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Weight-based dosing of ribavirin improves outcomes for patients with hepatitis C
Date:10/1/2007

A sustained viral response was achieved by significantly more patients who received a weight-based dose (44.2 percent) than fixed dose (40.5 percent) ribavirin, the authors report. Overall, response rates decreased as weight increased when a fixed dose was used but remained unaltered with a weight-based dose. Discontinuation rates and reported adverse events did not differ significantly between the two treatment schemes, and relapse rates were lower for patients who had received weight-based dosing. The researchers also found that 48 weeks of treatment offered no additional benefit compared to 24 weeks for patients with genotypes 2 or 3..

Another group of researchers from the same study, also lead by Jacobson, used the study data to understand the impact of weight-based ribavirin with peginterferon alfa-2b in African American patients with HCV genotype 1. Genotype 1 is the hardest to treat, and it afflicts African Americans disproportionately.

Three hundred eighty seven African American patients with genotype 1 were included in the analysis: of those weighing 65 kg or more, and therefore receiving different doses of ribavirin in each arm, 188 had received flat-dose ribavirin, and 174 had received weight-based dosing. Significantly fewer patients in the flat-dose group (10 percent) attained a sustained virological response, compared to 21 percent in the flat-dose group. Relapse rates were 30 percent and 22 percent, respectively.

An unexpected finding of our study was the increase in efficacy with an increase in ribavirin dose in heavier patients, the authors report. That is, sustained viral response rates increased as body weight increased, suggesting that ribavirin distribution may be more complex than realized and body weight may only approximate the marker for size required to dose RBV consistently, the authors say.

In conclusion, weight-based dosing of ribavirin offered a significant advantage in efficacy of treatment fo
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Contact: Amy Molnar
amolnar@wiley.com
John Wiley & Sons, Inc.
Source:Eurekalert

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