Therapeutic effectiveness of biosimilar standard interferon versus pegylated interferon for chronic hepatitis C genotypes 2 or 3

Vigani, Aline Gonzalez; Gonçales, Eduardo S L; Pavan, Maria Helena Postal; Genari, Flavia; Tozzo, Raquel; Lazarini, Mariana; Fais, Viviane Cristina; Feltrin, Adriana; Gonçales, Neiva Sellan Lopes; Gonçales, Fernando Lopes

doi:10.1016/s1413-8670(12)70316-1

Cited by 5 publications

(1 citation statement)

References 15 publications

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“…Considering the effectiveness of retreatment, results from a Brazilian cohort of patients with HCV genotypes 2 and 3 showed 34.4% of SVR rate for nonresponders to previous treatment and 50% for relapsers with Peg-interferon combined with Ribavirin [ 79 ]. Other Brazilian cohort studies obtained 79.3% (46/58) of SVR for patients with HCV genotypes 2 or 3 treated with Peg-interferon plus Ribavirin and 49.1% (56/114) among those treated with biosimilar standard interferon plus Ribavirin [ 80 ].…”

Section: Evidences On Hcv-treatment and The Promising New Braziliamentioning

confidence: 99%

Chronic Hepatitis C: An Overview of Evidence on Epidemiology and Management from a Brazilian Perspective

Castro

Perazzo

Grinsztejn

et al. 2015

International Journal of Hepatology

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Chronic hepatitis C remains one of the main causes of chronic liver disease worldwide and presents a variable natural history ranging from minimal changes to advanced fibrosis and cirrhosis and its complications, such as development of hepatocellular carcinoma. Approximately, 1.45 million people are estimated to be infected by HCV in Brazil representing a major public health issue. The aim of this paper was to review the epidemiology and management of chronic hepatitis C from a Brazilian perspective. The management of chronic hepatitis C has been challenged by the use of noninvasive methods to stage liver fibrosis as an alternative to liver biopsy and the high cost of new interferon-free antiviral treatments. Moreover, the need of cost-effectiveness analysis in hepatitis C and the recent changes in treatment protocols were discussed.

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Section: Evidences On Hcv-treatment and The Promising New Braziliamentioning

confidence: 99%

Chronic Hepatitis C: An Overview of Evidence on Epidemiology and Management from a Brazilian Perspective

Castro

Perazzo

Grinsztejn

et al. 2015

International Journal of Hepatology

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Splenectomy prior to antiviral therapy in patients with hepatitis C virus related decompensated cirrhosis

Ji¹,

Zhang²,

Huang³

et al. 2013

The Brazilian Journal of Infectious Diseases

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Patients with hepatitis C virus-related decompensated cirrhosis can benefit from interferon-based antiviral therapy, but the common complication of cytopenia is a contraindication for this treatment. Splenectomy prior to interferon therapy may alleviate this problem. To investigate whether splenectomy improves the efficacy of antiviral therapy, 13 interferon-naïve hepatitis C virus decompensated cirrhotic patients underwent splenectomy between January 2008 and January 2011, followed 1-3 months later by an interferon-based therapeutic regimen (pegylated/standard interferon-α combined with ribavirin for 48 weeks). Ten (76.9%) of the patients developed postoperative complications, which included minor portal vein thrombosis (2/13, 15.4%) and transient ascites (8/13, 61.5%). At one-month post-splenectomy, the patients showed significantly increased platelet (pre-surgery: 48.2±15.9 vs. 186.0±70.6×10(3)μL(-1), p<0.001) and leukocyte (2.1±0.5 vs. 5.7±1.4×10(3)μL(-1), p<0.001) counts. Eight (61.5%) of the patients achieved sustained virological response, including all HCV genotype 2a-infected patients (4/4, 100%) and some of the genotype 1b-infected patients (4/9, 44.4%). Temporary interferon-α suspension was required for one patient to address severe intestinal infection. These results indicate that splenectomy prior to interferon-based therapy was safe and may facilitate adherence to subsequent antiviral therapy in selected HCV cirrhotic patients with portal hypertension and hypersplenism.

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Chronic Hepatitis C treatment for genotype 2 or 3 in Brazil: cost effectiveness analysis of peginterferon plus ribavirin as first choice treatment

Blatt

Storb

Mühlberger³

et al. 2014

Braz. J. Pharm. Sci.

