Low- and standard-dose peginterferon alfa-2a for chronic hepatitis C, genotype 2 or 3: efficacy, tolerability, viral kinetics and cytokine response
Article first published online: 16 FEB 2010
Published 2010. This article is a US Government work and is in the public domain in the USA
Alimentary Pharmacology & Therapeutics
Volume 31, Issue 9, pages 1018–1027, May 2010
How to Cite
ROTMAN, Y., BORG, B. B., SOZA, A., FELD, J. J., MODI, A. A., LOOMBA, R., LUTCHMAN, G., RIVERA, E., DOO, E., GHANY, M. G., HELLER, T., NEUMANN, A. U., LIANG, T. J. and HOOFNAGLE, J. H. (2010), Low- and standard-dose peginterferon alfa-2a for chronic hepatitis C, genotype 2 or 3: efficacy, tolerability, viral kinetics and cytokine response. Alimentary Pharmacology & Therapeutics, 31: 1018–1027. doi: 10.1111/j.1365-2036.2010.04263.x
- Issue published online: 5 APR 2010
- Article first published online: 16 FEB 2010
- Publication data Submitted 21 July 2009 First decision 1 August 2009 Resubmitted 8 February 2010 Accepted 9 February 2010 Epub Accepted Article 16 February 2010
Aliment Pharmacol Ther 31, 1018–1027
Background Chronic infection with hepatitis C, genotype 2/3, responds better than other genotypes to peginterferon and ribavirin treatment. We hypothesized that a lower dose of peginterferon would be as effective, but less toxic than standard doses.
Aim To test the hypothesis that a lower dose of peginterferon would be as effective as, but less toxic than, standard doses.
Methods A total of 30 patients were treated with low-dose peginterferon alfa-2a (90 μg/week) and 27 patients with standard doses (180 μg/week) for 24 weeks in combination with 800 mg/day of ribavirin. Patients who failed treatment were offered 48 weeks of standard-dose treatment. Viral and serum inducible protein 10 (IP-10) levels were measured and early viral kinetic parameters were calculated.
Results Sustained virological response was achieved in 68% of the low-dose and 87% of the standard-dose patients (per protocol, P = 0.79 for non-inferiority). Re-treatment was successful in all patients who tolerated full dose and duration. The standard-dose group had greater first-phase declines of viral levels and faster time to negativity. The second-phase slope was not dose-dependent. IP-10 induction was significantly greater with the standard dose. Although fatigue and general feeling during treatment were worse for standard dose, haematological toxicity and depression did not differ between groups.
Conclusion A lower dose of peginterferon is associated with some symptomatic benefit, but the response is not equivalent to standard dosing.