BACKGROUND AND AIMS: Retreatment with a combination of alpha interferon (IFN) plus ribavirin of patients with chronic hepatitis C who did not respond to IFN monotherapy has not been assessed in large controlled studies. METHODS: To assess the effectiveness and tolerability of IFN/ribavirin retreatment of non-responders to IFN and to identify predictors of complete (biochemical and virological) sustained response, we performed a meta-analysis of individual data on 581 patients from 10 centres. Retreatment with various IFN schedules (mean total dose 544 mega units) and a fixed ribavirin dose (1000-1200 mg/daily depending on body weight) was given for 24-60 (mean 39.5) weeks. RESULTS: Biochemical end of treatment and sustained responses were observed in 271/581 (46.6\%; 95\% confidence interval (CI) 42.6-50.7\%) and in 109/581 (18.7\%; 95\% CI 15.6-22.0\%) cases, respectively. Two hundred and six of 532 patients (38.7\%; 95\% CI 34.6-42.9\%) had an end of treatment complete response to retreatment while a complete sustained response occurred in 88 of 559 (15.7\%; 95\% CI 12.8-18.8\%). Fifty four of 581 patients (9.2\%; 95\% CI 7.0-11.7\%) stopped retreatment due to adverse effects. By logistic regression, complete sustained response was predicted independently by age <45 years (p=0.04), by normal pretreatment gamma-glutamyltransferase levels (p=0.01), and by a second course total IFN dose of at least 432 mega units (p=0.008). CONCLUSIONS: The overall low probability of effectiveness argues against indiscriminate retreatment of all IFN monotherapy non-responders with IFN/ribavirin. Patients less than 45 years old with normal gamma-glutamyltransferase levels who were retreated with high dose long course combination therapy had a complete sustained response rate of 30\%.
|Data di pubblicazione:||2002|
|Titolo:||Retreatment with interferon plus ribavirin of chronic hepatitis C non-responders to interferon monotherapy: a meta-analysis of individual patient data.|
|Autore/i:||C. Cammà;S. Bruno;F. Schepis;O. L. Iacono;P. Andreone;A. G. Gramenzi;A. Mangia;A. Andriulli;M. Puoti;A. Spadaro;M. Freni;V. D. Marco;L. Cino;G. Saracco;A. Chiesa;A. Crosignani;N. Caporaso;F. Morisco;M. G. Rumi;A. Craxì|
|Codice identificativo ISI:||WOS:000179385900024|
|Codice identificativo Scopus:||2-s2.0-0036896655|
|Codice identificativo Pubmed:||12427791|
|Citazione:||Retreatment with interferon plus ribavirin of chronic hepatitis C non-responders to interferon monotherapy: a meta-analysis of individual patient data / C. Cammà;S. Bruno;F. Schepis;O. L. Iacono;P. Andreone;A. G. Gramenzi;A. Mangia;A. Andriulli;M. Puoti;A. Spadaro;M. Freni;V. D. Marco;L. Cino;G. Saracco;A. Chiesa;A. Crosignani;N. Caporaso;F. Morisco;M. G. Rumi;A. Craxì. - In: GUT. - ISSN 0017-5749. - STAMPA. - 51(2002), pp. 864-869.|
|Tipologia||Articolo su rivista|
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