype 2, 26 genotype 1), received PEG-Intron twice a week (mean dose 2.4 mcg/kg/week) (group B). Both groups received ribavirin 11 mg/kg/day.
Groups were comparable for rate of naive, non responders and relapsers, for prevalence of genotype 1, for male/female ratio and for age of patients.
Genotype 1 patients were treated for 48 weeks, genotype 2 for 24 weeks. The follow-up period was 24 weeks.
End of treatment response was higher in group B for genotype 1 (58% vs 27%, p= 0.055). SVR was higher in group B for genotype 1 (46% vs 27%, p= 0.033).
Overall early response was higher in group B than group A (53% vs 27%, p= 0.044). Among naive patients SVR was higher in group B (72% vs 25%, p=0.024).
Total dropouts were 7 on 15 (32%) and 8 on 35 (19%) for group A and B respectively.
In a non selected population of patients with chronic hepatitis C, twice a week administration of PEG-Intron is more effective than once a week administration in genotype 1 naive patients.
Tolerability and adherence to treatment was higher for the twice a week group (B), probably because the twice a week administration is able to induce tachyphilaxis, producing a continuous drug exposure.
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