Retreatment of Hepatitis C with Consensus Interferon and Ribavirin After Nonresponse or Relapse to Pegylated Interferon and Ribavirin: A National VA Clinical Practice Study
| Autor: | Helen S. Yee, Summer Chapman, Hui Shen, Myrna L. Cozen, Kathryn Tortorice, Fran Cunningham, Alexander Monto, Sue Currie |
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| Rok vydání: | 2011 |
| Předmět: |
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medicine.medical_specialty Physiology Hepatitis C virus Interferon alpha-2 medicine.disease_cause Antiviral Agents Polyethylene Glycols chemistry.chemical_compound Recurrence Pegylated interferon Internal medicine Ribavirin Humans Medicine Veterans Affairs Retrospective Studies business.industry Gastroenterology Interferon-alpha virus diseases Hepatitis C Middle Aged Viral Load Hepatology medicine.disease Virology Recombinant Proteins United States digestive system diseases humanities United States Department of Veterans Affairs Treatment Outcome Tolerability chemistry Interferon Type I Retreatment Drug Therapy Combination Female business Pegylated Interferon Alfa medicine.drug |
| Zdroj: | Digestive Diseases and Sciences. 56:2439-2448 |
| ISSN: | 1573-2568 0163-2116 |
| Popis: | Studies of the retreatment with consensus interferon (CIFN) and ribavirin (RBV) of hepatitis C virus (HCV)-infected patients who failed prior pegylated interferon alfa/ribavirin (PEG-IFN/RBV) have found quite variable efficacy and tolerability of this therapy. As such, CIFN/RBV use and efficacy in clinical practice were evaluated within the Department of Veterans Affairs (VA), the largest national, integrated system for HCV care.The purpose of this study was to determine rates of sustained virologic response (SVR) and patterns of CIFN/RBV use in the VA. Methods included retrospective review of national VA data in HCV-infected patients who had previously failed≥12 weeks of PEG-IFN/RBV and were prescribed CIFN/RBV between October 1, 2003 and September 30, 2006.A total of 597 patients met the study criteria. CIFN was primarily dosed as 15 mcg subcutaneously daily combined with standard doses of RBV. Mean treatment duration was 21 weeks; CIFN was discontinued within 4 weeks in 24%. Hematological growth factors were used in 49%. Post-treatment viral loads were available in 385 patients. SVR to CIFN/RBV was achieved in 11%, and was significantly higher in prior PEG-IFN/RBV relapsers compared with nonresponders (31% vs. 6%, respectively; P0.0001). A 2-log10 or greater drop in HCV RNA after 24 weeks of PEG-IFN/RBV was a predictor of subsequent SVR to CIFN/RBV.CIFN/RBV was used frequently in clinical practice for retreatment of PEG-IFN/RBV. In this setting, early treatment discontinuation was common. Overall SVR was low, although response was significantly better in prior PEG-IFN/RBV relapsers and those who had a 2-log(10) or greater decline than in nonresponders. |
| Databáze: | OpenAIRE |
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