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Therapy of chronic hepatitis C with PEG-IFN α-2b plus ribavirin in patients with genotype 2 or 3: 16 versus 24 weeks, clinical outcome and direct cost analyses.
Eur J Gastroenterol Hepatol. 2013 Dec; 25(12):1396-401.EJ

Abstract

INTRODUCTION

Short antiviral therapy has been proposed for patients with chronic hepatitis C, easy genotypes, low fibrosis score, low viral load at baseline, and rapid virological response (RVR). However, this approach is not completely accepted.

OBJECTIVES

The aims of this study were (a) to evaluate the sustained virological response (SVR) in noncirrhotic patients with genotype 2 or 3, achieving an RVR, randomized to receive pegylated-interferon (IFN) α-2b plus ribavirin for either 16 or 24 weeks and (b) to carry out direct cost analysis comparing patients treated for 16 versus 24 weeks.

RESULTS

Of the 142 initially evaluated patients, 130 were enrolled according to the selection criteria, but independent of the viral load. According to the intention-to-treat analysis, SVR was achieved in 104 patients (80%). Logistic regression analysis showed that RVR (P<0.001) and genotype 2 (P<0.03) were the most important factors independently associated with SVR. Among patients with RVR, SVR was comparable between patients treated for 16 weeks and those treated for 24 weeks (86.2 vs. 89.7%, P=NS). The mean direct costs were €4003.7 for patients treated for 16 weeks and €5676.7 for those treated for 24 weeks, with a 30% difference between the two arms.

CONCLUSION

In patients achieving an RVR, a 16-week treatment with pegylated-interferon plus ribavirin was comparable to a 24-week treatment. Short treatment in patients with RVR allows us to save 30% of the direct costs, independent of the viral load at baseline.

Authors+Show Affiliations

aDepartment of Infectious Diseases and Tropical Medicine, S. Bortolo Hospital bDepartment of Infectious Diseases, Schio, Vicenza cGastroenterology Unit, Gorizia Hospital, Gorizia dDepartment of Gastroenterology, AASL2, San Paolo Hospital, Savona eInstitute of Hygiene fDepartment of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

23743559

Citation

Fabris, Paolo, et al. "Therapy of Chronic Hepatitis C With PEG-IFN Α-2b Plus Ribavirin in Patients With Genotype 2 or 3: 16 Versus 24 Weeks, Clinical Outcome and Direct Cost Analyses." European Journal of Gastroenterology & Hepatology, vol. 25, no. 12, 2013, pp. 1396-401.
Fabris P, Carlotto A, Del Bianco T, et al. Therapy of chronic hepatitis C with PEG-IFN α-2b plus ribavirin in patients with genotype 2 or 3: 16 versus 24 weeks, clinical outcome and direct cost analyses. Eur J Gastroenterol Hepatol. 2013;25(12):1396-401.
Fabris, P., Carlotto, A., Del Bianco, T., Malfatti, F., Tramarin, A., Miotti, M. A., Baldo, V., Floreani, A., Giordani, M. T., & Grasso, A. (2013). Therapy of chronic hepatitis C with PEG-IFN α-2b plus ribavirin in patients with genotype 2 or 3: 16 versus 24 weeks, clinical outcome and direct cost analyses. European Journal of Gastroenterology & Hepatology, 25(12), 1396-401. https://doi.org/10.1097/MEG.0b013e328362dc22
Fabris P, et al. Therapy of Chronic Hepatitis C With PEG-IFN Α-2b Plus Ribavirin in Patients With Genotype 2 or 3: 16 Versus 24 Weeks, Clinical Outcome and Direct Cost Analyses. Eur J Gastroenterol Hepatol. 2013;25(12):1396-401. PubMed PMID: 23743559.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Therapy of chronic hepatitis C with PEG-IFN α-2b plus ribavirin in patients with genotype 2 or 3: 16 versus 24 weeks, clinical outcome and direct cost analyses. AU - Fabris,Paolo, AU - Carlotto,Antonio, AU - Del Bianco,Tiziana, AU - Malfatti,Federica, AU - Tramarin,Andrea, AU - Miotti,Marco A, AU - Baldo,Vincenzo, AU - Floreani,Annarosa, AU - Giordani,Maria Teresa, AU - Grasso,Alessandro, PY - 2013/6/8/entrez PY - 2013/6/8/pubmed PY - 2014/6/11/medline SP - 1396 EP - 401 JF - European journal of gastroenterology & hepatology JO - Eur J Gastroenterol Hepatol VL - 25 IS - 12 N2 - INTRODUCTION: Short antiviral therapy has been proposed for patients with chronic hepatitis C, easy genotypes, low fibrosis score, low viral load at baseline, and rapid virological response (RVR). However, this approach is not completely accepted. OBJECTIVES: The aims of this study were (a) to evaluate the sustained virological response (SVR) in noncirrhotic patients with genotype 2 or 3, achieving an RVR, randomized to receive pegylated-interferon (IFN) α-2b plus ribavirin for either 16 or 24 weeks and (b) to carry out direct cost analysis comparing patients treated for 16 versus 24 weeks. RESULTS: Of the 142 initially evaluated patients, 130 were enrolled according to the selection criteria, but independent of the viral load. According to the intention-to-treat analysis, SVR was achieved in 104 patients (80%). Logistic regression analysis showed that RVR (P<0.001) and genotype 2 (P<0.03) were the most important factors independently associated with SVR. Among patients with RVR, SVR was comparable between patients treated for 16 weeks and those treated for 24 weeks (86.2 vs. 89.7%, P=NS). The mean direct costs were €4003.7 for patients treated for 16 weeks and €5676.7 for those treated for 24 weeks, with a 30% difference between the two arms. CONCLUSION: In patients achieving an RVR, a 16-week treatment with pegylated-interferon plus ribavirin was comparable to a 24-week treatment. Short treatment in patients with RVR allows us to save 30% of the direct costs, independent of the viral load at baseline. SN - 1473-5687 UR - https://www.unboundmedicine.com/medline/citation/23743559/Therapy_of_chronic_hepatitis_C_with_PEG_IFN_α_2b_plus_ribavirin_in_patients_with_genotype_2_or_3:_16_versus_24_weeks_clinical_outcome_and_direct_cost_analyses_ L2 - http://dx.doi.org/10.1097/MEG.0b013e328362dc22 DB - PRIME DP - Unbound Medicine ER -