The combination of peginterferon alfa-2a and ribavirin shows real promise as curative therapy for hepatitis C, even in difficult-to-treat patients such as those infected with genotype 1 strain and those who failed treatment with conventional interferon, according to a pair of presentations at the annual Digestive Disease Week.

In a large, multicenter phase III clinical trial among treatment-naive people with genotype 1 chronic hepatitis C, 61 percent of patients treated with combination therapy achieved a sustained virological response, meaning they were effectively cured of their infection. This is a higher cure rate than that recorded previously in patients with genotype 1 hepatitis C. In addition, 17 percent of patients who did not respond to treatment during the initial 12 weeks of therapy did respond between weeks 12 and 24 and eventually achieved sustained virological response. Therefore, the investigators concluded that patients should not stop treatment before week 24.

In a second phase III study, 54 percent of patients who did not respond or relapsed following conventional interferon monotherapy were cured following treatment with combination therapy. Interestingly, 50 percent of patients with genotype 1 hepatitis C who had not responded to previous treatment with conventional interferon achieved a sustained virological response. This by far exceeds the 19 percent rate previously reported with combination pegylated interferon alfa-2b plus ribavirin in Japanese non-responders to interferon monotherapy.

"Hepatitis C is a real problem in Japan," said Namiki Izumi, MD, chief of the Division of Gastroenterology and Hepatology at Musashino Red Cross Hospital in Tokyo and one of the lead investigators of one study. "These results give real hope of a cure, and we are waiting eagerly for the approval of PEGASYS plus COPEGUS in Japan so we can offer our patients the best treatment options available."