Both Hepatitis C Drugs Work About the Same: Study

A large effectiveness study comparing Schering-Plough's pegylated-interferon Pegintron and ribavirin with Roche's Pegasys and ribavirin shows both hepatitis C treatments worked equally well.

The study by Dr. Mark Sulkowski of Johns Hopkins University involved 3,000 patients with hepatitis C. Its findings are meant to help guide doctors' decisions about which treatments work best.

"There has been a lot of debate about these two regimens," said Dr. Andrew Muir of Duke University, a co-author of the Schering-Plough-funded study. "It's great to have a study of this size that really answers this question."

In participants who began either of the two standard treatments during early or less-advanced stages of hepatitis C liver disease, the virus was reduced to undetectable levels in 40-43 percent. Patients with more advanced disease, including the buildup of scar tissue, experienced a 20-23 percent success rate.

Both regimens cost about the same: from $12,000 to $25,000, depending on the stage of illness and whether treatment lasts 24 or 48 months.

According to Muir, doctors currently recommend patients stay on a higher dose of treatment to ensure the best response. But a subgroup of 700 study patients taking a lower dose fared just as well, with a cure rate of 38 percent. Muir said he plans to encourage patients to start on a higher dose, but he said, "Maybe I don't need to push my patients as much if they are having side effects." Hepatitis C patients undergoing treatment often feel as though they have a bad case of influenza.

"When considering treatments for hepatitis C infection, patients and their doctors now have solid evidence that they can weigh both antiviral therapies equally for effectiveness, safety, and tolerability," said Sulkowski.

The study, "Peginterferon Alfa-2b or Alfa-2a With Ribavirin for Treatment of Hepatitis C Infection," was published in the New England Journal of Medicine (2009;361(6):580-593).