Related Experiment Videos
Chronic hepatitis C: treatment comparison between 3 and 5 million units of interferon alpha-2b
F Castro1, E A Torres, J Oharriz
1Department of Medicine, School of Public Health, University of Puerto Rico, San Juan, PR 00936-0350.
Abstract:
Interferon (IFN) is the only drug that has been approved by the FDA for therapy of chronic hepatitis C. However, optimal dose and duration of therapy are still controversial. This study compares the effectiveness of treatment of chronic hepatitis C patients with 3 vs. 5 million units (MU) of recombinant alpha-interferon 2-b three times per week. We also evaluated the relapse rate with a shorter 12 week-course of therapy in those patients who had normalization of aminotransferases by week 12. Seventy-five patients were randomized to receive either 3 vs. 5 MU of IFN; seventy-two completed the study. A complete response was seen in 11/35 (31%) of those treated with 5 MU vs. 13/37 (35%) in the 3 MU dose (p = 0.74). Patients were followed after IFN was withdrawn and only 2 had persistently normal aminotransferases. Analysis of multiple variables was done to predict response to IFN and only elevations of GGT, ferritin and alkaline phosphatase were found to be predictors of a poor response. Therefore, we recommend initial therapy with 3 MU of IFN for a longer period than 12 weeks in patients who show a response.
Insights
This study found no significant difference in treatment effectiveness between 3 and 5 million units of interferon (IFN) for chronic hepatitis C. Longer therapy duration beyond 12 weeks is recommended for patients showing initial response to IFN.
Area of Science:
- Hepatology
- Virology
- Pharmacology
Background:
- Interferon (IFN) is the sole FDA-approved drug for chronic hepatitis C.
- Optimal dosage and duration of IFN therapy remain subjects of debate.
Purpose of the Study:
- To compare the efficacy of 3 vs. 5 million units (MU) of recombinant alpha-interferon 2-b in treating chronic hepatitis C.
- To evaluate the relapse rate after a 12-week course of IFN therapy in patients with normalized aminotransferases.
Main Methods:
- Seventy-five patients with chronic hepatitis C were randomized to receive either 3 MU or 5 MU of IFN three times weekly.
- Patients were monitored for response and relapse after treatment cessation.
Main Results:
- Complete response rates were similar: 31% (5 MU) vs. 35% (3 MU) (p = 0.74).
- Only 2 patients maintained normal aminotransferases post-treatment.
- Elevated GGT, ferritin, and alkaline phosphatase predicted a poor response to IFN therapy.
Conclusions:
- A lower dose of 3 MU of IFN may be as effective as 5 MU for chronic hepatitis C.
- A treatment duration longer than 12 weeks is advisable for patients responding to IFN.
- Predictors of poor response include elevated GGT, ferritin, and alkaline phosphatase levels.