D'Souza, R., Main, J., Crossey, M., Rosenberg, W., Murray-Lyon, I.M., Hayward, C. and Foster, G.R.
Discontinuation of pegylated interferon plus ribavirin in patients who are not responding to therapy - patients' views of early cessation of therapy
Alimentary Pharmacology & Therapeutics, 21, (1), . (doi:10.1111/j.1365-2036.2004.02295.x).
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Background: Current therapy for chronic hepatitis C infection involves a course of pegylated interferon and ribavirin. Patients who do not show a virological response after 12 weeks of therapy have a low probability of sustained virological response and it is therefore recommended that such patients stop treatment.
Aim: To assess patients' views of early treatment cessation.
Methods: We conducted a open-labelled study in three UK centres, in which patients with biopsy-proven chronic hepatitis C requiring therapy were offered the choice of a full course of therapy with 40 kDa pegylated interferon-? 2a plus ribavirin (24 or 48 weeks depending on viral genotype) or early cessation if therapy had failed after 12 weeks.
Results: Ninety-five participants were enrolled and the majority (69%) did not wish to discontinue therapy even if it had low probability of success. In this unselected UK population, very few patients (4%) did not achieve an early virological response with the 40-kDa pegylated interferon-? 2a plus ribavirin and two of the four early virological non-responders decided to continue therapy.
Conclusion: Early discontinuation of 'ineffective' anti-viral therapy may prove less popular with patients than with health care providers, and further patient-directed education regarding the cost-effectiveness of therapy will be needed if early discontinuation of unsuccessful therapy is to be accepted by patients.
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