Interferon plus amantadine versus interferon alone in the treatment of naı̈ve patients with chronic hepatitis C: a UK multicentre study

Amantadine for chronic hepatitis C: a magic bullet or yet another dead duck?

“…Possibly, but the case is still open. An interesting finding in both studies [27,28] is that at 3 months of treatment, patients on the combination are significantly more likely to be HCV-RNA negative (62 vs. 47% in the UK study, 61 vs. 46% in the Italian study). These figures, which are consistently higher than the ETR, suggest that an initial additive effect of AMA exists, and helps to reduce temporarily the viral load to undetectable levels.…”

“…Debate has recently been focused on the possible use of amantadine (AMA), an agent with direct activity against RNA viruses, to enhance the effects of interferons. Two papers [27,28] add to the controversy.…”

“…In the first, ref. [27], produced by a cooperative UK group after a small pilot trial at one of the centres involved, a total of 179 naïve patients (pilot 1 multicentre studies), 9% with cirrhosis and an unusually low 32% of genotype 1, were randomized to receive IFN-a-2a at 4.5 MU t.i.w. for 48 weeks with or without AMA hydrochloride at 100 mg twice daily.…”

“…Other studies of triple therapy with or without IFN induction [33][34][35][36] in smaller series of nonresponders or relapsers to IFN monotherapy would suggest that adding AMA does not recover a significant amount of sustained responsiveness. It is unknown whether the slight advantage observed for AMA in viral clearance rates at 3 months in naïves [27,28] also exists in non-responders.…”