Treatment discontinuation with peg-interferon: what to consider

Area of Science:

• Hepatology
• Virology
• Clinical Medicine

Background:

• Chronic hepatitis C virus (HCV) infection impacts liver and extrahepatic diseases.
• Interferon-based regimens were the standard for HCV eradication.
• Predictors for sustained virological response (SVR) with interferon were identified.

Purpose of the Study:

• To review the utility of futility stopping rules in interferon-based hepatitis C treatment.
• To identify patients with a low likelihood of SVR who could potentially discontinue therapy.

Main Methods:

• Review of literature on interferon-based regimens for chronic hepatitis C.
• Analysis of baseline and on-treatment predictors of treatment response.
• Evaluation of the concept and application of futility stopping rules.

Main Results:

• Interferon-based therapies have established predictors of response.
• Futility stopping rules can identify patients unlikely to achieve SVR.
• Direct-acting antivirals have shifted treatment paradigms away from interferon.

Conclusions:

• Futility stopping rules are valuable for managing patients on interferon-containing regimens.
• Discontinuing therapy in non-responders can prevent unnecessary side effects and costs.
• The evolution to interferon-free therapies has changed the context for these rules.