Efficacy and safety of double filtration plasmapheresis in combination with interferon therapy for chronic hepatitis C

Kaneko, Shuichi; Sata, Michio; Ide, Tatsuya; Yamashita, Tatsuya; Hige, Shuhei; Tomita, Eiichi; Mochida, Satoshi; Yamashita, Yoshihisa; Inui, Yoshiaki; Kim, Soo Ryang; Komada, Naoto; Mikami, Takafumi; Satoh, S.; Morita, Sumiharu; Takaguchi, Koichi; Hirashima, Noboru; Nishio, Yuji; Watanabe, Daisuke; Kioka, Kiyohide; Fujiwara, Kenji

doi:10.1111/j.1872-034x.2010.00708.x

Cited by 21 publications

(22 citation statements)

References 20 publications

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“…In DFPP + PEG-IFN therapy, viral reduction after 4 weeks of treatment has been 2.43 ± 1.07 log IU/ml with overall SVR achieved in 70.8% (17/24) of patients [3], and 2.79 ± 1.85 log IU/ml with cEVR in 57.5% (104/181) [4]. The current study showed a viral reduction of 3.24 ± 1.00 log IU/ml with a cEVR rate of 45% (8/20 patients).…”

Section: Discussionmentioning

confidence: 99%

“…Re-treatment with PEG-IFN-α2a/RBV of 107 relapsers to PEG-IFN/RBV therapy has achieved cEVR in 43% [22]; re-treatment with PEG-IFN-α2a/RBV of 469 relapse and NVR patients to PEG-IFN-α2b/RBV has achieved cEVR in only 13% [23]. Re-treatment with DFPP + PEG-IFN/RBV of 73 relapse and NVR patients to previous PEG-IFN/RBV therapy has achieved cEVR in 63.0% of relapsers and in 18.9% of NVR patients [4]. Therefore, it is expected that the addition of DFPP to PEG-IFN/RBV therapy will be effective in the re-treatment of relapse and NVR patients to previous PEG-IFN/RBV therapy.…”

Section: Discussionmentioning

confidence: 99%

“…By the protocol-defined primary analysis of the former, the SVR rate has been 16% at the most, even for a 72-week induction group [2]. The use of DFPP (approved in Japan in April 2008 for the re-treatment of chronic CHC patients with genotype 1b and high viral loads) together with IFN administration has produced a substantial reduction in the viral load during the early stages of treatment, and has effected a high SVR [3,4], suggesting that this treatment is a new modality for difficult-to-treat CHC patients. …”

Section: Introductionmentioning

confidence: 99%

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Double-Filtration Plasmapheresis plus Interferon-β for HCV-1b Patients with Non-Sustained Virological Response to Previous Combination Therapy

Kim

Saito²,

Imoto³

et al. 2011

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Background and Aims: Double-filtration plasmapheresis (DFPP) together with interferon (IFN) administration produces a substantial reduction in the viral load during the early stages of treatment. Methods: Based on their responses to previous pegylated IFN and ribavirin (PEG-IFN/RBV) therapy, 20 patients were divided into null virological response (NVR; n = 12) and relapse (n = 8) groups. DFPP was used in combination with IFN-β/RBV with subsequent administration of PEG-IFN-α2a/RBV therapy (DFPP + IFN-β/RBV then PEG-IFN/RBV). Early viral dynamics was assessed, focusing especially on complete early virological response (cEVR) associated with sustained virological response. Additionally, the interleukin 28B gene, the IFN/RBV resistance-determining region, the IFN sensitivity-determining region and the core regions were analyzed. Results: Rapid virological response was achieved in 0% (0/12) of NVR and in 75% (6/8) of relapse patients, with a significant difference between the two groups (p = 0.001). Similarly, cEVR was achieved in 8% (1/12) of NVR and in 88% (7/8) of relapse patients, with a significant difference between the two groups (p = 0.037). By multivariate logistic regression analysis, interleukin-28B major was a significant determiner of cEVR (odds ratio = 24.19, p = 0.037). Conclusion: DFPP + IFN-β/RBV then PEG-IFN/RBV therapy is indicated more for relapse than for NVR patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Double-Filtration Plasmapheresis plus Interferon-β for HCV-1b Patients with Non-Sustained Virological Response to Previous Combination Therapy

