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Title: Improved inflammatory activity with peginterferon alfa-2b maintenance therapy in non-cirrhotic prior non-responders: A randomized study
Authors: POYNARD, ThierryBRUIX, JordiSCHIFF, Eugene R.DIAGO, MoisesBERG, ThomasMORENO-OTERO, RicardoLYRA, Andre C.CARRILHO, FlairGRIFFEL, Louis H.BOPARAI, NavdeepJIANG, RuiyunBURROUGHS, MargaretBRASS, Clifford A.ALBRECHT, Janice K.
Citation: JOURNAL OF HEPATOLOGY, v.58, n.3, p.452-459, 2013
Abstract: Background 82 Aims: Therapeutic options for patients failing hepatitis C retreatment are limited. EPIC3 included a prospective trial assessing long-term peginterferon alfa-2b (PegIFN alpha-2b) maintenance therapy in patients with METAVIR fibrosis scores (MFS) of F2 or F3 who previously failed hepatitis C retreatment. Methods: Patients with F2/F3 MFS who failed retreatment were randomized to PegIFN alpha-2b (0.5 mu g/kg/week, n = 270) or observation (n = 270) for 36 months. Blinded liver biopsies obtained before retreatment and after maintenance therapy were evaluated using MFS and activity scores, and confirmatory testing was performed using FibroTest and ActiTest. Results: In total, 348 patients had paired biopsies: 192 patients had missing post-treatment biopsies and were considered as having no change in fibrosis/activity scores. In total, 16% of patients receiving PegIFN alpha-2b and 11% of observation patients had improvement in MFS (p = 0.32). More PegIFN alpha-2b than observation patients had improvement in activity score (20% vs. 9%; p <0.001). Among patients treated for >2.5 years, improvement in MFS or activity score was more common with PegIFN alpha-2b than observation (21% vs. 14%, p = 0.08 and 26% vs. 10%, p <0.001). FibroTest and ActiTest evaluations indicated significant benefit associated with PegIFN alpha-2b in terms of reduced fibrosis progression and improved activity score. The safety profile of PegIFN alpha-2b was similar to previous studies. Conclusions: PegIFN alpha-2b did not significantly improve MFS estimated by biopsy compared with observation; however, activity scores were significantly improved and MFS trended toward increased improvement with treatment durations >2.5 years. Both FibroTest and ActiTest were significantly improved during maintenance therapy.
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Artigos e Materiais de Revistas Científicas - FM/MGT
Departamento de Gastroenterologia - FM/MGT

Artigos e Materiais de Revistas Científicas - HC/ICHC
Instituto Central - HC/ICHC

Artigos e Materiais de Revistas Científicas - LIM/07
LIM/07 - Laboratório de Gastroenterologia Clínica e Experimental

Artigos e Materiais de Revistas Científicas - ODS/03
ODS/03 - Saúde e bem-estar

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