Brief Article
Copyright ©2010 Baishideng. All rights reserved.
World J Gastroenterol. Jan 7, 2010; 16(1): 89-97
Published online Jan 7, 2010. doi: 10.3748/wjg.v16.i1.89
On-treatment predictions of success in peg-interferon/ribavirin treatment using a novel formula
Hidetsugu Saito, Hirotoshi Ebinuma, Keisuke Ojiro, Kanji Wakabayashi, Mika Inoue, Shinichiro Tada, Toshifumi Hibi
Hidetsugu Saito, Hirotoshi Ebinuma, Keisuke Ojiro, Kanji Wakabayashi, Mika Inoue, Shinichiro Tada, Toshifumi Hibi, Department of Internal Medicine, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 1608582, Japan
Author contributions: Saito H, Ebinuma H, Ojiro K, Wakabayashi K and Tada S contributed to the analysis of the clinical data; Inoue M contributed as a clinical assistant to collect data from the affiliated hospitals; Hibi T provided financial support for this work; Saito H designed the study and wrote the manuscript.
Correspondence to: Hidetsugu Saito, MD, PhD, Department of Internal Medicine, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 1608582, Japan. hsaito@sc.itc.keio.ac.jp
Telephone: +81-3-33531211  Fax: +81-3-33518705
Received: September 25, 2009
Revised: November 6, 2009
Accepted: November 13, 2009
Published online: January 7, 2010
Abstract

AIM: To predict treatment success using only simple clinical data from peg-interferon plus ribavirin therapy for chronic hepatitis C.

METHODS: We analyzed the clinical data of 176 patients with chronic hepatitis and hepatitis C virus genotype 1 who received 48 wk standard therapy, derived a predictive formula to assess a sustained virological response of the individual patient using a logistic regression model and confirmed the validity of this formula. The formula was constructed using data from the first 100 patients enrolled and validated using data from the remaining 76 patients.

RESULTS: Sustained virological response was obtained in 83 (47.2%) of the patients and we derived formulae to predict sustained virological response at pretreatment and weeks 4, 12 and 24. The likelihood of sustained virological response could be predicted effectively by the formulae at weeks 4, 12 and 24 (the area under the curve of the receiver operating characteristic: 0.821, 0.802, and 0.891, respectively), but not at baseline (0.570). The formula at week 48 was also constructed and validation by test data achieved good prediction with 0.871 of the area under the curve of the receiver operating characteristic. Prediction by this formula was always superior to that by viral kinetics.

CONCLUSION: These results suggested that our formula combined with viral kinetics provides a clear direction of therapy for each patient and enables the best tailored treatment.

Keywords: Logistic regression analysis, Predictive formula, Prolongation of the therapy, Response-guided therapy, Viral kinetics