10 Potential Enhancement of Both Early (Evr) and Sustained (Svr) Virological Response by Fluvastatin in Chronic Hepatitis C Treated With Standard Pegifn-Ribavirin Therapy. A Pilot Study

Georgescu, E; Streba, Liliana; Teodorescu, R; Mateescu, Garofiţa Olivia; Abagiu, M. Tataru

doi:10.1016/s0168-8278(11)60012-3

Cited by 9 publications

(8 citation statements)

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“…However, compared to 64% in the control group, the difference was not significant. Interestingly, further analysis of the subgroups showed that the addition of fluvastatin to the optimized SOC treatment significantly improved the SVR in genotype 1 patients and high viral load (>400,000 IU/ml), which is in accordance with published studies [26,27]. …”

Section: Discussionsupporting

confidence: 89%

“…In a pilot study, Sezaki et al [25] demonstrated that the addition of fluvastatin 20 mg daily to SOC treatment might increase the SVR in patients infected with HCV genotype 1b and a high viral load. Recently, Georgescu et al [26] and Kondo et al [27 ]reported that the addition of fluvastatin 20 mg daily to SOC treatment significantly improved the SVR in patients infected with HCV genotype 1b. However, Milazzo et al [28] reported that the addition of fluvastatin 80 mg daily to SOC treatment did not significantly improve the SVR among HIV/HCV-coinfected patients, but significantly improved RVR.…”

Section: Discussionmentioning

confidence: 99%

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Impact of Added Fluvastatin to Standard-of-Care Treatment on Sustained Virological Response in Naïve Chronic Hepatitis C Patients Infected with Genotypes 1 and 3

et al. 2013

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Objectives: The combination of pegylated interferon-α and ribavirin is a standard-of-care (SOC) treatment for chronic hepatitis C (CHC), and it achieves a sustained virological response (SVR) in 41-52% of genotype 1 and in 73-79% of genotype 3 patients. In a few clinical trials, the combination of fluvastatin and SOC increased the SVR in genotype 1 patients. Methods: This prospective study enrolled 179 naïve CHC patients. In the fluvastatin group patients received the combination of SOC and fluvastatin 80 mg daily; historical controls matching the study group in genotype, age and gender were treated with the SOC treatment only. Results: On-treatment viral responses as well as the SVR did not differ significantly between the two groups, except for the genotype 1 patients with a high viral load presenting a significantly higher SVR rate in the fluvastatin group (75%) compared to the control group (41%; p = 0.024). Multivariate logistic regression identified hepatitis C virus (HCV) genotype 3 infection (p < 0.001), age ≤40 years (p < 0.001), liver steatosis <5% (p < 0.01) and low viral load (p < 0.001) as independent predictors of an SVR. Conclusion: A combination of fluvastatin and SOC significantly improved the SVR in naïve CHC patients infected with HCV genotype 1 and high viral load, but it did not improve the SVR in patients infected with HCV genotype 3.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Impact of Added Fluvastatin to Standard-of-Care Treatment on Sustained Virological Response in Naïve Chronic Hepatitis C Patients Infected with Genotypes 1 and 3

et al. 2013

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“…Our multivariate logistic regression analysis revealed that statin use was the only predictor for SVR. In agreement with our results Sezaki et al [25], Georgescu et al [26] and Kondo et al [27] who had demonstrated the addition of fluvastatin 20 mg daily to SOC treatment significantly improved the SVR in patients infected with HCV genotype 1b.…”

Section: Discussionsupporting

confidence: 93%

Statins Added to Chronic Hepatitis C Treatment: Is it Beneficial?

