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Adherence to combination therapy enhances sustained response in genotype-1-infected patients with chronic hepatitis C.

Publication ,  Journal Article
McHutchison, JG; Manns, M; Patel, K; Poynard, T; Lindsay, KL; Trepo, C; Dienstag, J; Lee, WM; Mak, C; Garaud, J-J; Albrecht, JK ...
Published in: Gastroenterology
October 2002

BACKGROUND & AIMS: Patient adherence to prescribed antiviral therapy in human immunodeficiency virus infection enhances response. We evaluated the impact of adherence to combination therapy with interferon or peginterferon plus ribavirin in chronic hepatitis C patients. METHODS: We assessed the effect of dose reduction on sustained virologic response (SVR) from prior trials with interferon alpha-2b plus ribavirin (n = 1010) or peginterferon alpha-2b 1.5 microg/kg/week plus ribavirin (n = 511). The actual treatment administered was verified from drug dispensing/return records and patient diaries. Two groups were defined: (1) patients who received >or=80% of both their total interferon and ribavirin doses for >or=80% of the expected duration of therapy and (2) patients who received reduced doses (<80% of one or both drugs for >or=80% of the expected duration of therapy). A statistical model provided comparative estimates of the response rates in compliant patients. RESULTS: Most patients were at least 80% compliant with interferon alpha-2b/ribavirin or peginterferon alpha-2b/ribavirin therapy and had SVR rates of 52% and 63%, respectively, for the 2 regimens. This was most apparent for HCV-1-infected patients. The impacts of adherence on efficacy from subgroup analysis and the statistical modeling approach were similar. CONCLUSIONS: HCV-1-infected patients who can be maintained on >80% of their interferon or peginterferon alpha-2b and ribavirin dosage for the duration of treatment in the setting of a clinical trial exhibit enhanced sustained response rates. Our results suggest that adherence will enhance the likelihood of achieving an initial virologic response. Adherence beyond 12-24 weeks will be advantageous only for those patients who have achieved such an early virologic response.

Duke Scholars

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Published In

Gastroenterology

DOI

ISSN

0016-5085

Publication Date

October 2002

Volume

123

Issue

4

Start / End Page

1061 / 1069

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Ribavirin
  • Retrospective Studies
  • Recombinant Proteins
  • Polyethylene Glycols
  • Middle Aged
  • Male
  • Interferons
  • Interferon-alpha
  • Interferon alpha-2
 

Citation

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McHutchison, J. G., Manns, M., Patel, K., Poynard, T., Lindsay, K. L., Trepo, C., … International Hepatitis Interventional Therapy Group, . (2002). Adherence to combination therapy enhances sustained response in genotype-1-infected patients with chronic hepatitis C. Gastroenterology, 123(4), 1061–1069. https://doi.org/10.1053/gast.2002.35950
McHutchison, John G., Michael Manns, Keyur Patel, Thierry Poynard, Karen L. Lindsay, Christian Trepo, Jules Dienstag, et al. “Adherence to combination therapy enhances sustained response in genotype-1-infected patients with chronic hepatitis C.Gastroenterology 123, no. 4 (October 2002): 1061–69. https://doi.org/10.1053/gast.2002.35950.
McHutchison JG, Manns M, Patel K, Poynard T, Lindsay KL, Trepo C, et al. Adherence to combination therapy enhances sustained response in genotype-1-infected patients with chronic hepatitis C. Gastroenterology. 2002 Oct;123(4):1061–9.
McHutchison, John G., et al. “Adherence to combination therapy enhances sustained response in genotype-1-infected patients with chronic hepatitis C.Gastroenterology, vol. 123, no. 4, Oct. 2002, pp. 1061–69. Pubmed, doi:10.1053/gast.2002.35950.
McHutchison JG, Manns M, Patel K, Poynard T, Lindsay KL, Trepo C, Dienstag J, Lee WM, Mak C, Garaud J-J, Albrecht JK, International Hepatitis Interventional Therapy Group. Adherence to combination therapy enhances sustained response in genotype-1-infected patients with chronic hepatitis C. Gastroenterology. 2002 Oct;123(4):1061–1069.
Journal cover image

Published In

Gastroenterology

DOI

ISSN

0016-5085

Publication Date

October 2002

Volume

123

Issue

4

Start / End Page

1061 / 1069

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Ribavirin
  • Retrospective Studies
  • Recombinant Proteins
  • Polyethylene Glycols
  • Middle Aged
  • Male
  • Interferons
  • Interferon-alpha
  • Interferon alpha-2