Hepatitis C: Less Treatment OK for Some
Study Shows Successful Outcomes for Patients Who Quit Drug Therapy Early
Genotype and HCV Outcomes continued...
Patients who did not achieve viral responses until week 12 of treatment needed 72 weeks of therapy for a similar cure rate. When these patients received standard duration treatment of 48 weeks, just 38% achieved sustained viral responses.
"We found that approximately a quarter of HCV genotype 1 patients may be cured by therapy in only 24 weeks, and that a [comparable number] may require extended treatment to 72 weeks," the researchers wrote.
The Norway study involved 302 HCV patients with genotypes 2 and 3 who achieved early viral responses with treatment. Half the patients were treated for a total of 12 weeks and the other half received the standard HCV genotype 2 and genotype 3 course of 24 weeks.
In all, 81% of the patients in the shorter-treatment group achieved sustained viral responses, compared to 91% in the longer-treatment arm of the study.
Customizing HCV Treatment
Both studies suggest that customizing treatment length based on early therapeutic responses could improve patient cure rates.
University of North Carolina hepatitis C expert Michael W. Fried, MD, agrees, but he adds that more research is needed to better understand how to best tailor treatments based on patient responses.
He points out that response rates were slightly better among early responders treated for the recommended times in both studies.
Fried is a professor of medicine and director of hepatology at the University of North Carolina at Chapel Hill.
"Response rates were similar, but they were not identical," he says. "There was still about a 10% drop in sustained responses among patients treated for shorter periods."
Fried says the findings may have the biggest implications for patients who respond to treatment but have trouble staying on it.
"People who are not tolerating treatment well or who may be anxious to stop may be able to stop early without too much risk," he says.