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Dynamic tailoring of treatment durations improves efficiency of hepatitis C treatment with pegylated interferon and ribavirin

Lindh, M. ; Arnholm, B. ; Björkman, Per LU orcid ; Hellstrand, K. ; Lagging, M. ; Nilsson, S. ; Wahlberg, T. ; Wallmark, E. ; Weiland, O. and Wejstal, R. , et al. (2013) In Journal of Viral Hepatitis 20(4). p.82-89
Abstract
The treatment durations for hepatitis C are guided by the analysis of hepatitis C virus (HCV) RNA in blood at certain time points. This multicentre, randomized open label trial evaluated the utility and performance of individualized treatment durations guided by viral decline rates in 103 patients with HCV genotype 1 infection. Pegylated interferon 2a and ribavirin were given as standard of care (SOC) for 24, 48 or 72weeks or as dynamic treatment (DT) for 2472weeks. The DT duration was based on the time point when log HCV RNA would reach 0 log copies/mL, as estimated by the second-phase decline. The rate of sustained virologic response was 63% for SOC and 54% for DT, but this difference was not significant in multiple regression analysis... (More)
The treatment durations for hepatitis C are guided by the analysis of hepatitis C virus (HCV) RNA in blood at certain time points. This multicentre, randomized open label trial evaluated the utility and performance of individualized treatment durations guided by viral decline rates in 103 patients with HCV genotype 1 infection. Pegylated interferon 2a and ribavirin were given as standard of care (SOC) for 24, 48 or 72weeks or as dynamic treatment (DT) for 2472weeks. The DT duration was based on the time point when log HCV RNA would reach 0 log copies/mL, as estimated by the second-phase decline. The rate of sustained virologic response was 63% for SOC and 54% for DT, but this difference was not significant in multiple regression analysis taking predictive factors such as interleukin-28B genotypes, age and baseline viremia into account (P=0.45). The mean required treatment time per cured patient was 51weeks for DT as compared with 58weeks for SOC (P=0.22) when given per protocol (n=95) and was significantly shorter (42 vs 51weeks) among patients who achieved undetectable HCV RNA (P=0.01). We conclude that DT was feasible and increased efficiency. The estimated time point for 0 log viral copies/mL is a new and quantitative response variable, which may be used as a complement to the qualitative variable rapid virologic response. The outcome parameter treatment weeks per cured patient could become a useful tool for comparing treatment efficiency also in the era of directly acting antivirals. (Less)
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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
HCV, interferon, kinetics, ribavirin, therapy
in
Journal of Viral Hepatitis
volume
20
issue
4
pages
82 - 89
publisher
Wiley-Blackwell
external identifiers
  • wos:000316330000012
  • scopus:84875221731
ISSN
1365-2893
DOI
10.1111/jvh.12014
language
English
LU publication?
yes
id
942f6b31-0ba3-4754-81a0-4ee2ac496eeb (old id 3749688)
date added to LUP
2016-04-01 11:12:59
date last changed
2022-05-18 17:05:40
@article{942f6b31-0ba3-4754-81a0-4ee2ac496eeb,
  abstract     = {{The treatment durations for hepatitis C are guided by the analysis of hepatitis C virus (HCV) RNA in blood at certain time points. This multicentre, randomized open label trial evaluated the utility and performance of individualized treatment durations guided by viral decline rates in 103 patients with HCV genotype 1 infection. Pegylated interferon 2a and ribavirin were given as standard of care (SOC) for 24, 48 or 72weeks or as dynamic treatment (DT) for 2472weeks. The DT duration was based on the time point when log HCV RNA would reach 0 log copies/mL, as estimated by the second-phase decline. The rate of sustained virologic response was 63% for SOC and 54% for DT, but this difference was not significant in multiple regression analysis taking predictive factors such as interleukin-28B genotypes, age and baseline viremia into account (P=0.45). The mean required treatment time per cured patient was 51weeks for DT as compared with 58weeks for SOC (P=0.22) when given per protocol (n=95) and was significantly shorter (42 vs 51weeks) among patients who achieved undetectable HCV RNA (P=0.01). We conclude that DT was feasible and increased efficiency. The estimated time point for 0 log viral copies/mL is a new and quantitative response variable, which may be used as a complement to the qualitative variable rapid virologic response. The outcome parameter treatment weeks per cured patient could become a useful tool for comparing treatment efficiency also in the era of directly acting antivirals.}},
  author       = {{Lindh, M. and Arnholm, B. and Björkman, Per and Hellstrand, K. and Lagging, M. and Nilsson, S. and Wahlberg, T. and Wallmark, E. and Weiland, O. and Wejstal, R. and Westin, J. and Widell, Anders and Norkrans, G.}},
  issn         = {{1365-2893}},
  keywords     = {{HCV; interferon; kinetics; ribavirin; therapy}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{82--89}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Journal of Viral Hepatitis}},
  title        = {{Dynamic tailoring of treatment durations improves efficiency of hepatitis C treatment with pegylated interferon and ribavirin}},
  url          = {{http://dx.doi.org/10.1111/jvh.12014}},
  doi          = {{10.1111/jvh.12014}},
  volume       = {{20}},
  year         = {{2013}},
}