Kim

Saito²,

Imoto³

et al. 2011

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“…Combination of DFPP and IFN also achieved impressive SVR in difficult-to-treat patients (i.e., relapsed, nonresponder, or HIVcoinfected patients) [181][182][183][184] and may also be safe for the elderly population [185]. However, the approach of apheresis for decreasing HCV viral load requires specialty equipment and possesses potential risk of adverse events (e.g., blood pressure lowering, puncture site hematoma, or infection) [181,185].…”

Section: Therapeutic Apheresis For the Removal Of Hcv Virionsmentioning

confidence: 99%

Strategies to Preclude Hepatitis C Virus Entry

Burnouf¹,

Lin²

2017

Advances in Treatment of Hepatitis C and B

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Without a preventive vaccine, hepatitis C virus (HCV) remains an important pathogen worldwide with millions of carriers at risk of end-stage liver diseases. Despite the introduction of novel direct-acting antivirals (DAAs), resistance problems, challenges with the difficult-to-treat populations and high costs limit the widespread application of these drugs. Antivirals with alternative mechanism(s) of action, such as by restricting viral entry or cell-to-cell spread, could help expand the scope of antiviral strategies for the management of hepatitis C. Transfusion-associated HCV infection remains another issue in endemic and resource-limited areas around the world. This chapter describes some of the latest developments in antiviral strategies to preclude HCV entry, such as through monoclonal antibodies and small molecules, as well as measures to enhance the safety of therapeutic plasma products in blood transfusion.

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“…The use of double-filtration plasmapheresis (DFPP), approved in Japan in April 2008 for the retreatment of chronic CHC patients with genotype 1b and high viral loads, together with IFN administration has produced a substantial reduction in the viral load during the early stages of treatment and has effected a high sustained virological response (SVR) [8,9], suggesting that this treatment is a new modality for difficult-to-treat CHC patients.…”

Section: Double-filtration Plasmapheresismentioning

confidence: 99%

Tailor-Made Therapy for Viral Hepatitis: Recent Advances

Kudo

2011

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Combination therapy of pegylated interferon-α with ribavirin (PEG-IFN/RBV) is a standard of care for chronic hepatitis C (CHC). The majority of CHC patients are infected with HCV genotype I. The recent discovery revealed by a genome-wide association study technology provides the important role of interleukin-28B (IL28B) and inosine triphosphatase (ITPA) in HCV infection. In addition, response to PEG-IFN/RBV therapy is correlated with insulin resistance, hepatic steatosis, and hepatic fibrosis in CHC patients. Double-filtration plasmapheresis together with IFN therapy has proved to be effective in the reduction of viral load during the early stage of treatment. In CHC patients, not only IL28B status, but also the treatment period of PEG-IFN/RBV is important. Even when new polymerase/protease inhibitors are introduced in the treatment of CHC, tailor-made treatment for CHC using IL28B, inosine triphosphatase testing or double-filtration plasmapheresis treatment prolonged treatment strategy is highly recommended. The relative etiologic role of prior hepatitis B virus infection in the development of non-B non-C hepatocellular carcinoma is also known in hepatitis B-endemic areas.

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Efficacy and safety of double filtration plasmapheresis in combination with interferon therapy for chronic hepatitis C

Abstract: The cEVR results in this study suggest that high rates of sustained virological response can be achieved in retreated and treatment-naïve patients using DFPP in combination with PEG-IFN/RBV therapy. Results indicate that this therapy could be safely conducted, even in elderly patients.

Cited by 21 publications

References 20 publications

Double-Filtration Plasmapheresis plus Interferon-β for HCV-1b Patients with Non-Sustained Virological Response to Previous Combination Therapy

Double-Filtration Plasmapheresis plus Interferon-β for HCV-1b Patients with Non-Sustained Virological Response to Previous Combination Therapy

Strategies to Preclude Hepatitis C Virus Entry

Tailor-Made Therapy for Viral Hepatitis: Recent Advances

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