Responses are durable for up to 5 years after completion of peginterferon alfa-2a treatment in hepatitis B e antigen-positive patients

W. L. Chuang, J. Jia, H. L.Y. Chan, K. H. Han, T. Tanwandee, D. Tan, X. Chen, E. Gane, T. Piratvisuth, L. Chen, Q. Xie, J. J.Y. Sung, D. Messinger, C. Wat, G. Bakalos, Y. F. Liaw

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    3 Scopus citations

    Abstract

    Background: In the large randomised NEPTUNE study, peginterferon alfa-2a 180 μg/wk for 48 weeks produced higher hepatitis B e antigen (HBeAg) seroconversion rates 24 weeks post-treatment (36%) than a lower dose (90 μg/wk) and/or shorter duration (24 weeks) (range 14%-26%). Aim: To determine seroconversion rates 5 years after completion of treatment in NEPTUNE. Methods: HBeAg-positive patients who completed 24 weeks’ follow-up in NEPTUNE (with peginterferon alfa-2a 90 μg/wk × 24 weeks [group 1]; 180 μg/wk × 24 weeks [2]; 90 μg/wk × 48 weeks [3] or 180 μg/wk × 48 weeks [4]) were followed up. Results: Three hundred and eighty three of the 544 patients in the original study were enrolled in the long-term follow-up study. Many patients (196 overall; more in groups 1-3 than 4) received nucleos(t)ide analogues or immunomodulators during follow-up, and more patients had missing data at year 5 in groups 2 and 4 (48 weeks, 50/112) than in groups 1 and 3 (24 weeks, 23/103), which confounds the planned per-protocol analysis. HBeAg seroconversion rates in groups 1, 2, 3 and 4 at year 5 were 47.5%, 50.7%, 52.2% and 67.1%, respectively, (odds ratio for group 4 versus 1-3: 2.02; 95% CI 1.21, 3.38), using multiple imputation methods for missing measurements. Conclusion: Seroconversion rates are durable for up to 5 years after completion of peginterferon alfa-2a therapy and, consistent with NEPTUNE, the results suggest that the licensed regimen (180 μg × 48 weeks) is more efficacious for HBeAg-positive patients than a lower dose and/or shorter treatment duration.

    Original languageEnglish (US)
    Pages (from-to)1306-1316
    Number of pages11
    JournalAlimentary Pharmacology and Therapeutics
    Volume47
    Issue number9
    DOIs
    StatePublished - May 2018

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    ASJC Scopus subject areas

    • Hepatology
    • Gastroenterology
    • Pharmacology (medical)

    Cite this

    Chuang, W. L., Jia, J., Chan, H. L. Y., Han, K. H., Tanwandee, T., Tan, D., Chen, X., Gane, E., Piratvisuth, T., Chen, L., Xie, Q., Sung, J. J. Y., Messinger, D., Wat, C., Bakalos, G., & Liaw, Y. F. (2018). Responses are durable for up to 5 years after completion of peginterferon alfa-2a treatment in hepatitis B e antigen-positive patients. Alimentary Pharmacology and Therapeutics, 47(9), 1306-1316. https://doi.org/10.1111/apt.14595