Source: Cancer Epidemiol Biomarkers Prev  |  Posted 10 years ago

Patients with hepatitis C who do not respond to standard doses of conventional interferon might benefit from higher doses plus ribavirin.

This combination was well tolerated among patients in a pilot study reported by specialists at the University of Texas Southwestern Medical Center, Dallas, Texas, United States. They pointed out that conventional interferon monotherapy fails to achieve virological clearance in most patients infected by hepatitis C.

However, the specialists conjectured, high-dose induction regimens might improve the initial clearance of virus. Also ribavirin might improve sustained response rates once clearance was achieved.

The specialists recruited 25 chronic hepatitis C patients who had not responded to standard dose interferon monotherapy. The study compared the efficacy and safety of re-treatment with an induction regimen of high-dose interferon alpha-2b either alone or with ribavirin.

Previous virological non-responders to standard dose interferon (3-5 MU three times weekly for 12 weeks) were randomised to receive one of two open-label regimens for 36 weeks.

Ten patients (Group A) received interferon alpha-2b 10 MU daily for 10 days followed by 5 MU daily for 74 days and then 5 MU three times weekly for 24 weeks. A further 15 patients (Group B) received the same regimen plus ribavirin 1000-1200 mg/day at day 11. All 25 patients were followed up for 24 weeks.

At the end of treatment, virological response was noted in one group A patient and in eight Group B patients. The sole responder in group A and three in group B relapsed on follow-up.

The apparent difference between the groups, with a 33 percent sustained response rate in Group B compared with none in Group A, nearly reached statistical significance.