PT - JOURNAL ARTICLE AU - Cammà, C AU - Bruno, S AU - Schepis, F AU - Lo Iacono, O AU - Andreone, P AU - Gramenzi, A G AU - Mangia, A AU - Andriulli, A AU - Puoti, M AU - Spadaro, A AU - Freni, M AU - Di Marco, V AU - Cino, L AU - Saracco, G AU - Chiesa, A AU - Crosignani, A AU - Caporaso, N AU - Morisco, F AU - Rumi, M G AU - Craxì, A TI - Retreatment with interferon plus ribavirin of chronic hepatitis C non-responders to interferon monotherapy: a meta-analysis of individual patient data AID - 10.1136/gut.51.6.864 DP - 2002 Dec 01 TA - Gut PG - 864--869 VI - 51 IP - 6 4099 - http://gut.bmj.com/content/51/6/864.short 4100 - http://gut.bmj.com/content/51/6/864.full SO - Gut2002 Dec 01; 51 AB - Background and aims: Retreatment with a combination of α interferon (IFN) plus ribavirin of patients with chronic hepatitis C who did not respond to IFN monotherapy has not been assessed in large controlled studies. Methods: To assess the effectiveness and tolerability of IFN/ribavirin retreatment of non-responders to IFN and to identify predictors of complete (biochemical and virological) sustained response, we performed a meta-analysis of individual data on 581 patients from 10 centres. Retreatment with various IFN schedules (mean total dose 544 mega units) and a fixed ribavirin dose (1000–1200 mg/daily depending on body weight) was given for 24–60 (mean 39.5) weeks. Results: Biochemical end of treatment and sustained responses were observed in 271/581 (46.6%; 95% confidence interval (CI) 42.6–50.7%) and in 109/581 (18.7%; 95% CI 15.6–22.0%) cases, respectively. Two hundred and six of 532 patients (38.7%; 95% CI 34.6–42.9%) had an end of treatment complete response to retreatment while a complete sustained response occurred in 88 of 559 (15.7%; 95% CI 12.8–18.8%). Fifty four of 581 patients (9.2%; 95% CI 7.0–11.7%) stopped retreatment due to adverse effects. By logistic regression, complete sustained response was predicted independently by age <45 years (p=0.04), by normal pretreatment γ-glutamyltransferase levels (p=0.01), and by a second course total IFN dose of at least 432 mega units (p=0.008). Conclusions: The overall low probability of effectiveness argues against indiscriminate retreatment of all IFN monotherapy non-responders with IFN/ribavirin. Patients less than 45 years old with normal γ-glutamyltransferase levels who were retreated with high dose long course combination therapy had a complete sustained response rate of 30%.