Poster Presentations

Session Title: Category 5g. VIRAL HEPATITIS: g. HEPATITIS C - CLINICAL (THERAPY)
Presentation Date: Apr 15, 2010

COMPARISON OF EFFICACY BETWEEN PEGINTERFERON ALFA-2A OR -2B PLUS RIBAVIRINE IN THE TREATMENT OF CHRONIC HEPATITIS C PATIENTS IN DAILY ROUTINE: RESULTS FROM PRACTICE

T. Witthoeft¹*, S. Mauss², D. Hueppe³, C. John⁴, R. Heyne⁵, B. Moeller⁵, R. Link⁶, A. Herrmann⁷, A. Baumgarten⁴, A. Dikopoulos⁸, G. Teuber^9
1Center of Gastroenterology, Stade, ²Center for HIV and Hepatogastroenterology, Duesseldorf, ³Center for Gastroenterology, Herne, ⁴Center of Gastroenterology, Practice of Internal Medicine, ⁵Center of Gastroenterology and Livercenter, Berlin, ⁶Internal Medicin, St. Josefs-Krankenhaus, Offenburg, ⁷Internal Medicine II, Friedrich-Schiller-Universitaet, Jena, ⁸Klinik fuer Innere Medizin I, Universitaetsklinikum Ulm, Ulm, ⁹Interdisziplinäres Facharztzentrum Sachsenhausen, Frankfurt/Main, Germany. *dr.thomas.witthoeft@t-online.de

Background: PRACTICE, a retrospective study analysing response to hepatitis C treatment between 2000 and 2007 in 24 German centres. In last time several direct comparisons between efficacy of peginterferon alfa-2a/RBV (A) and peginterferon alfa-2b/RBV (B) were presented (Sulkowski et al, Ascione et al, Rumi et al.) but RBV assignment and composition of genotypes was different.
Methods: Data of G1 patients were analysed by three matched pair (MP) analysis. Parameters for MP I analyses were: age; BL viral load; BMI; prior treatment history, history of drug addiction and HIV-co-infection. MP II analysis included additionally to MP I cumulative RBV dose (≤60% / >60%-80% / >80%-100% / > 100%) as defined by prescribing information. MP III was matched by the criteria of Matched Pairs I plus initial RBV dose, which included evaluation of any dose reductions and dose reduction strategy. Potential effect of body weight on RBV starting dose was controlled as patients were matched for BMI.
Results: See Table for SVR rates. Majority of patients in MP III (90.2% in Group A and 87.2% in Group B) did not require RBV dose reduction; the extent of dose reduction with ≥400 mg or in 200 mg steps was comparable. Even the average time to the first dose reduction was similar (92.1 days in group A, 94.5 days in B)
Conclusions: For a valid comparison of peginterferon regimes it is important to match patient groups by BL factors. Further impact on SVR originates from the RBV dose. Real life data show that the kind of dose adjustment of ribavirin is very similar in daily routine. Since the approved regimes are different in this respect, data comparing A and B have to be evaluated carefully.