Page 48 - The Flying Publisher Guide to Hepatitis C Treatment

48 | Hepatitis C Treatment

5. Maintenance therapy with low-dose of PegIFN. Non-
sustained responders to SoC, with advanced fibrosis or cirrhosis,
have a high risk for disease progression and complications. Two
large multicentre trials have evaluated the benefits of
maintenance therapy with low-dose PegIFN in this group:
– the COPILOT study (Colchicine vs. PegIFN alfa-2b 0.5
µg/kg/week Long Term) (Afdhal 2008)
– the HALT-C study (Hepatitis C Antiviral Long-Term
Treatment Against Cirrhosis with PegIFN alfa-2a 90
µg/week) (Di Bisceglie 2008)
In the COPILOT study 555 patients with prior failure to
interferon-based therapy were randomized to receive either
PegIFN alfa-2b 0.5 µg/kg/week (n=286) or colchicine 0,6 mg twice
daily (n=269). No differences were observed between the two
groups with respect to progression of the CP score, development
of complications of portal hypertension or HCC.
The HALT-C trial was a prospective, randomized, controlled
study of long-term maintenance therapy with PegIFN alfa-2a 90
µg/week (n=517) or no treatment (n=533) for 3.5 years in
patients with chronic hepatitis C (CHC) and advanced fibrosis or
cirrhosis (Ishak score 3-6) who did not achieve SVR after
interferon-based therapy. By the end of the study period, there
was no difference between the control and treated groups in the
frequency of death, hepatic decompensation or development of
HCC. Overall, the COPILOT and HALT-C trials showed that
maintenance therapy with low-dose PegIFN alfa-2a or alfa-2b
does not reduce the rate of liver-related death, clinical
disease progression and complications over a period of up to 4
years.

6. Triple-combination therapy. Triple therapy combination of
PegIFN/RBV with a protease inhibitors (telaprevir or boceprevir)
in HCV genotype 1-experienced patients has been shown to
produce high rates of virological response in both prior relapsers