Abstract
The efficacy of various regimens using interferon-α (IFN-α) in the treatment of hepatitis C virus (HCV) infection was analyzed in a meta-analysis of 33 randomized clinical trials (RCTs). The results of the meta-analysis showed increased complete and sustained ALT response rates in patients receiving IFN 3 MU three times a week for six months compared with patients receiving placebo or no treatment. The dose effect (6 MU three times a week versus 3 MU three times a week) on complete ALT response rate at the end of treatment was significant, with a mean 10% improvement at both six and 12 months. There also was a significant dose effect on sustained response for 12 months treatment, with a mean 17% improvement. There was a significant treatment duration effect on sustained response rate at 3 MU three times a week and 6 MU three times a week, with a mean improvement of 16% (≥12 months vs six months) with 3 MU three times a week. Due to adverse events, we conclude that the best efficacy-risk ratio favors IFN treatment with 3 MU three times a week for at least 12 months. The results of our RCT comparing three IFN regimens showed that patients receiving 3 MU three times a week for up to 18 months exhibited significant improvements in histological activity score, normalization of serum ALT concentrations, and sustained response compared with patients receiving a lower dose or shorter duration of treatment with IFN. Together, these results support the conduct of another RCT to evaluate the hypothesis that long-term, continuous IFN treatment may significantly reduce the incidence of cirrhosis in patients with HCV infection.
Similar content being viewed by others
References
Poynard T, Bedossa P, Chevallier M, Mathurin P, Lemonnier C, Trepo C, Couzigou P, Payeu JL, Sajus M, Costa JM, Vidaud M, Chaput JC and the Multicenter Study Group: A comparison of three interferon alfa-2b regimens for the long-term treatment of chronic non-A, non-B hepatitis. N Engl J Med 332:1457–1462, 1995
Poynard T, Leroy V, Cohard M, Thevenot T, Mathurin P, Opolon P, Zarski JP: Meta-analysis of interferon randomized trials in the treatment of viral hepatitis C. Effects of dose and duration. Hepatology 24:778–789, 1996
Peto R, Collins R, Gray R: Large-scale randomized evidence: large, simple trials and overviews of trials. J Clin Epidemiol 48:23–40, 1991
DerSimonian R, Laird N: Meta-analysis in clinical trials. Control Clin Trials 7:177–188, 1986
Chemello L, Bonetti P, Cavalletto L, Talato F, Donadon V, Casarin P, Belussi F, Frezza M, Noventa F, Pontisso P, Benvegnù L, Casarin C, Alberti A, and the TriVeneto Viral Hepatitis Group: Randomized trial comparing three different regimens of alpha-2a interferon in chronic hepatitis C. Hepatology 22:700–706, 1995
Kasahara A, Hayashi N, Hiramatsu N, Oshita M, Hagiwara H, Katayama K, Kato M, Masazawa M, Yoshihara H, Kishida Y, Shimizu Y, Inoue A, Fusamoto H, Kamada T: Ability of prolonged interferon treatment to suppress relapse after cessation of therapy in patients with chronic hepatitis C: A multicenter randomized controlled trial. Hepatology 21:291–297, 1995
Jouët P, Roudot-Thoraval F, Dhumeaux D, Métreau J-M, and le groupe français pour l'étude du traitement des hépatities chroniques NANB/C: Comparative efficacy of interferon alfa in cirrhotic and noncirrhotic patients with non-A, non-B, C hepatitis. Gastroenterology 106:686–690, 1994
Saracco G, Rosina F, Abate ML, Chiandussi L, Gallo V, Cerutti E, Di Napoli A, Solinas A, Deplano A, Tocco A, Cossu P, Chien D, Kuo G, Polito A, Weiner AJ, Houghton MJ, Verme G, Bonino F, Rizzetto M: Long-term follow-up of patients with chronic hepatitis C treated with different doses of interferon-α2b. Hepatology 18:1300–1305, 1993
Lin R, Roach E, Zimmerman M, Strasser S, Farrell GC, for the Australian Hepatitis C Study Group: Interferon alfa-2b for chronic hepatitis C: Effects of dose increment and duration of treatment on response rates. Results of the first multicentre Australian trial. J Hepatol 23:487–496, 1995
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Poynard, T., Leroy, V., Mathurin, P. et al. Treatment of chronic hepatitis C by interferon for longer duration than six months. Digest Dis Sci 41 (Suppl 12), 99S–102S (1996). https://doi.org/10.1007/BF02087883
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02087883