Limitation of combination therapy of interferon and ribavirin for older patients with chronic hepatitis C†

Abstract

In contrast to the United States, Japanese patients with chronic hepatitis C currently treated with interferon are generally 10 to 15 years older. Older patients, however, tend to experience more frequent adverse events. This study was conducted to clarify the effect of patient age on the efficacy and safety of combination therapy. We consecutively enrolled 208 patients with naïve chronic hepatitis C. Patients were classified into three groups according to age: younger than 50 years of age (n ‫؍‬ 52); 50 to 59 years old (n ‫؍‬ 83); and 60 years of age or older (n ‫؍‬ 73). Interferon alpha-2b therapy was administered daily for 2 weeks, followed by 3 times per week for 22 weeks, while ribavirin was administered daily. Of the 208 study patients, discontinuation of therapy or dose reduction was required in 116 (56%) and was more frequent in older patient groups: 38%, 48%, and 77% for the <50, 50-59, and >60-year-old patient groups, respectively (P < .001). Multivariate analysis showed patient age to be independently associated with adherence to therapy. A sustained virological response was achieved in 77 (37%) patients, with genotype, viral load, and adherence to therapy associated with this achievement. A tendency toward a lower sustained virological response rate was seen in the older patients. In conclusion, patient age is an important factor contributing to the safety of combination therapy. Thus, treatment schedule should be modified, or other therapeutic modalities should be considered for older patients with chronic hepatitis C. (HEPATOLOGY 2006;43:54-63.)

Efficacy and Safety of Combination Therapy of Natural Human Interferon Beta and Ribavirin in Chronic Hepatitis C patients

“…However, one big problem of the combination therapy is the treatment-related side effect (6,7). In particular, physicians in charge tend to avoid the combination therapy of peginterferon-alpha and ribavirin for chronic hepatitis C patients with depression or interferon (IFN)-reduced depression.…”

“…IFN-beta-related side effects are mild and few compared to therapy of IFN-alpha (6)(7)(8). In particular, IFN-betainduced mental disorders are mild compared to those induced by IFN-alpha (9).…”

Combination Therapy of Peginterferon and Ribavirin for Chronic Hepatitis C Patients with Genotype 1b and Low-virus Load

“…However, the dropout rates in patients treated with combination therapy was higher than those treated with IFN monotherapy (17,18 (22). T a b l e 1 .…”

Efficacy and Safety of Combination Therapy of Natural Human Interferon .BETA. and Ribavirin in Chronic Hepatitis C Patients with Genotype 2 and High Virus Load

“…However, the dropout rates in patients treated with combination therapy of peginterferon and ribavirin are higher than those treated with IFN monotherapy (15)(16)(17). In particular, the adverse events due to combination therapy of IFN …”