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Higher Doses of Hepatitis C Drugs Improve Outcomes

But higher doses are less well-tolerated

TUESDAY, Sept. 30 (HealthDay News) -- Higher doses of peginterferon alfa-2a and ribavirin can improve the virologic response and relapse rate in difficult-to-treat patients with chronic hepatitis C virus (HCV) infection, although the higher doses are less well-tolerated by patients, according to study findings published in the October issue of Hepatology.

Michael W. Fried, M.D., from the University of North Carolina in Chapel Hill, and colleagues randomly assigned 188 patients with chronic HCV infection (genotype 1, HCV RNA over 800,000 IU/mL, and body weight over 85 kg) to 180 μg/week peginterferon alfa-2a plus 1,200 or 1,600 mg/day ribavirin, or 270 μg/week peginterferon alfa-2a plus 1,200 or 1,600 mg/day ribavirin for 48 weeks.

The researchers found that patients receiving the higher dose of peginterferon alfa-2a and ribavirin had the highest rates of sustained virologic response at week 72 (47 percent, HCV RNA less than 50 IU/mL) and the lowest relapse rate between weeks 48-72 (19 percent). This was significantly better than the group receiving the lower dose of both drugs. However, the higher dose of both drugs was less well-tolerated, the authors note.

"Higher fixed doses of peginterferon alfa-2a (270 μg/week) and ribavirin (1,600 mg/day) may increase sustained virologic response rates compared with lower doses of both drugs in patients with a cluster of difficult-to-treat characteristics," Fried and colleagues conclude.

The study was funded by F. Hoffmann-LaRoche. Several of the study authors report financial relationships with the pharmaceutical industry.

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