Kuboki Makoto, Iino Shiro, Okuno Tadao, Omata Masao, Kiyosawa Kendo, Kumada Hiromitsu, Hayashi Norio, Sakai Takahiro
Division of Hepatology, Kawasaki Medical School, Okayama, Japan.
J Gastroenterol Hepatol. 2007 May;22(5):645-52. doi: 10.1111/j.1440-1746.2007.04834.x.
The efficacy and safety of peginterferon alpha-2a (40 KD) (peg-IFNalpha-2a) plus ribavirin has not been reported for Japanese patients with chronic hepatitis C. The aim of this study was to evaluate this combination in treatment-naïve patients and in non-responders or relapsers to interferon monotherapy.
Overall, 201 treatment-naïve patients with hepatitis C virus (HCV) genotype-1b were randomly assigned to 180 microg peg-IFNalpha-2a once-weekly plus ribavirin 600-1000 mg/day or peg-IFNalpha-2a plus placebo for 48 weeks. Additionally, peg-IFNalpha-2a plus ribavirin was administered for 48 weeks to 100 non-responders or relapsers (85% genotype-1) to previous interferon monotherapy.
A sustained virological response (SVR) was attained among significantly more treatment-naïve patients receiving combination therapy than monotherapy (61% vs 26%, P < 0.001). For patients with high baseline HCV RNA, the SVR rate was 59% with peg-IFNalpha-2a plus ribavirin versus 24% with peg-IFNalpha-2a monotherapy. Among non-responders or relapsers to previous interferon monotherapy, 54% attained an SVR. Adverse events were generally mild, and discontinuations rates due to adverse events or laboratory abnormalities were low.
In Japanese patients, peg-IFNalpha-2a plus ribavirin provided significant improvement in SVR rates compared with peg-IFNalpha-2a alone in treatment-naïve patients, and was effective as re-treatment for non-responders or relapsers to previous treatment with interferon monotherapy.
聚乙二醇干扰素α-2a(40KD)(peg-IFNα-2a)联合利巴韦林用于日本慢性丙型肝炎患者的疗效和安全性尚未见报道。本研究旨在评估该联合疗法在初治患者以及干扰素单药治疗无应答者或复发者中的效果。
总共201例初治的丙型肝炎病毒(HCV)基因1b型患者被随机分为两组,一组接受每周一次180μg的peg-IFNα-2a联合每日600 - 1000mg利巴韦林治疗,另一组接受peg-IFNα-2a联合安慰剂治疗,疗程均为48周。此外,100例既往干扰素单药治疗无应答者或复发者(85%为基因1型)接受peg-IFNα-2a联合利巴韦林治疗48周。
接受联合治疗的初治患者中获得持续病毒学应答(SVR)的比例显著高于接受单药治疗的患者(61%对26%,P < 0.001)。对于基线HCV RNA水平高的患者,peg-IFNα-2a联合利巴韦林的SVR率为59%,而peg-IFNα-2a单药治疗的SVR率为24%。在既往干扰素单药治疗无应答者或复发者中,54%获得了SVR。不良事件一般较轻,因不良事件或实验室异常导致的停药率较低。
在日本患者中,与单独使用peg-IFNα-2a相比,peg-IFNα-2a联合利巴韦林在初治患者中显著提高了SVR率,并且对既往干扰素单药治疗无应答者或复发者再次治疗有效。