A tool for selecting patients with a high probability of sustained virological response to peginterferon alfa-2a (40kD)/ribavirin

作者：Ferenci Peter^*; Aires Rodrigo; Ancuta Ioan; Arohnson Andrew; Cheinquer Hugo; Delic Dragan; Gschwantler Michael; Larrey Dominique; Tallarico Ludovico; Schmitz Manuela; Tatsch Fernando; Ouzan Denis

来源：Liver International, 2014, 34(10): 1550-1559.

DOI：10.1111/liv.12439

• Caucasian
• hepatitis C
• peginterferon alfa
• ribavirin
• predictive scoring
• PROPHESYS
• sustained virological response

Background %26 AimsPretreatment identification of patients likely to achieve a sustained virological response (SVR) with peginterferon alfa-2a/ribavirin would be useful for individualizing treatment choices. The aim of this analysis was to devise a simple scoring system to identify patients with high probability of achieving an SVR with peginterferon alfa-2a/ribavirin. %26lt;br%26gt;MethodsUsing data from 2109 Caucasian treatment-naive hepatitis C virus (HCV) genotype 1 mono-infected patients from the PROPHESYS cohorts, the relationship between favourable baseline characteristics and SVR was explored using generalized additive model analysis, and a scoring system was devised to predict SVR. %26lt;br%26gt;ResultsPoints were assigned for: age (years) (35: 2; %26gt;35, 45: 1; %26gt;45: 0); body mass index (kg/m(2)) (20: 2; %26gt;20, 22: 1; %26gt;22: 0); HCV RNA (IU/ml) (100000: 3; %26gt;100000-400000: 2; %26gt;400000-800000: 1; %26gt;800000: 0); platelets (%26gt;150 x10(9)/l: 1; 150 x10(9)/l: 0); alanine aminotransferase [xupper limit of normal (ULN)] (%26gt;3: 1; 3: 0); serum aspartate aminotransferase (xULN) (1: 1; %26gt;1: 0). 1029, 698 and 382 patients had scores of 0-2, 3-4 and 5, respectively, among whom SVR rates were 35.0, 54.9 and 76.7%. SVR in patients with scores 5 and undetectable HCV RNA by week 4 was 86.7%. The score was tested against two databases of patients who received peginterferon alfa-2a/ribavirin in other clinical trials; similar high SVR rates in patients with scores 5 were reported. %26lt;br%26gt;ConclusionsThe scoring system can reliably identify treatment-naive HCV genotype 1 mono-infected Caucasian patients who have a high probability of achieving an SVR with peginterferon alfa-2a/ribavirin and will be particularly useful where protease inhibitors are not readily available.

• 出版日期2014-11