Thalidomide with peginterferon alfa-2b and ribavirin in the treatment of non-responders genotype 1 chronic hepatitis C patients: proof of concept

Abstract

Background: fewer than half of patients infected with hepatitis C virus (HCV) achieve sustained viral clearance after peginterferon alfa/ribavirin (Peg-IFN/RBV) therapy.Aims: thalidomide posses anti-inflammatory and immunomodulatory properties through inhibition of tumor necrosis factor and costimulatory effect on human CD8+ T cells.Methods: we started a prospective, open label trial of retreatment of very-difficult-to-treat genotype 1 chronic hepatitis C patients (CHC) patients, who had failed to respond to the (Peg-IFN/RBV), with a triple therapy consisting in these same antivirals plus thalidomide 200 mg/day (the TRITAL study).Results: none of the eleven patients fulfilling the inclusion criteria and included in the trial reached complete early virological response or sustained virological response. Viral load decline after 12 weeks of triple therapy thalidomide-based retreatment did not differ from viral dynamics during the first course. The triple therapy was well tolerated and only one patient developed mild bilateral neuropathy.Conclusions: thalidomide addition to standard therapy is tolerated and did not increase the SVR rate in very-difficult-to-treat genotype 1 CHC patients. Different schedules are warranted to improve attempting retreatment of non responder CHC patients.

The oncologic burden of hepatitis C virus infection: A clinical perspective

“…DAAs used to treat HCV infection and their metabolism, transporter effects, and potential for interactions with chemotherapy, targeted agents, and supportive care medications commonly used to treat cancer are outlined in Tables . For more detailed information, please refer to Lexicomp Online (http://hep-druginteractions.org; Lexicomp, Inc, Hudson, OH; November 2016) and medication package labeling.…”

The dark side of drug repurposing. From clinical trial challenges to antimicrobial resistance: analysis based on three major fields

“…Still, a memorable case, such as thalidomide, will spring to mind ( 4 ). The drug, infamously recognized in its devastating original form as a sedative and curative for morning sickness, returned to the medical world for the treatment of leprosy and, subsequently, multiple myeloma ( 5 ). It is worth noting that the discovery of thalidomide’s efficacy in treating leprosy, specifically erythema nodosum leprosum, was a serendipitous occurrence ( 6 ).…”