Efficacy and tolerability of pegylated‐interferon alpha‐2a in hemodialysis patients with chronic hepatitis C

Kökoğlu, Ömer Faruk; Uçmak, Hasan; Hoşoğlu, Salih; Çetinkaya, Ali; Kantarçeken, Bülent; Büyükbeşe, Mehmet Akif; Isık, Ismet Onder

doi:10.1111/j.1440-1746.2005.04008.x

Cited by 81 publications

(70 citation statements)

References 30 publications

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“…Regarding IFN monotherapy in hemodialysis patients with chronic HCV infection, there are limited data in Turkey provided from studies of small series, and SVR rates vary between 46.1-75% in these series. Apart from our case report, we could not encounter a study subjecting ribavirin or protease inhibitor usage in hemodialysis patients in Turkey [3,[19][20][21][22] .…”

Section: Discussionmentioning

confidence: 94%

Sustained Virologic Response with Triple Therapy in a Hemodialysis Patient with Chronic HCV Infection

Kaygusuz¹,

Gül²,

Gülhan³

2014

Mediterr J Infect Microb Antimicrob

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Chronic hepatitis C virus (HCV) infection is more prevalent and has been proven to be an independent risk factor over mortality among hemodialysis patients than normal population. Since sustained virologic response (SVR) is so beneficial and may be maintained in 90-100% of post-transplant cases, treatment of chronic HCV infection is strongly suggested for all patients undergoing renal transplantation. A 45-year-old male patient had been offered to have renal transplantation due to chronic renal failure, and referred to our clinic because of chronic HCV infection (HCV-RNA positive). He had received hemodialysis three times a week since 2007. The patient was diagnosed with chronic HCV infection fifteen years ago and was given a 48-week lasting IFN therapy in 2000 and a subsequent therapy of PEG-IFN-α2a for 48 weeks in 2004. Although both therapies had yielded end of treatment responses, subsequent relapses occurred. The patient was given a combination treatment involving PEG-IFN-α2a (135 μg/wk) for 24 weeks and ribavirin (200 mg/day) for 24 weeks and telaprevir (3 x 750 mg) for the first 12 weeks, and a weekly control visit in our clinic. The therapy was generally well tolerated and SVR was achieved. Triple therapy might be used as a treatment option in hemodialysis patients with genotype 1 chronic HCV infections.

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Section: Discussionmentioning

confidence: 94%

Sustained Virologic Response with Triple Therapy in a Hemodialysis Patient with Chronic HCV Infection

Kaygusuz¹,

Gül²,

Gülhan³

2014

Mediterr J Infect Microb Antimicrob

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“…36,119 Many Asian experts treated dialysis patients with HCV infection by using PEG-IFN α-2a or PEG-IFN α-2b monotherapy for 24-48 weeks. [120][121][122][123][124][125][126][127][128][129] However, the SVR rates varied widely (from 0%-100%) because of small sample size, heterogeneous population, and divergent regimens. Recently, two large-scale trials evaluated East Asian HCV-1 and HCV-2 hemodialysis patients receiving PEG-IFN α-2a for 48 and 24 weeks, and the SVR rates …”

Section: Peginterferon α With or Without Rbv Therapy In A Special Popmentioning

confidence: 99%

Nanomedicines in the treatment of hepatitis C virus infection in Asian patients: optimizing use of peginterferon alfa

Liu¹,

Kao

2014

IJN

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Asia is endemic for hepatitis C virus (HCV) infection, which is the leading cause of cirrhosis, hepatic decompensation, hepatocellular carcinoma, and liver transplantation worldwide. HCV has six major genotypes and each HCV genotype has its specific geographic distribution. HCV genotypes 1, 2, 3, and 6 are common in Asia. The aim of HCV treatment is to eradicate the virus by effective therapeutic agents; viral clearance is durable after long-term post-treatment follow-up. In most Asian countries, peginterferon alfa (PEG-IFN α) in combination with ribavirin remains the standard of care, and the overall sustained viral response (SVR) rate in Asian HCV patients is higher than that in Western patients. The differences are most significant in patients with HCV genotype 1 (HCV-1) infection, which is attributed to the higher frequency of IFN-responsive or favorable interleukin-28B (IL-28B) genotype in Asian populations than in other ethnic populations. In addition, the introduction of response-guided therapy, where the optimized treatment duration is based on the early viral kinetics during the first 12 weeks of treatment, increases the SVR rate. Recently, telaprevir or boceprevir-based triple therapy was found to further improve the SVR rate in treated and untreated HCV-1 patients and has become the new standard of care in Western and some Asian countries. Many novel direct-acting antiviral agents, either in combination with PEG-IFN α plus ribavirin or used as IFN-free regimens are under active investigation. At the time of this writing, simeprevir and sofosbuvir have been approved in the US. Because the SVR rates in Asian HCV patients receiving PEG-IFN α plus ribavirin therapy are high, health care providers should judiciously determine the clinical usefulness of these novel agents on the basis of treatment duration, anticipated viral responses, patient tolerance, financial burdens, and drug accessibility.

