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Weekly Pegylated Interferon α-2b vs daily Interferon a-2b versus standard regimen of Interferon a-2b in the treatment of patients with chronic hepatitis C virus infection

par Horsmans, Y.;Colle, Isabelle;Van Vlierberghe, Hans;Langlet, Philippe ;Adler, Michael ;Bourgeois, Nadine ;Brenard, Réginald;Michielsen, Peter;Goossens, Ann;Bruckers, Liesbeth
Référence Acta gastro-enterologica Belgica (Ed. multilingue), 71, 3, page (293-297)
Publication Publié, 2008-07

Article révisé par les pairs

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Résumé :

Background and study aims: The combination of Pegylated (PEG)interferon 2b and ribavirin is considered to be the standard treatment for naïve chronic hepatitis C patients. Study aims are to evaluate the differences between standard interferon and PEG-interferon by conducting a multi-centre, controlled randomized trial comparing 3 groups. Group A: daily interferon alfa-2b at a dose of 4 MIU + ribavirin, Group B: PEG-interferon alfa-2b at a dose of 100 mcg/week + ribavirin; Group C: interferon alfa-2b at a dose of 3 MIU TIW + ribavirin. Patients and methods: Multicentrer, open label study including naïve chronic Hepatitis C Virus patients randomised in three groups with a ratio of 2:2:1. Group A: daily interferon α-2b (4 MIU s.c. for patients >65 kg or 0.06 MIU/kg < 65 kg) and ribavirin, group B: PEG-interferon α-2b (100 μg s.c. weekly for patients > 65 kg or 1.5 μg/kg weekly for patients < 65 kg) and ribavirin and group C (reference arm): interferon α-2b (3MIU s.c. TWI) and ribavirin. The duration of the treatment was 48 weeks for all 3 groups, with a 6 month follow-up period. 336 patients were enrolled in the study and included in the intention-to-treat analysis; 78 never started treatment (35 in group A, 28 in group B and 15 in group C): 101 in group A, 98 in group B and 59 in group C. Results: Demographic data, PCR results and reasons for early withdrawal have been statistically analysed. At baseline, the 3 groups did not show any statistical difference regarding age, gender, race, genotypes and METAVIIR score. At week 24 on treatment, HCV ribonucleic acid RNA was undetectable in 87% in group A, in 79% in group B and in 69% in group C. At the end of treatment, 73% 74% and 58% respectively, had a negative PCR result. At week 24 of follow-up, these results were 71%, 64% and 48%, respectively. When comparing the efficacy of the daily interferon (+ ribavirin) and the PEG-interferon (+ ribavirin) regimen, no statistical difference was found (p = 0.32). In group A, 38% of drop-outs were due to adverse events compared to 37% in group B and 58% in group C. No statistical differences were observed regarding safety. Conclusion: Daily weight based interferon α-2b dosing and PEG interferon α-2b weighed based dosing once weekly both in combination with Ribavirin offer the same efficacy and safety rates.