Hassanein Tarek, Cooksley Graham, Sulkowski Mark, Smith Coleman, Marinos George, Lai Ming-Yang, Pastore Giuseppe, Trejo-Estrada Rafael, Horta E Vale Ana, Wintfeld Neil, Green Jesse
Department of Medicine, Division of Gastroenterology and Hepatology, University of California, San Diego, USA.
J Hepatol. 2004 Apr;40(4):675-81. doi: 10.1016/j.jhep.2003.12.014.
BACKGROUND/AIMS: Peginterferon alfa-2a plus ribavirin improves sustained virological responses compared with interferon alfa-2b and ribavirin, or peginterferon alfa-2a alone in chronic hepatitis C. We examined the impact of these treatments on health related quality of life (HRQOL).
Patients (n=1121) were randomized to peginterferon alfa-2a weekly plus ribavirin or placebo, or interferon alfa-2b thrice weekly plus ribavirin. HRQOL was assessed with the SF-36 Health Survey and Fatigue Severity Scale (FSS).
Patients receiving peginterferon alfa-2a plus ribavirin reported better HRQOL than those receiving interferon alfa-2b plus ribavirin. These differences were statistically significant for three SF-36 domains and both FSS scores (p<=0.05). Patients receiving peginterferon alfa-2a plus placebo had the least impairment; adding ribavirin significantly decreased five domains of the SF-36 and both FSS scores. Sustained virological response was associated with improvement at follow-up on all SF-36 and FSS scores.
The effects of combination therapy on HRQOL and fatigue are less with peginterferon alfa-2a plus ribavirin than interferon alfa-2b plus ribavirin. Each medication in combination therapy with interferon and ribavirin, affects patients' quality of life differently. Understanding the relationship of specific therapeutic options to HRQOL may help physicians minimize the impact of therapy on HRQOL.
背景/目的：与干扰素α-2b联合利巴韦林或单用聚乙二醇干扰素α-2a相比，聚乙二醇干扰素α-2a联合利巴韦林可提高慢性丙型肝炎的持续病毒学应答率。我们研究了这些治疗方法对健康相关生活质量（HRQOL）的影响。
将1121例患者随机分为聚乙二醇干扰素α-2a每周一次联合利巴韦林或安慰剂组，或干扰素α-2b每周三次联合利巴韦林组。采用SF-36健康调查和疲劳严重程度量表（FSS）评估HRQOL。
接受聚乙二醇干扰素α-2a联合利巴韦林治疗的患者报告的HRQOL优于接受干扰素α-2b联合利巴韦林治疗的患者。在SF-36的三个领域和两个FSS评分中，这些差异具有统计学意义（p≤0.05）。接受聚乙二醇干扰素α-2a联合安慰剂治疗的患者受损最小；加用利巴韦林显著降低了SF-36的五个领域和两个FSS评分。持续病毒学应答与随访时所有SF-36和FSS评分的改善相关。
聚乙二醇干扰素α-2a联合利巴韦林对HRQOL和疲劳的影响小于干扰素α-2b联合利巴韦林。干扰素和利巴韦林联合治疗中的每种药物对患者生活质量的影响不同。了解特定治疗方案与HRQOL的关系可能有助于医生将治疗对HRQOL的影响降至最低。
