News: 24 Weeks of Peg-Interferon/Ribavirin Best for Treating HCV Genotypes 2 and 3

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Thomas Wagner - 18 Jul 2007 17:51 GMT

NEW YORK (Reuters Health) Jul 11 - In patients infected with hepatitis C
virus (HCV) genotype 2 or 3, the standard 24-week course of
peg-interferon alfa-2a and ribavirin produces a greater overall
sustained virologic response rate than a shortened 16-week course.

[...]"The sustained virologic response rate was significantly lower in
patients treated for 16 weeks than in patients treated for 24 weeks (62%
versus 70%)," the study team reports in the July 12 issue of The New
England Journal of Medicine.

[...] However, Dr. Shiffman noted, reducing the duration of treatment is
associated with a higher relapse rate - 31% in the 16-week treatment arm
versus 18% in the 24-week treatment arm.

Thus, it's Dr. Shiffman's opinion that "if patients with genotypes 2 or
3 are tolerating HCV treatment well, they will do the best if they
complete 24 weeks of treatment and should not be eager to reduce the
duration of therapy."

Full text at http://www.medscape.com/viewarticle/559651

Thomas

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Paul - 19 Jul 2007 05:54 GMT

On Wed, 18 Jul 2007 12:51:27 -0400, Thomas Wagner <tomw@capecod.com>,

>[...]"The sustained virologic response rate was significantly lower in
>patients treated for 16 weeks than in patients treated for 24 weeks (62%
[quoted text clipped - 9 lines]
>complete 24 weeks of treatment and should not be eager to reduce the
>duration of therapy."

With stats like that it's got to be 24 weeks really hasn't it?
I bet some of the more penny pinching managers of our National Health
Service will be disappointed though.

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greyhackles - 19 Jul 2007 14:36 GMT

>On Wed, 18 Jul 2007 12:51:27 -0400, Thomas Wagner <tomw@capecod.com>,
>
[quoted text clipped - 15 lines]
>I bet some of the more penny pinching managers of our National Health
>Service will be disappointed though.

To be fair, along with reducing the cost of therapy, another goal of these and
similar studies has been to determine the optimal duration of therapy to
achieve success while reducing "collateral damage" to the patient.

It is clear, however, from this and earlier studies, that somewhere between 5
and 10% of g2/g3s would fail to achieve a durable SVR with reduced duration of
treatment. That's significant enough to keep the shorter-term advocates at
bay.

Imo, eventually, the whole notion of "standardized treatment" will be cast
aside in favor of a strategy that uses a much higher level of monitoring to
tune both dosing and duration on a per-patient basis. The enabler will be a
low-cost highly sensitive viral load test...

Cheers

/greyhackles

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Paul - 19 Jul 2007 18:52 GMT

On Thu, 19 Jul 2007 09:36:24 -0400, greyhackles
<greyhackles@NOSPAMyahoo.com>, in message ID
<flpu93525brldb2ski4ckmn7iq5ejqva59@4ax.com>, in the newsgroup
alt.support.hepatitis-c wrote:

>>On Wed, 18 Jul 2007 12:51:27 -0400, Thomas Wagner <tomw@capecod.com>,
>>
[quoted text clipped - 19 lines]
>similar studies has been to determine the optimal duration of therapy to
>achieve success while reducing "collateral damage" to the patient.

Of course you are right about the collateral damage issue Greyhackles.
I'm afraid I still have a bee in my bonnet about the way my late
friend was treated and tend to be a bit scathing about healthcare
professionals - sometimes unfairly. I'll get over it but it will take
more time.

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