{"id":1782,"date":"2004-10-01T01:00:00","date_gmt":"2004-10-01T00:00:00","guid":{"rendered":"https:\/\/angh.net\/abstracts\/traitement-par-interferon-pegyle-alfa-2b-et-ribavirine-de-malades-atteints-dhepatite-chronique-c-non-repondeurs-resultats-de-letude-multicentrique-nationale-ribapeg-nr-angh\/"},"modified":"2018-10-20T18:39:34","modified_gmt":"2018-10-20T16:39:34","slug":"traitement-par-interferon-pegyle-alfa-2b-et-ribavirine-de-malades-atteints-dhepatite-chronique-c-non-repondeurs-resultats-de-letude-multicentrique-nationale-ribapeg-nr-angh","status":"publish","type":"post","link":"https:\/\/angh.net\/abstracts\/traitement-par-interferon-pegyle-alfa-2b-et-ribavirine-de-malades-atteints-dhepatite-chronique-c-non-repondeurs-resultats-de-letude-multicentrique-nationale-ribapeg-nr-angh\/","title":{"rendered":"TRAITEMENT PAR INTERFERON PEGYLE ALFA 2B ET RIBAVIRINE DE MALADES ATTEINTS D\u2019HEPATITE CHRONIQUE C NON REPONDEURS : RESULTATS DE L\u2019ETUDE MULTICENTRIQUE NATIONALE RIBAPEG-NR (ANGH)"},"content":{"rendered":"

2004<\/strong><\/p>\n

I Rosa, V Auray-Cartier, H Hag\u00e8ge, P Cassan, C Wartelle, J Denis, JP Arpurt, O Nouel, D Gargot, B Nalet, A Pariente, M Chousterman et le groupe d’\u00e9tude RIBAPEG-NR.<\/em><\/p>\n

H\u00e9patologie <\/strong>– \u00a00000-00-00 –\u00a0CO –<\/p>\n

________________________________<\/p>\n

L\u2019attitude th\u00e9rapeutique concernant les malades atteints d\u2019h\u00e9patite chronique C non r\u00e9pondeurs n\u2019est pas codifi\u00e9e et l\u2019efficacit\u00e9 et les modalit\u00e9s de la bith\u00e9rapie pegyl\u00e9e doivent \u00eatre \u00e9valu\u00e9es chez ces malades.
\nLe but de cette \u00e9tude a \u00e9t\u00e9 d\u2019\u00e9valuer l\u2019efficacit\u00e9 et la tol\u00e9rance de deux sch\u00e9mas th\u00e9rapeutiques associant l\u2019interf\u00e9ron pegyl\u00e9 alfa 2b (PEG-IFN) \u00e0 la ribavirine (RBV) chez des malades n\u2019ayant pas r\u00e9pondu \u00e0 un premier traitement par interf\u00e9ron standard en monoth\u00e9rapie ou en association avec la ribavirine.
\nMalades et m\u00e9thodes : il s\u2019agissait d\u2019une \u00e9tude ouverte multicentrique de phase 3, randomis\u00e9e. Les malades recevaient soit : un traitement d’induction PEG-IFN 2\u00b5g\/kg\/semaine + RBV 800 mg\/jour pendant 8 semaines puis PEG-IFN 1\u00b5g\/kg\/semaine + RBV 800 mg\/jour pendant 40 semaines (Bras A), soit : PEG-IFN 1\u00b5g\/kg\/semaine + RBV 800 mg\/jour pendant 48 semaines (Bras B). Les malades \u00e9taient stratifi\u00e9s \u00e0 l\u2019inclusion selon le g\u00e9notype (1 versus non-1), et selon le traitement ant\u00e9rieur (IFN versus IFN + RBV). Le traitement \u00e9tait stopp\u00e9 si l\u2019ARN du VHC \u00e9tait positif \u00e0 la 24\u00e8me semaine. Le crit\u00e8re principal de jugement \u00e9tait la r\u00e9ponse virologique prolong\u00e9e (RVP) d\u00e9finie par un ARN du VHC n\u00e9gatif 6 mois apr\u00e8s la fin du traitement. L\u2019analyse \u00e9tait r\u00e9alis\u00e9e en intention de traiter.
\nR\u00e9sultats : 233 malades ont \u00e9t\u00e9 inclus dans 53 centres hospitaliers g\u00e9n\u00e9raux, 118 dans le bras A et 115 dans le bras B. Les malades \u00e9taient infect\u00e9s par un g\u00e9notype 1 dans 69% des cas et la charge virale \u00e9tait >800 000 UI\/ml dans 71% des cas. Cinquante deux pour cent des malades avaient un score de fibrose F3-F4 selon METAVIR et 24% avaient une cirrhose constitu\u00e9e. Quarante deux pour cent des malades avaient \u00e9t\u00e9 trait\u00e9s par de l’IFN en monoth\u00e9rapie et 58% avaient re\u00e7u IFN +RBV. Le poids moyen des malades \u00e9tait de 73 kg (de 44 \u00e0 150 kg). La r\u00e9ponse virologique en fin de traitement \u00e9tait significativement sup\u00e9rieure chez les malades ayant re\u00e7u un traitement d’induction (Bras A), respectivement 31% versus 19% (Bras B) (p=0,02). A S72, la RVP globale \u00e9tait de 15,5%. Les facteurs pr\u00e9dictifs de r\u00e9ponse \u00e9taient le g\u00e9notype non 1 (26% versus 11%, p=0,002) et un traitement ant\u00e9rieur par IFN en monoth\u00e9rapie (21% versus 11%, p=0,02). En revanche, la RVP n’\u00e9tait pas significativement diff\u00e9rente dans les deux groupes induction\/non induction, respectivement 16% versus 15%.
\nConclusion :1) Chez les malades non r\u00e9pondeurs, la r\u00e9ponse virologique en fin de traitement est significativement sup\u00e9rieure dans le bras induction. 2) L’efficacit\u00e9 sup\u00e9rieure du traitement par induction n’est pas maintenue \u00e0 S72, la RVP globale \u00e9tant de 15,5%. 3) Le b\u00e9n\u00e9fice du traitement par induction pourrait \u00eatre conserv\u00e9 par une dur\u00e9e d’induction plus longue ou par une dur\u00e9e totale de traitement sup\u00e9rieure \u00e0 48 semaines. 3) Une dose de RBV sup\u00e9rieure \u00e0 celle de 800 mg\/jour utilis\u00e9e dans l’\u00e9tude pourrait permettre d’am\u00e9liorer la RVP globale.<\/p>\n","protected":false},"excerpt":{"rendered":"