Aa¹,

F²

2016

J Hepatol Gastroint Dis

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Objectives: Chronic hepatitis C (CHC) is a major health problem in Egypt with about 9.8% of Egyptian population having an active hepatitis C infection. Almost Every step in the Hepatitis C virus (HCV) life cycle is closely related to lipid metabolism. HCV circulate in the body in lipid-rich particle, attach to hepatocytes via lipoprotein receptors. Recent attention focused on HMG CoA Reductase inhibitors (statins) and their potential therapeutic role in hepatitis C. Methods:This retrospective closed cohort study included 60 naïve CHC patients. The HCV statins group patients (n = 26) received the combination of Standard of care (Interferon alfa and repavirin) and fluvastatin 80 mg daily; HCV non statins group (n = 43) treated with the SOC treatment only. Both groups receive their treatment over a duration of 48 weeks. Results:On-treatment viral responses as well as the SVR were significantly better in HCV statins group in comparison to HCV non statins group; rapid virological response (RVR), early virological response (EVR) and sustained virological response (SVR) were (13.3%, 73.3% and 68.3%) in HCV statins group vs. (0%, 58.8% and 52.9%) HCV non statins group with p value 0.00, 0.003 and 0.003 respectively. Multivariate logistic regression model identified statins use as a significant predictor of an SVR. Conclusion:A combination of fluvastatin and SOC significantly improved the SVR in naïve CHC Egyptian patients. Further powered randomized control trails are needed to elucidate statins role in HCV treatment. Keywords: HCV-treatment; Statins; Response AimThe primary aim of the study was to assess the efficacy of adding statins to SOC therapy (PEG IFN/ribavirin) on the on-treatment virologic response as well as on SVR in CHC naïve Egyptian patients.

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“…In another small, uncontrolled trial in which 20 mg/d of fluvastatin were given in addition to the Peg + R combination in 21 patients, SVR was 67% in 15 patients receiving triple therapy for 48 weeks [22]. In a recent randomized trial, Georgescu et al [23] analyzed the impact of adding 20 mg/d of fluvastatin or placebo to Peg + R on In addition to their antiviral effects, it has recently been shown that some statins (fluvastatin and simvastatin) are able to selectively induce apoptosis of hepatoma cells. Fluvastatin, a lipophilic statin, is known to inhibit proliferation and induce apoptosis in many cancer cells.…”

Section: Statins and Hepatitis C: Clinical Datamentioning

confidence: 99%

“…Additionally, emerging data from recent studies using statins either as monotherapy or in combination with the standard of care (SOC) are provocative [18][19][20][21][22][23][24].O'Leary et al [18] undertook a human pilot study and treated 10 CHC patients with hypercholesterolemia with atorvastatin (at the conventional daily dose of 20 mg) for 12 weeks. They reported no statistically significant change in HCV RNA levels compared with pretreatment levels at 4 and 12 weeks, in spite of improvement in lipid parameters.…”

Section: Statins and Hepatitis C: Clinical Datamentioning

confidence: 99%

Hepatitis C Virus and Statins: Is There a Role?

2011

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Hepatitis C treatment-response rates range from 50%-80% depending on genotype, viral load, fibrosis stage, interleukin 28B (IL28B) polymorphism, and metabolic abnormalities. Lipid metabolism could influence sustainedvirological response (SVR), and raised levels of low-density lipoprotein cholesterol were found in sustained responders. The capacity of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors to impede hepatitis C virus (HCV) replicon replication in vitro in a dose-dependent fashion raised hope that this class of medications could serve as an adjunct to standard interferon-based therapy. In cell culture models of HCV infection, antiviral activity of statins was greater for fluvastatin. The mechanisms by which statins interfere with HCV replication are not completely understood yet. Adding statins to peginterferon plus ribavirin may improve (SVR) in HCV patients, but this method requires further prospective evaluation. However, current data suggest that lipid metabolism may be linked to IL28B polymorphisms, and patients bearing favorable genotype CC (rs12979860) showed higher cholesterol levels and higher (SVR) rates, emerging as a confounding factor in the interaction of statins and SVR. The use of statins raises many questions, and additional trials are needed before we can use statins as adjuvant therapy for HCV.

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10 Potential Enhancement of Both Early (Evr) and Sustained (Svr) Virological Response by Fluvastatin in Chronic Hepatitis C Treated With Standard Pegifn-Ribavirin Therapy. A Pilot Study

Cited by 9 publications

References 0 publications

Impact of Added Fluvastatin to Standard-of-Care Treatment on Sustained Virological Response in Naïve Chronic Hepatitis C Patients Infected with Genotypes 1 and 3

Impact of Added Fluvastatin to Standard-of-Care Treatment on Sustained Virological Response in Naïve Chronic Hepatitis C Patients Infected with Genotypes 1 and 3

Statins Added to Chronic Hepatitis C Treatment: Is it Beneficial?

Hepatitis C Virus and Statins: Is There a Role?

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