Authors' objectives:

Combination therapy, interferon alfa plus ribavirin, will probably be licensed in 1999, initially for those who have relapsed following interferon alone. Since the release of the SHPIC report in September 1998 three new randomised controlled trials (RCTs) examining the efficacy and safety of interferon alfa in combination with ribavirin in the treatment of chronic hepatitis C have been published. This update summarises the results of these three trials and should be read in conjunction with the original report.

Authors' recommendations: There is now good evidence that interferon alfa plus ribavirin is more effective than interferon alone, at a standard dose of 3MU TIW, in those not previously treated with interferon. In patients with three or more factors predicting response 24 weeks of combination therapy is sufficient. However in those patients with two or fewer predictive factors 48 weeks treatment is worthwhile. In untreated patients, there is a case for waiting until the combination is available rather than treating now with inteferon alone. There is also good evidence that six months combination therapy is more effective than 6 months interferon monotherapy in those who have relapsed. Combination therapy has not been compared to higher doses or longer duration of interferon. Combination therapy has an acceptable safety profile but requires regular monitoring for early detection of the recognised side effects. Further trials are planned evaluating the newer types of interferon (pegylated interferon) and the role of maintenance treatment in patients who are likely to have a poor response. There is no evidence to support maintenance therapy at present. All treatment regimens are for a specified duration.

Authors' methods: Review

Project Status: Completed

URL for project: http://www.nhsconfed.net/shpic/doc11.htm

Year Published: 1999

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Scotland, United Kingdom

Organisation Name: Scottish Health Purchasing Information Centre

Copyright: Scottish Health Purchasing Information Centre