2004 I Rosa, V Auray-Cartier, H Hag\u00e8ge, P Cassan, C Wartelle, J Denis, JP Arpurt, O Nouel, D Gargot, B Nalet, A Pariente, M Chousterman et le groupe d’\u00e9tude RIBAPEG-NR. H\u00e9patologie – \u00a00000-00-00 –\u00a0CO – ________________________________ L\u2019attitude th\u00e9rapeutique concernant les malades atteints d\u2019h\u00e9patite chronique C non r\u00e9pondeurs n\u2019est pas codifi\u00e9e et l\u2019efficacit\u00e9 et les modalit\u00e9s […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[3],"tags":[15],"class_list":["post-1782","post","type-post","status-publish","format-standard","hentry","category-hepatologie","tag-15"],"yoast_head":"\nTRAITEMENT PAR INTERFERON PEGYLE ALFA 2B ET RIBAVIRINE DE MALADES ATTEINTS D\u2019HEPATITE CHRONIQUE C NON REPONDEURS : RESULTATS DE L\u2019ETUDE MULTICENTRIQUE NATIONALE RIBAPEG-NR (ANGH) - Abstracts des congr\u00e8s de l'ANGH<\/title>\n<meta name=\"description\" content=\"ANGH R\u00e9sum\u00e9s congr\u00e8s H\u00e9patologie Gastroent\u00e9romogie Hepatology Gastroenterology Etudes cliniques Clinical study\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/angh.net\/abstracts\/traitement-par-interferon-pegyle-alfa-2b-et-ribavirine-de-malades-atteints-dhepatite-chronique-c-non-repondeurs-resultats-de-letude-multicentrique-nationale-ribapeg-nr-angh\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"TRAITEMENT PAR INTERFERON PEGYLE ALFA 2B ET RIBAVIRINE DE MALADES ATTEINTS D\u2019HEPATITE CHRONIQUE C NON REPONDEURS : RESULTATS DE L\u2019ETUDE MULTICENTRIQUE NATIONALE RIBAPEG-NR (ANGH) - 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