Short interferon and ribavirin treatment for HCV genotype 2 or 3 infection: NORDynamIC trial and real-life experience

Jesper Waldenström, Martti Färkkilä, Karolina Rembeck, Gunnar Norkrans, Nina Langeland, Kristine Mørch, Court Pedersen, Mads Rauning Buhl, Urpo Nieminen, Hannu Nuutinen, Åsa Alsiö, Lars Holmström, Rolf Jungnelius, Katarina Lund, Anders Rubensson, Erik Torell, Johan Westin, Martin Lagging

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

OBJECTIVE: Interferon-free therapy for hepatitis C virus (HCV) infection is costly, and therefore patients with advanced fibrosis are prioritized. Although coupled with considerable side effects, a large proportion of genotype 2/3 infected patients achieve a sustained virological response (SVR) following interferon-based therapy. The present study evaluates experimental clinical trial and verifying real-life data with the aim of identifying patients with a high likelihood of favorable outcome following short interferon-based treatment.

MATERIAL AND METHODS: The impact of established response predictors, e.g. age, ITPA and IL28B genetic variants, IP-10, liver histopathology and early viral kinetics on outcome was evaluated among HCV genotype 2/3 infected patients enrolled in the NORDynamIC trial. Similarly outcome was evaluated among Finnish and Swedish real-life genotype 2/3 infected patients treated for 12-16 weeks in accordance with national guidelines.

RESULTS: In the NORDynamIC trial, age <40 years or achieving HCV RNA <1000 IU/mL day 7 were highly predictive of favorable outcome following 12 weeks therapy. Among 255 Finnish real-life patients below the age of 40 years treated for 12 weeks with interferon and ribavirin, 87% of HCV genotype 2 and 79% of genotype 3 infected patients achieved SVR, and among 117 Swedish real-life patients treated for 12-16 weeks, 97% of HCV genotype 2 and 94% of genotype 3 infected achieved SVR.

CONCLUSIONS: Short interferon-based therapy offers a high likelihood of achieving SVR for selected HCV genotype 2/3 infected patients, and is an acceptable option given that a thorough discussion of the side effects is provided prior to initiation.

OriginalsprogEngelsk
TidsskriftScandinavian Journal of Gastroenterology
Vol/bind51
Udgave nummer3
Sider (fra-til)337-343
Antal sider7
ISSN0036-5521
DOI
StatusUdgivet - 2016

Fingeraftryk

Ribavirin
Hepacivirus
Virus Diseases
Clinical Trials
Guidelines
RNA
Liver

Citer dette

Waldenström, Jesper ; Färkkilä, Martti ; Rembeck, Karolina ; Norkrans, Gunnar ; Langeland, Nina ; Mørch, Kristine ; Pedersen, Court ; Rauning Buhl, Mads ; Nieminen, Urpo ; Nuutinen, Hannu ; Alsiö, Åsa ; Holmström, Lars ; Jungnelius, Rolf ; Lund, Katarina ; Rubensson, Anders ; Torell, Erik ; Westin, Johan ; Lagging, Martin. / Short interferon and ribavirin treatment for HCV genotype 2 or 3 infection : NORDynamIC trial and real-life experience. I: Scandinavian Journal of Gastroenterology. 2016 ; Bind 51, Nr. 3. s. 337-343.
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title = "Short interferon and ribavirin treatment for HCV genotype 2 or 3 infection: NORDynamIC trial and real-life experience",
abstract = "OBJECTIVE: Interferon-free therapy for hepatitis C virus (HCV) infection is costly, and therefore patients with advanced fibrosis are prioritized. Although coupled with considerable side effects, a large proportion of genotype 2/3 infected patients achieve a sustained virological response (SVR) following interferon-based therapy. The present study evaluates experimental clinical trial and verifying real-life data with the aim of identifying patients with a high likelihood of favorable outcome following short interferon-based treatment.MATERIAL AND METHODS: The impact of established response predictors, e.g. age, ITPA and IL28B genetic variants, IP-10, liver histopathology and early viral kinetics on outcome was evaluated among HCV genotype 2/3 infected patients enrolled in the NORDynamIC trial. Similarly outcome was evaluated among Finnish and Swedish real-life genotype 2/3 infected patients treated for 12-16 weeks in accordance with national guidelines.RESULTS: In the NORDynamIC trial, age <40 years or achieving HCV RNA <1000 IU/mL day 7 were highly predictive of favorable outcome following 12 weeks therapy. Among 255 Finnish real-life patients below the age of 40 years treated for 12 weeks with interferon and ribavirin, 87{\%} of HCV genotype 2 and 79{\%} of genotype 3 infected patients achieved SVR, and among 117 Swedish real-life patients treated for 12-16 weeks, 97{\%} of HCV genotype 2 and 94{\%} of genotype 3 infected achieved SVR.CONCLUSIONS: Short interferon-based therapy offers a high likelihood of achieving SVR for selected HCV genotype 2/3 infected patients, and is an acceptable option given that a thorough discussion of the side effects is provided prior to initiation.",
author = "Jesper Waldenstr{\"o}m and Martti F{\"a}rkkil{\"a} and Karolina Rembeck and Gunnar Norkrans and Nina Langeland and Kristine M{\o}rch and Court Pedersen and {Rauning Buhl}, Mads and Urpo Nieminen and Hannu Nuutinen and {\AA}sa Alsi{\"o} and Lars Holmstr{\"o}m and Rolf Jungnelius and Katarina Lund and Anders Rubensson and Erik Torell and Johan Westin and Martin Lagging",
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doi = "10.3109/00365521.2015.1087588",
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Waldenström, J, Färkkilä, M, Rembeck, K, Norkrans, G, Langeland, N, Mørch, K, Pedersen, C, Rauning Buhl, M, Nieminen, U, Nuutinen, H, Alsiö, Å, Holmström, L, Jungnelius, R, Lund, K, Rubensson, A, Torell, E, Westin, J & Lagging, M 2016, 'Short interferon and ribavirin treatment for HCV genotype 2 or 3 infection: NORDynamIC trial and real-life experience', Scandinavian Journal of Gastroenterology, bind 51, nr. 3, s. 337-343. https://doi.org/10.3109/00365521.2015.1087588

