Standard interferon-alpha in combination with ribavirin for hepatitis C patients with advanced liver disease and thrombocytopenia

Hofer, Harald; Gurguta, C.; Bergholz, U.; Steindl–Munda, Petra; Ferenci, Péter

doi:10.1007/s00508-006-0704-0

Cited by 4 publications

(3 citation statements)

References 28 publications

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“…4,5 Thus, it is important for chronic hepatitis C patients to receive IFN-␣ treatment to prevent malignant transformation by eradicating hepatitis C virus. [6][7][8][9][10][11] However, IFN-␣-induced thrombocytopenia often leads to dose reduction or discontinuation of IFN-␣ therapy. In particular, it is difficult to treat patients with advanced cirrhosis by IFN-␣ because often these patients also have severe thrombocytopenia.…”

Section: Introductionmentioning

confidence: 99%

Interferon-α2b–induced thrombocytopenia is caused by inhibition of platelet production but not proliferation and endomitosis in human megakaryocytes

Yamane

Nakamura

Suzuki

et al. 2008

Blood

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Section: Introductionmentioning

confidence: 99%

Interferon-α2b–induced thrombocytopenia is caused by inhibition of platelet production but not proliferation and endomitosis in human megakaryocytes

Yamane

Nakamura

Suzuki

et al. 2008

Blood

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“…Th ere is reason to believe that diff erences in therapeutic outcome are infl uenced by patient selection and the proportions and severity of underlying liver disease [11][12][13][14]. Only 69% of our patients could have participated in an RCT, therefore our overall results (SVR rate 44.3%) diff er in many respects from data reported from large RCTs [3,4] where SVR rates range from 56 to 63%, similar to the rate achieved in those of our patients who could have participated in an RCT (50% [15].…”

Section: Discussionmentioning

confidence: 99%

Antiviral treatment of chronic hepatitis C in clinical routine

Maieron

Metz-Gercek

Hackl³

et al. 2010

Wien Klin Wochenschr

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“…Boxes give the reasons for why no treatment was initiated. †Patients with advanced liver cirrhosis treated with low‐dose standard IFN/RBV36 or adapted therapy resulting from renal impairment; ‡See reasons for noninclusion; ∫Baseline.…”

Section: Methodsmentioning

confidence: 99%

Treatment of chronic hepatitis C genotype 1 patients at an academic center in europe involved in prospective, controlled trials: Is there a selection bias?

et al. 2011

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Pegylated interferon-alpha2/ribavirin (peg-IFN/RBV) is the standard of care (SOC) for patients with chronic hepatitis C (CHC) infection. Currently, direct-acting antiviral agents (DAAs) are evaluated in clinical trials. The aim of this study was to compare baseline characteristics and sustained virologic response (SVR) rates in patients included in clinical trials to those receiving SOC. Medical records of all 503 treatment-naïve patients with CHC, genotype (GT) 1, referred over a 4-year period (January 2006-December 2009) were reviewed. Only 310 of 503 (62%) patients received antiviral therapy, 141 were enrolled in randomized, controlled trials (''study patients''; 101 in DAA studies), and 169 received SOC. At baseline, viral load and platelet count were higher and bilirubin was lower in study patients than in SOC patients. History of psychiatric disorders was more common in SOC patients (43 [25%] versus study patients with 18 [13%]; P < 0.01). Liver biopsy was obtained in 98% of study patients, but only in 59% of SOC patients. Twenty-nine (21%) and 40 (40%) study and SOC patients, respectively, had advanced fibrosis (F3/4; P 5 0.001). By intent-to-treat analysis, SVR rates were higher in DAAs (64%; 95% confidence interval [CI]: 53.4-74.4) than in SOC patients (46%; 95% CI: 37.9-53.7; P < 0.01), but not different when calculated on a treated-per-protocol (TPP) basis. Interleukin (IL)28B GT was equally distributed in both cohorts. By chance, more patients treated with IFN/RBV had rs12979860 C/C-GT (up to 44%) than DAA-treated patients. If analyzed according to the IL28B polymorphism, TPP SVR rates did not reach statistically significant differences among study and SOC patients. Conclusions: Baseline characteristics slightly favored study patients, but IL28B GT and treatment adherence were the most important factors determining outcome. Thus, the applicability of the results of controlled studies has to be tested in a ''real-world'' setting. (HEPATOLOGY 2012;55:30-38)

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Standard interferon-alpha in combination with ribavirin for hepatitis C patients with advanced liver disease and thrombocytopenia

Abstract: Treatment with standard interferon-alpha2b/ribavirin could be of benefit in patients with advanced liver cirrhosis and thrombocytopenia however, a vigilant monitoring of these high risk patients is mandatory.

Cited by 4 publications

References 28 publications

Interferon-α2b–induced thrombocytopenia is caused by inhibition of platelet production but not proliferation and endomitosis in human megakaryocytes

Interferon-α2b–induced thrombocytopenia is caused by inhibition of platelet production but not proliferation and endomitosis in human megakaryocytes

Antiviral treatment of chronic hepatitis C in clinical routine

Treatment of chronic hepatitis C genotype 1 patients at an academic center in europe involved in prospective, controlled trials: Is there a selection bias?

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