Long-Term Peginterferon Shows Promise Against Hepatitis B in Pilot Study

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Long-Term Peginterferon Shows Promise Against Hepatitis B in Pilot Study

NEW YORK (Reuters Health) Dec 21 - Sixty weeks of treatment with pegylated
interferon alfa-2a appears to produce a higher rate of sustained virologic
response in patients with hepatitis B e antigen (HBeAg)-negative chronic
hepatitis B than that usually achieved with the standard treatment duration of
48 weeks. The study is reported in the December issue of the American Journal
of Gastroenterology.

There is a high rate of relapse when conventional interferon or peginterferon
are given for 48 weeks, but higher rates of lasting response have been seen
when conventional interferon is given for 2 years, note Dr. Robert Perrillo at
Baylor University Medical Center in Dallas Texas, and colleagues.

The researchers therefore undertook a pilot study with 13 patients to evaluate
the virologic effectiveness of a 60-week course of treatment with
peginterferon. They also explored the effectiveness of combination therapy
using lamivudine.

The primary end point was sustained virologic response, which was defined as
hepatitis B virus DNA less than 20,000 copies/mL and a decrease from baseline
in HBV DNA of at least 2 log copies/mL.

Seven of the 13 patients were randomized to receive peginterferon alfa-2a only
for 60 weeks, and the other six received the same course of peginterferon,
plus lamivudine from weeks 13 through 60. All 13 patients were followed for at
least 24 weeks post-treatment.

By the end of treatment, only one patient in each group had not achieved a
sustained virologic response. As of the end of the follow-up period (week 84),
5 of 7 (71%) treated with peginterferon monotherapy and 3 of 6 (50%) treated
with the combination therapy met the criteria for a sustained virologic
response.

The overall 62% sustained virologic response rate in this study compares with
a response rate of 42% seen in a recent similar trial of a 48-week regimen,
Dr. Perrillo and colleagues point out.

They call for larger randomized, controlled trials to study the effectiveness
of peginterferon against HBeAg-negative chronic hepatitis B, with
post-treatment follow-up of up to 5 years.

Am J Gastroenterol 2007;102:2718-2723

http://www.medscape.com/viewarticle/567871?src=mp

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