Magazine article Clinical Psychiatry News

Obesity No Hurdle to Combination HCV Therapy

Magazine article Clinical Psychiatry News

Obesity No Hurdle to Combination HCV Therapy

Article excerpt

BOSTON -- Combination therapy with peginterferon [alpha]-2b and weight-based ribavirin produces consistent rates of sustained virologic response in obese patients with chronic hepatitis C virus, according to data from the largest hepatitis C virus study ever conducted in the United States.

In fact, the weight-based dosing regimen "produces sustained virologic response rates among obese patients similar to those seen in normal-weight individuals," Dr. Ira M. Jacobson reported at the annual meeting of the American Association for the Study of Liver Disease.

Previous studies have shown that overweight patients with hepatitis C virus (HCV) infection are less likely to achieve a sustained virologic response (SVR) with antiviral therapy than are their normal-weight counterparts. And obese patients--those with a body mass index greater than 30 kg/[m.sup.2]--have a significantly reduced probability of attaining SVR, compared with normal-weight or overweight patients, said Dr. Jacobson of Weill Medical College of Cornell University, in New York.

Previously reported results from the current study--the WIN-R (Weight-Based Dosing of PEG-Intron and Rebetol) multicenter, prospective, open-label trial--showed that weight-based dosing of ribavirin is important in maximizing SVR rates in patients with chronic hepatitis C.

Across the study population, "SVR rates were significantly higher with peginterferon [alpha]-2b plus weight-based ribavirin than with flat-dose ribavirin," said Dr. Jacobson.

To evaluate the consistency of this effect among obese patients with HCV, Dr. Jacobson and his colleagues conducted a sub-analysis of data from the 4,900-patient WIN-R trial, looking at the outcomes of 51 chronic HCV patients in the study with a body weight of 125 kg or more.

All of the patients in the study were 18-70 years of age, were treatment naive, had elevated alanine aminotransferase levels within 6 months of study enrollment, had liver biopsy findings consistent with chronic HCV within 36 months of study enrollment, and had compensated liver disease.

Patients were randomly assigned to receive subcutaneous peginterferon [alpha]-2b (PEG-Intron) at a dosage of 1.5 mcg/kg per week and either flat-dose (800 mg/day) or weight-based oral ribavirin (Rebetol) daily. …

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