Ribavirin

Red

Brand Name(s):Rebetol, Copegus

Indication:Hepatitis C

Rationale:1,2,3,8

Considered:Mar-04

Review Date:Mar-20

Comments:
NICE TA 331
Simeprevir (also known as Olysio) with peginterferon alfa and ribavirin is recommended as a possible treatment for adults with genotype 1 or 4 chronic hepatitis C.

Full guidance available at:http://www.nice.org.uk/guidance/ta331/resources/guidance-simeprevir-in-combination-with-peginterferon-alfa-and-ribavirin-for-treating-genotypes1-and4-chronic-hepatitisc-pdf
Feb 2015
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NICE TA 300 – Information at: http://www.nice.org.uk/nicemedia/live/14311/65882/65882.pdf
Nov 2013
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Refer to NICE Guidance PH43 December 2012 – Hepatitis B and C Ways to promote and offer testin

1.1 Combination therapy with peginterferon alfa (2a or 2b) and ribavirin is recommended as a treatment option for adults with chronic hepatitis C:
* who have been treated previously with peginterferon alfa (2a or 2b) and ribavirin in combination, or with peginterferon alfa monotherapy, and whose condition either did not respond to treatment or responded initially to treatment but subsequently relapsed or
* who are co-infected with HIV.

1.2 Shortened courses of combination therapy with peginterferon alfa (2a or 2b) and ribavirin are recommended for the treatment of adults with chronic hepatitis C who:
* have a rapid virological response to treatment at week 4 that is identified by a highly sensitive test and
* are considered suitable for a shortened course of treatment.

1.3 When deciding on the duration of combination therapy, clinicians should take into account the licensed indication of the chosen drug (peginterferon alfa-2a or peginterferon alfa-2b), the genotype of the hepatitis C virus, the viral load at the start of treatment and the response to treatment (as indicated by the viral load).

NICE TA 200
Peginterferon alfa and ribavirin for the treatment of chronic hepatitis C September 2010

1.1 Combination therapy, comprising peginterferon alfa-2a and ribavirin or peginterferon alfa-2b and ribavirin, is recommended, within the licensed indications of these drugs, for the treatment of mild chronic hepatitis C.

1.2 Monotherapy with peginterferon alfa-2a or peginterferon alfa-2b is recommended, within the licensed indications of these drugs, for the treatment of mild chronic hepatitis C for people who are unable to tolerate ribavirin, or for whom ribavirin is contraindicated.

1.3 The decision on whether a person with mild chronic hepatitis C should be treated immediately or should wait until the disease has reached a moderate stage (‘watchful waiting’) should be made by the person after fully informed consultation with the responsible clinician. The decision to treat need not depend on a liver biopsy to determine the stage of the disease if treatment is initiated immediately. However, a biopsy may be recommended by the clinician for other reasons or if a strategy of watchful waiting is chosen.

1.4 There is insufficient evidence to recommend combination therapy or monotherapy with peginterferon alfa for people with mild chronic hepatitis C who are under the age of 18 years, or those who have had a liver transplant.

NICE TA 75
Peginterferon alfa and ribavirin for the treatment of mild chronic hepatitis C November 2007