Clinical trial: Interferon alpha-2b continuous long-term therapy vs. repeated 24-week cycles for re-treating chronic hepatitis C

J. G. McHutchison, K. Patel, E. R. Schiff, N. Gitlin, R. E. Mur, G. T. Everson, R. L. Carithers, G. L. Davis, P. Marcellin, M. L. Shiffman, J. Harvey, J. K. Albrecht

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

Background: Treatment options are limited for patients with hepatitis C virus who do not experience sustained viral eradication with pegylated interferon and ribavirin therapy. Aim: To compare, in an open-label, randomized study, long-term continuous interferon alpha-2b treatment with repeated 24-week courses in patients with chronic hepatitis C virus that relapsed after prior interferon monotherapy. Methods: A total of 499 patients received 24 weeks of interferon alpha-2b, 3 MIU administered 3 TIW. Responders (normal alanine aminotransferase and negative hepatitis C virus -RNA, n = 244) were then randomized to continuous interferon therapy (1, 2 or 3 MIU TIW depending on response) or cyclical therapy (3 MIU TIW for 24 weeks per relapse). Mean Knodell inflammation (I + II + III) and necrosis (IV) scores at baseline vs. year 2 were compared. Results: Patients receiving continuous low-dose therapy vs. cycled therapy had larger reductions in inflammation (-3.9 vs. -3.1) and fibrosis (-0.49 vs. -0.24). Among both groups, the mean change was -3.4 for inflammation and -0.36 for fibrosis. Overall, 73% (95% CI: 67-79) of patients experienced reduced inflammation and 28% (95% CI: 22-34) had reduced fibrosis. Conclusions: Our results suggest hepatitis C virus patients experiencing viral suppression during long-term maintenance therapy with interferon demonstrate histological improvement. Further prospective trials testing this hypothesis are in progress.

Original languageEnglish (US)
Pages (from-to)422-432
Number of pages11
JournalAlimentary Pharmacology and Therapeutics
Volume27
Issue number5
DOIs
StatePublished - Mar 1 2008

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology
  • Pharmacology (medical)

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    McHutchison, J. G., Patel, K., Schiff, E. R., Gitlin, N., Mur, R. E., Everson, G. T., Carithers, R. L., Davis, G. L., Marcellin, P., Shiffman, M. L., Harvey, J., & Albrecht, J. K. (2008). Clinical trial: Interferon alpha-2b continuous long-term therapy vs. repeated 24-week cycles for re-treating chronic hepatitis C. Alimentary Pharmacology and Therapeutics, 27(5), 422-432. https://doi.org/10.1111/j.1365-2036.2007.03590.x