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Second New Interferon Drug Combo Cures Hepatitis C

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Depression, fatigue, and flulike symptoms are common among people who take interferon therapy. And ribavirin causes birth defects, so both women and men must avoid conceiving a child while taking the drug. But even though she suffered from the treatment, Marichal is very happy.

"I would do it again -- being cured is the end result," she says.

Most hepatitis C patients in the U.S. are infected with a strain of hepatitis C called genotype 1 -- the hardest of all hepatitis C strains to cure. In the new Pegasys/ribavirin study, 46% of people infected with genotype 1 became hepatitis C negative and stayed that way. In the earlier PEG-Intron/ribavirin study, this occurred in 48% of genotype 1 patients.

The new study compared 453 patients taking Pegasys/ribavirin with 224 patients taking Pegasys alone (plus a fake injection to simulate combination therapy), and with 444 patients getting standard interferon/ribavirin treatment. Any patient not responding within 12 weeks was offered the chance to switch treatment. Among standard-treatment patients, 45% had a sustained response, while only 30% had sustained responses to Pegasys alone. The response, though, was 56% among patients on the new combination therapy.

One important study finding was that a majority of the patients who became hepatitis C negative did so early in the treatment. This gives doctors an early chance to see whether the drug combination is working -- and to switch treatments if it is not.

All of the patients in this and previous large-scale trials of PEG-interferon had never taken interferon before. But another important study reported here shows that the new drugs can work even in patients for whom standard daily-dose interferon/ribavirin therapy didn't work.

Ira M. Jacobson, MD, chief of the division of gastroenterology and hepatology at Weill Medical College of Cornell University in New York, reported combined results for patients who had failed standard interferon/ribavirin treatment and were taking one of two different doses of PEG-Intron/ribavirin.

Halfway through their 48 weeks of treatment, 35% of these difficult-to-treat patients were hepatitis C negative.

"These studies are important because they investigate possible new treatment options for patients with disease [that is resistant to treatment], in whom it is difficult to achieve a sustained response," Jacobson says.

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