Sept. 25, 2002 -- A new combination drug therapy may be able to help people with even some of the most difficult-to-treat forms of hepatitis C manage their disease and prevent complications.
A study shows that the combination of a new, longer-acting form of interferon, Pegasys, and Rebetol works better in treating chronic hepatitis C than the current standard of treatment (Intron A and Rebetol) and has fewer side effects.
The new therapy was also more effective in stimulating a positive response in patients considered to have the most treatment-resistant disease -- those with particular types of hepatitis virus and those with large amounts of virus in the blood.
Hepatitis C virus (HCV) is the most common blood-borne infection in the U.S., and the chronic form of the condition affects about 4 million Americans. The virus is usually spread through contact with infected blood, and transmission through sexual intercourse is rare.
Hepatitis C is considered the most serious of the five forms of the hepatitis virus, which attack the liver. Nearly three-fourths of those infected with hepatitis C will go on to develop liver failure.
Although some interferon-based therapies for hepatitis C are effective in managing the disease for many people, a large number of HCV-infected people do not respond to these treatments and have a more resistant form of the virus.
For the study, published in the Sept. 26 issue of The New England Journal of Medicine, researchers randomly assigned more than 1,000 patients with chronic HCV to receive one of the following therapies for 48 weeks: weekly Pegasys plus daily Rebetol, weekly Pegasys plus placebo, Intron A three times a week plus daily Rebetol.
The study showed that Pegasys plus Rebetol worked in more patients (56%) than Pegasys alone (29%) or Intron A plus Rebetol (44%).
Also, fewer side effects, such as flu-like symptoms and depression, were reported among those on the new combination therapy.
Study researcher Michael W. Fried, MD, of the University of North Carolina in Chapel Hill, and colleagues say 97% of the patients who responded to the new therapy showed a response by week 12. That might make it easier for doctors to tell if the therapy will work in an individual early on in the treatment and to discuss with the patient whether they should continue taking the therapy.
Pegasys is not yet FDA-approved, but a similar brand of interferon, PEG-Intron, is.