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Interferon / Ribavirin Combination therapy for chronic hepatitis
C
Following preliminary reports of small studies that suggested a
clinically important enhanced benefit from combination therapy with
interferon-a (IFN) and ribavirin over IFN monotherapy in chronic
hepatitis C, a meta-analysis of data from these studies was
performed to estimate the efficacy and tolerability of combination
therapy in chronic hepatitis C. Records were obtained from 59
patients who had received combination therapy with IFN 3 MU three
times weekly and ribavirin 1000-1200 mg daily for six months and
were followed for six months after stopping combination
therapy.
Outcome measures included the percentage of patients showing ALT
normalization and HCV-RNA negativity six months after therapy
(sustained response) and the percentage of patients stopping
therapy because of side effects. Sustained response was observed in
21% of IFN nonresponders and in 60% of patients who had relapsed
after IFN. For naive patients, the estimated sustained response
rate was 52%; the observed response rate was 46%. No serious
adverse effects were noted; less than 10% of patients discontinued
study medication. This meta-analysis of IFN-ribavirin combination
therapy for chronic hepatitis C suggests that combination therapy
results in a two- to threefold greater efficacy than IFN
monotherapy, whereas side effects are similar to IFN monotherapy,
with the exception of ribavirin-induced anemia.
Interferon-ribavirin combination therapy might become the next step
in antiviral therapy for chronic hepatitis C.
Author: Schlam SW, Erasmus University Rotterdam, Hosp.
Dijkzigt, Dept. Internal Med. 2, Hepatology Section, NL-3015 GD
Rotterdam, Netherlands
Source: DIGESTIVE DISEASES AND SCIENCES 1996 DEC;41(12):S 131-S
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