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Brazilian Guidelines to HCV treatment (2007) recommended that the first choice treatment for patients with chronic hepatitis C (CHC) and genotype 2 or 3 is interferon alpha (IFN) plus ribavirin (RBV) for 24 weeks. The aim of this study is compare the cost and effectiveness to Hepatitis C treatment in patients with genotype 2 or 3 of peginterferon alpha (PEG) as the first choice of treatment within PEG for those that do not respond to IFN. The target population is CHC patients with genotype 2 or 3 in Brazil. The interventions are: PEG-SEC (first IFN plus RBV for 24 weeks, after, for non-responders and relapsers subsequently PEG plus RBV for 48 weeks); PEG-FIRST24 (PEG+RBV for 24 weeks). The type of the study is cost-effectiveness analysis. The data sources are: Effectiveness data from meta-analysis conducted on the Brazilian population. Treatment cost from Brazilian micro costing study is converted into USD (2010). The perspective is the Public Health System. The outcome measurements are Sustained Viral Response (SVR) and costs. PEG-FIRST24 (SVR: 87.8%, costs: USD 8,338.27) was more effective and more costly than PEG-SEC (SVR: 79.2%, costs: USD 5,852.99). The sensitivity analyses are: When SVR rates with IFN was less than 30% PEG-FIRST is dominant. On the other hand, when SVR with IFN was more then 75% PEG-SEC is dominant (SVR=88.2% and costs USD $ 3,753.00). PEG-SEC is also dominant when SVR to PEG24 weeks was less than 54%. In the Brazilian context, PEG-FIRST is more effective and more expensive than PEG-SEC. PEG-SEC could be dominant when rates of IFN therapy are higher than 75% or rates of PEG24 therapy are lower than 54%.Uniterms: Hepatitis C chronic/treatment. Interferon alpha/Hepatitis C treatment. Ribavirin/Hepatitis C treatment. Peginterferon alpha/Hepatitis C treatment. Hepatitis C/ treatment/cost-effectiveness evaluation.O protocolo brasileiro de tratamento da Hepatite C (2007) recomendava como primeira escolha para pacientes com hepatite C crônica e portadores de genótipo 2 ou 3 o tratamento com interferona alfa (IFN) associada à ribavirina (RBV), por 24 semanas. O objetivo deste estudo é comparar o custo e a efetividade para pacientes com hepatite C crônica e portadores do genótipo 2 ou 3 o uso de peguinterferon (PEG) como primeiro escolha com o PEG como secunda escolha para aqueles que não responderam ao tratamento com IFN. A população alvo compreende pacientes com hepatite C crônica portadores de genótipo 2 ou 3 no Brasil. As intervenções são: PEG-SEC (IFN + RBV por 24 semanas, para os não respondedores e recidivantes tratamento subsequente com PEG + RBV por 48 semanas; PEG-FIRST24 (PEG + RBV por 24 semanas). O tipo de estudo envolvido é Análise de Custo Efetividade. Os dados de efetividade são provenientes de um metanálise de estudos brasileiros e os dados de custo do tratamento de um estudo de custo do contexto brasileiro. A perspectiva é o Sistema Público de Saúde. Os desfechos avaliados foram Resposta Viral Sustentada (RVS) e Custos. 8%, costs: USD 8.338,27) foi mais efetivo e apresentou mai...

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Therapeutic effectiveness of biosimilar standard interferon versus pegylated interferon for chronic hepatitis C genotypes 2 or 3

Abstract: In patients with HCV genotypes 2 or 3 infection, a higher SVR was observed in patients receiving Peg-IFN plus RBV related to patients treated with biosimilar standard IFN plus RBV.

Cited by 5 publications

References 15 publications

Chronic Hepatitis C: An Overview of Evidence on Epidemiology and Management from a Brazilian Perspective

Chronic Hepatitis C: An Overview of Evidence on Epidemiology and Management from a Brazilian Perspective

Splenectomy prior to antiviral therapy in patients with hepatitis C virus related decompensated cirrhosis

Chronic Hepatitis C treatment for genotype 2 or 3 in Brazil: cost effectiveness analysis of peginterferon plus ribavirin as first choice treatment

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