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“…15 PEG IFNs are an attractive option for the treatment of HCV-infected HD patients. [9][10][11][12][13] Although PEG IFN alpha-2b is mainly excreted by the kidneys, 14,22 PEG IFN alpha-2a, because of its pharmacokinetic properties and its prevalent hepatic excretion, could have a greater utilization rationale in patients with various degrees of kidney impairment or with endstage disease. 14 Pharmacokinetics studies have confi rmed the feasibility of PEG IFN alpha-2a therapy at full dosages in patients with creatinine clearance as low as 20 mL/ minute.…”

Section: Peg-ifn Alpha-2a Monotherapy In Hd Hepatitis C Patientsmentioning

confidence: 99%

“…[9][10][11][12][13] In particular, PEG-IFN alpha-2a, because of its hepatic clearance, is an attractive option for patients with ESRD undergoing HD. 14 The aim of this pilot study was to investigate the effi cacy, safety, and tolerability of PEG-IFN alpha-2a in 10 HD patients with chronic hepatitis C.…”

mentioning

confidence: 99%

Monotherapy with Pegylated Interferon Alpha‐2a in Hemodialyzed Patients with Chronic Hepatitis C

Zoppoli

Maio²,

Artioli

et al. 2008

Dialysis & Transplantation

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BACKGROUND In our pilot study, we aimed to treat a group of HCV-infected HD patients with pegylated interferon (PEG-IFN) alpha-2a, a new and potentially efficacious therapeutic possibility. METHODS We treated 10 consecutively enrolled chronic hepatitis C hemodialysis (HD) patients (5 men, 5 women; ages 31-70 years; 7 with genotypes 1-4, 3 with genotypes 2-3) with PEG-IFN alpha-2a (135 μg/week) for 24 weeks (genotypes 2-3) or for 48 weeks (genotypes 1-4). Primary end points were sustained viral response (SVR) rate and safety and tolerability profiles. Secondary end points were rapid response (after 12 weeks of treatment), and response at the end of therapy. RESULTS Viral load reduction was observed in all the patients after 12 weeks of treatment. Seven were HCV-RNA negative and continued therapy. Five patients dropped out before the completion of therapy because of significant adverse events (pancytopenia, severe weight loss). PEG-IFN alpha-2a was reduced to 90 μg/week in 5 patients within the first 4 weeks of therapy. Overall, SVR was 20% at the end of follow-up. CONCLUSION PEG-IFN alpha-2a is efficacious in inducing a fast virological response (12 weeks of therapy) in 70% of HCV-infected HD patients and a considerable fall in liver cytolysis enzymes blood values. The use of granulocyte colony-stimulating factor for neutropenia, starting with lower initial doses of PEG-IFN alpha-2a (e.g., 90 μg/week) or in combination with ribavirin, after appropriate dose adjustment studies, should be evaluated in randomized prospective studies

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Efficacy and tolerability of pegylated‐interferon alpha‐2a in hemodialysis patients with chronic hepatitis C

Abstract: The present study showed that PEG-IFN alpha-2a for 48 weeks is efficacious and well tolerated in hemodialysis patients with HCV.

Cited by 81 publications

References 30 publications

Sustained Virologic Response with Triple Therapy in a Hemodialysis Patient with Chronic HCV Infection

Sustained Virologic Response with Triple Therapy in a Hemodialysis Patient with Chronic HCV Infection

Nanomedicines in the treatment of hepatitis C virus infection in Asian patients: optimizing use of peginterferon alfa

Monotherapy with Pegylated Interferon Alpha‐2a in Hemodialyzed Patients with Chronic Hepatitis C

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