Ribavirin in the treatment of chronic hepatitis C unresponsive to alfa interferon

Camps, J.; Garcı́a, Nicolás; Riezu-Boj, José Ignacio; Civeira, M.P.; Prieto, Jesús

doi:10.1016/s0168-8278(05)80550-1

Cited by 61 publications

(29 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[7][8][9][10] Most of these studies were of small sample size, and heterogeneous treatment regimens complicate interpretation of results. Others have tried to re-treat with ribavirin, either alone 11,12 or in combination with interferon, 13,14 with variable success. However, these were again small series and their results need to be confirmed with larger randomized trials.…”

mentioning

confidence: 99%

Re-treatment with interferon alfa of patients with chronic hepatitis C

et al. 1998

View full text Add to dashboard Cite

Treatment of patients with chronic hepatitis C has had limited success because of relapses and nonresponse to interferon alfa therapy (currently the only established therapeutic agent). A retrospective study was done to determine the efficacy of re-treatment with interferon and the predictors of response in patients who failed to achieve sustained response after one standard course of interferon therapy (3 million units three times a week for 24 weeks). One hundred and eleven patients (47 relapsers and 64 nonresponders), mean age 45 years, were included in the study. Eighteen relapsers and 13 nonresponders received a higher dose (5 MU), and 11 relapsers and 6 nonresponders received a longer duration (48 weeks) of interferon therapy. The remaining patients received the same regimen as the first treatment. Eighty-one percent and 23% of relapsers and nonresponders, respectively, had an end-of-treatment response, and 19% and 3% of the corresponding patient groups had a sustained response to re-treatment. Two patients with breakthrough during their first treatment were the only nonresponders with sustained response after re-treatment. Sustained response was observed only in patients who received an increased dose or duration of interferon therapy. No predictor of sustained response was found. In conclusion, sustained response to re-treatment with interferon was only observed with augmentation of dose or duration of therapy in some relapsers and patients who had breakthrough. Established predictors of response to interferon in naive patients, in particular serum hepatitis C virus RNA and genotype, were not associated with sustained response to re-treatment. (HEPATOLOGY 1998;27: 1144-1148.)To date, interferon remains the only established therapeutic agent for the treatment of chronic hepatitis C. Administration of 3 MU of interferon alfa three times a week for 6 months produces a sustained response rate of less than 20%. [1][2][3][4][5][6] Various workers have attempted to re-treat with interferon patients who failed to achieve sustained response after one course of interferon treatment. Discordant results have been reported, with sustained response rates ranging from 0% to 53% in relapsers and nonresponders. 7-10 Most of these studies were of small sample size, and heterogeneous treatment regimens complicate interpretation of results. Others have tried to re-treat with ribavirin, either alone 11,12 or in combination with interferon, 13,14 with variable success. However, these were again small series and their results need to be confirmed with larger randomized trials. Iron reduction, alone 15 or in combination with interferon therapy, 16 has been attempted by others, but no sustained responses were reported in these series. In summary, the appropriate retreatment regimen for relapsers and nonresponders after one course of interferon therapy is yet to be established.It has been shown that virological factors such as viral load and genotype are predictors of sustained response to the first course of interferon treatment...

show abstract

mentioning

confidence: 99%

Re-treatment with interferon alfa of patients with chronic hepatitis C

et al. 1998

View full text Add to dashboard Cite

show abstract

“…Further studies of ribavirin monotherapy followed with similar results (Di Bisceglie et al, 1992Bodenheimer et al, 1997). Some patients who failed to respond to interferon nevertheless had a biochemical response when given ribavirin (Camps et al, 1993). Subsequent studies of longer duration of therapy were instigated when quantitative virology was available and again demonstrated consistent decreases in transaminase levels when patients were on therapy but, at most, a modest reduction on the HCV RNA levels and no sustained response.…”

Section: Ribavirinmentioning

confidence: 75%

Treatment of Chronic Viral Hepatitis

Main

McCarron

1998

Antivir Chem Chemother

View full text Add to dashboard Cite

Interferon-α therapy has proved effective for up to 40% of patients with adult-acquired chronic hepatitis B virus (HBV) infection and for 20-25% of those with chronic hepatitis C virus (HCV) infection. Nucleoside analogues, such as lamivudine and famciclovir, are showing promise as antiviral agents for chronic HBV and the combination of interferon-α and ribavirin is proving to be successful therapy for 40-50% of patients with chronic HCV. In this article we review current therapy and discuss future strategies of the therapy of chronic viral hepatitis.

show abstract

“…Sustained therapy response rates, however, are as low as 15% [3]. New substances such as the nucleo side analogue ribavirin are presently under investigation for the treatment of naive, relapsing and non-responder patients with chronic hepatitis C [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Synthetic Antisense Oligodeoxynucleotides as Potential Drugs against Hepatitis C

1997

View full text Add to dashboard Cite

Antisense oligodeoxynucleotides (ODNS) can be used to specifically inhibit hepatitis C viral gene expression. Due to its high degree of conservation and its important function as internal ribosomal entry site, the 5’-non-coding region of the hepatitis C virus has been the most effective target to inhibit translation so far. Inhibition of luciferase reporter gene expression of up to 96 ± 2% has been achieved. Modifications of ODNs like phosphorothioate, methylphosphonate or benzylphosphonate modification of terminal or intramolecular internucleotide phosphates lead to altered lipophilicity and binding stability to its RNA target and resistance against serum nucleases. The mode of action of ODNs is mainly dependent on an efficient induction of RNase H activity. The uptake of ODNs occurs via receptor-mediated or absorptive and fluid-phase endocytosis. After release from the endosomes, ODNs may exert their effects by interaction with cytosolic or nuclear structures. Side effects can occur when this interaction affects intra- or extracellular targets essential for biological cell function. If these problems can be solved, antisense technology has the potential for future therapy of human disease.

show abstract

Ribavirin in the treatment of chronic hepatitis C unresponsive to alfa interferon

Cited by 61 publications

References 30 publications

Re-treatment with interferon alfa of patients with chronic hepatitis C

Re-treatment with interferon alfa of patients with chronic hepatitis C

Treatment of Chronic Viral Hepatitis

Synthetic Antisense Oligodeoxynucleotides as Potential Drugs against Hepatitis C

Contact Info

Product

Resources

About