Tailored Interferon Therapy Based on Individual Response Produces Superior Results
in Chronic Hepatitis B Patients
By
Liz Highleyman  Interferon
(conventional and pegylated),
which stimulates the immune response, is one of the approved treatments for
chronic hepatitis B, used instead of, or in addition to, directly targeted
antiviral agents such as lamivudine (Epivir-HBV),
adefovir (Hepsera), entecavir
(Baraclude), and telbivudine (Tyzeka).
As
reported in the June 11, 2008 advance online edition of the Journal of Viral
Hepatitis, K. Luo from Nanfang Hospital in Guangzhou, China, and colleagues
conducted a study to assess whether individualized interferon therapy, rather
than a standard regimen, might improve treatment outcomes.
A control group
of 127 hepatitis B "e" antigen (HBeAg) positive patients received standard
therapy with 5 million units of conventional interferon alpha 3 times weekly for
6 months.
The experimental group, consisting of 247 patients, also received
the same dose of interferon, but treatment duration was individually tailored
based on response. The study protocol provided for continuation of treatment if
HBV DNA levels were continuously decreasing. Treatment ended when virological
(HBV DNA), antigenic (HBeAg positive or negative status), and biochemical (ALT
level) endpoints were reached, or when HBV DNA was no longer falling.
Results
•
The
median length of tailored treatment was 10 months (range 6-24 months).
•
The
end-of-treatment response rates were 39.3% in the tailored therapy group compared
with 23.6% in the standard duration control group (P = 0.002).
•
After
12-months of follow-up, the sustained response rates were 40.5% and 28.3%, respectively
(P = 0.013).
•
Excluding
patients who dropped out, 228 patients in the tailored therapy group and 115 in
the control group completed a median of about 40 months of follow-up.
•
Among
these patients, the long-term response rates were 45.3% and 33.1%, respectively
(P = 0.014).
Based
on these findings, the study authors concluded that, "Interferon-alpha
treatment tailored in length demonstrated significantly increased efficacy
in patients with chronic hepatitis B."
7/22/08
Reference
K
Luo, Q Mao, P Karayiannis, and others. Tailored regimen of interferon alpha for
HBeAg-positive chronic hepatitis B: a prospective controlled study. Journal
of Viral Hepatitis. June 11, 2008 [Epub ahead of print]. |
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FDA-approved
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