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PEGINTRON 210 MCG TWICE WEEKLY ALLOWS ABOUT ONE THIRD OF POOR RESPONDERS ON 210
MCG WEEKLY TO BECOME TREATMENT RESPONDERS (HCV-RNA< 50 IU/ML) Bennet Cecil, MD Hepatitis C Treatment Centers Inc Mary Lavelle ARNP Louisville VAMC Background & Aims: The maximal commercially available dose of PegIntron is 150 mcg/0.5 ml vials containing 210 mcg of drug. For hard to treat patients, this is an inadequate weekly dose. We previously demonstrated that interferon dose escalation permits some poor responders to become sustained responders.1 It is logical to use higher PegIntron doses in poor responders to 210 mcg per week. Methods: Patients with a poor response to 210 mcg PegIntron per week or viral breakthrough (reappearance of detectable HCV-RNA during treatment) were offered High dose PegIntron. This consisted of twice weekly injections of 140 mcg. The dose was gradually increased to 210-mcg sc twice weekly. Serial viral levels were obtained during treatment. Patients with progressive fall in HCV-RNA on twice weekly therapy were continued on treatment, while those with a poor response were stopped. Ribavirin was added in treatment responders. Results: This strategy allowed 15 of 42 poor responders to become treatment responders (HCV-RNA < 50 IU/ml). 14 patients were nonresponders, 12 were partial responders and one stopped because of psychiatric side effects. Mc Nemar’s test was used to compare the proportion of patients (1 of 42) with a treatment response (HCV-RNA < 50 IU/ml) to high dose PegIntron to the proportion of the same patients (15 of 42) with a treatment response to PegIntron 210 mcg per twice weekly. Chi-square = 11.161 with 1 degree of freedom; P =<0.001 Conclusions: High Dose PegIntron (up to 210 mcg twice weekly) was well tolerated and permits a treatment response rate in about one third of poor responders to PegIntron 210 mcg per week. Patients should be offered this option before being labeled nonresponders. 1.Poster Presentation AASLD 2001 Dallas Texas. Bennet Cecil, Mary Lavelle. Individualized hepatitis C therapy of military veterans: Interferon dose escalation improves the sustained response rate. |