Technology Appraisal Guidance No. 106
Source: National Institute for Health and Care Excellence
This guidance has been partially updated by ‘Peginterferon alfa and ribavirin for the treatment of chronic hepatitis C’ (NICE technology appraisal guidance 200 [TA200]) and 'Peginterferon alfa and ribavirin for treating chronic hepatitis C in children and young people' (NICE technology appraisal guidance 300), as shown below.
NICE issued guidance on the use of interferon alfa, pegylated interferon alfa (peginterferon alfa) and ribavirin in the treatment of people with moderate to severe chronic hepatitis C in January 2004 (NICE technology appraisal guidance 75). The evidence in this appraisal relates to the extension of this treatment to people with mild chronic hepatitis C.
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1.4 This recommendation has been updated and replaced by NICE technology appraisal guidance 200.
1.5 This recommendation has been updated and replaced by NICE technology appraisal guidance 200.
1.6 There is insufficient evidence to recommend combination therapy or monotherapy with peginterferon alfa for people with mild chronic hepatitis C who have had a liver transplant. For those under the age of 18 years, see NICE technology appraisal guidance 300.
The guidance shown above constitutes Section 1 of the full document. A copy of the full document and a summary of the evidence is available on the Internet at http://www.nice.org.uk/guidance/ta106
Copies of the document can also be obtained by contacting 0845 003 7783 or emailing email@example.com and quoting reference number N1099.
This guidance represents the view of the Institute which was arrived at after careful consideration of the available evidence. Health professionals are expected to fully take it into account when exercising their clinical judgement. This guidance does not, however, override the individual responsibility of health professionals to make appropriate decisions in the circumstances of the individual patient, in consultation with the patient and/or guardian or carer.
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Enquiries concerning the guidance should be addressed to: National Institute for Health and Care Excellence, MidCity Place, 71 High Holborn, London WC1V 6NA. email: firstname.lastname@example.org
Peginterferon Alfa and Ribavirin for the Treatment of Mild Chronic Hepatitis C.
Issue Date: August 2006
Review Date: November 2007