The Repeat (REtreatment with PEgasys in pATients not responding to Peg-Intron therapy) study was designed to explore whether intensified treatment with a higher fixed-dose induction of Pegasys in combination with Copegus and longer treatment duration may increase treatment success rates in patients who did not respond to at least 12 weeks of Peg-Intron/ribavirin combination therapy. All patients received Copegus (1,000/1,200mg/day) in combination with Pegasys.
The results showed that response at 12 weeks was a powerful predictor of the eventual outcome with majority of patients with undetectable virus at 12 weeks achieving a sustained virological response (SVR) after 72 weeks of treatment, while few patients with detectable virus at 12 weeks achieved SVR. A pooled analysis of the 72-week patients versus the 48-week patients showed that 72 weeks of treatment had the biggest impact on success of treatment, with a doubling of SVR rate compared to 48 weeks (16% vs. 8%).
Donald Jensen, professor of medicine and director of the Center for Liver Diseases at the University of Chicago Hospital in Chicago, and lead investigator in Repeat, said: “A significant finding from Repeat is confirmation of the reliability of using a patient’s response at 12 weeks as a predictor of treatment success, even in patients with cirrhosis.
“This means that patients who achieve undetectable virus at 12 weeks can continue treatment with a good likelihood of success. It also means that clinicians can confidently discontinue treatment in patients who do not achieve an early response.”