Short interferon and ribavirin treatment for HCV genotype 2 or 3 infection : NORDynamIC trial and real-life experience. / Waldenström, Jesper; Färkkilä, Martti; Rembeck, Karolina; Norkrans, Gunnar; Langeland, Nina; Mørch, Kristine; Pedersen, Court; Rauning Buhl, Mads; Nieminen, Urpo; Nuutinen, Hannu; Alsiö, Åsa; Holmström, Lars; Jungnelius, Rolf; Lund, Katarina; Rubensson, Anders; Torell, Erik; Westin, Johan; Lagging, Martin.

I: Scandinavian Journal of Gastroenterology, Bind 51, Nr. 3, 2016, s. 337-343.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Short interferon and ribavirin treatment for HCV genotype 2 or 3 infection

T2 - NORDynamIC trial and real-life experience

AU - Waldenström, Jesper

AU - Färkkilä, Martti

AU - Rembeck, Karolina

AU - Norkrans, Gunnar

AU - Langeland, Nina

AU - Mørch, Kristine

AU - Pedersen, Court

AU - Rauning Buhl, Mads

AU - Nieminen, Urpo

AU - Nuutinen, Hannu

AU - Alsiö, Åsa

AU - Holmström, Lars

AU - Jungnelius, Rolf

AU - Lund, Katarina

AU - Rubensson, Anders

AU - Torell, Erik

AU - Westin, Johan

AU - Lagging, Martin

PY - 2016

Y1 - 2016

N2 - OBJECTIVE: Interferon-free therapy for hepatitis C virus (HCV) infection is costly, and therefore patients with advanced fibrosis are prioritized. Although coupled with considerable side effects, a large proportion of genotype 2/3 infected patients achieve a sustained virological response (SVR) following interferon-based therapy. The present study evaluates experimental clinical trial and verifying real-life data with the aim of identifying patients with a high likelihood of favorable outcome following short interferon-based treatment.MATERIAL AND METHODS: The impact of established response predictors, e.g. age, ITPA and IL28B genetic variants, IP-10, liver histopathology and early viral kinetics on outcome was evaluated among HCV genotype 2/3 infected patients enrolled in the NORDynamIC trial. Similarly outcome was evaluated among Finnish and Swedish real-life genotype 2/3 infected patients treated for 12-16 weeks in accordance with national guidelines.RESULTS: In the NORDynamIC trial, age <40 years or achieving HCV RNA <1000 IU/mL day 7 were highly predictive of favorable outcome following 12 weeks therapy. Among 255 Finnish real-life patients below the age of 40 years treated for 12 weeks with interferon and ribavirin, 87% of HCV genotype 2 and 79% of genotype 3 infected patients achieved SVR, and among 117 Swedish real-life patients treated for 12-16 weeks, 97% of HCV genotype 2 and 94% of genotype 3 infected achieved SVR.CONCLUSIONS: Short interferon-based therapy offers a high likelihood of achieving SVR for selected HCV genotype 2/3 infected patients, and is an acceptable option given that a thorough discussion of the side effects is provided prior to initiation.

AB - OBJECTIVE: Interferon-free therapy for hepatitis C virus (HCV) infection is costly, and therefore patients with advanced fibrosis are prioritized. Although coupled with considerable side effects, a large proportion of genotype 2/3 infected patients achieve a sustained virological response (SVR) following interferon-based therapy. The present study evaluates experimental clinical trial and verifying real-life data with the aim of identifying patients with a high likelihood of favorable outcome following short interferon-based treatment.MATERIAL AND METHODS: The impact of established response predictors, e.g. age, ITPA and IL28B genetic variants, IP-10, liver histopathology and early viral kinetics on outcome was evaluated among HCV genotype 2/3 infected patients enrolled in the NORDynamIC trial. Similarly outcome was evaluated among Finnish and Swedish real-life genotype 2/3 infected patients treated for 12-16 weeks in accordance with national guidelines.RESULTS: In the NORDynamIC trial, age <40 years or achieving HCV RNA <1000 IU/mL day 7 were highly predictive of favorable outcome following 12 weeks therapy. Among 255 Finnish real-life patients below the age of 40 years treated for 12 weeks with interferon and ribavirin, 87% of HCV genotype 2 and 79% of genotype 3 infected patients achieved SVR, and among 117 Swedish real-life patients treated for 12-16 weeks, 97% of HCV genotype 2 and 94% of genotype 3 infected achieved SVR.CONCLUSIONS: Short interferon-based therapy offers a high likelihood of achieving SVR for selected HCV genotype 2/3 infected patients, and is an acceptable option given that a thorough discussion of the side effects is provided prior to initiation.

U2 - 10.3109/00365521.2015.1087588

DO - 10.3109/00365521.2015.1087588

M3 - Journal article

C2 - 26418670

VL - 51

SP - 337

EP - 343

JO - Scandinavian Journal of Gastroenterology

JF - Scandinavian Journal of Gastroenterology

SN - 0036-5521

IS - 3

ER -