No abstract

FH Anderson, L Zeng, EM Yoshida, NR Rock. Failure of ketoprofen and interferon combination therapy to improve interferon-resistant chronic hepatitis C. Can J Gastroenterol 1997;11(4):294-297. Preliminary reports suggest that patients with interferon (IFN)-resistant chronic hepatitis C respond better to a combination of IFN-a and nonsteroidal anti-inflammatory drugs than to IFN alone. The efficacy of IFN combined with ketoprofen in the treatment of patients with IFN-resistant chronic hepatitis C was evaluated. Seventeen patients, nonresponsive after at least six months of treatment with IFN-a2b and subsequently treated with the combination of IFN-a2b plus ketoprofen for four months, were studied. Serum aminotransferases (alanine aminotransferase [ALT] and aspartate aminotransferase [AST]) and serum hepatitis C virus (HCV) RNA were analyzed before and throughout treatment. No patient normalized serum aminotransferases after combination therapy. There were no significant differences in mean serum ALT and AST levels before and after ketoprofen intervention. Serum HCV RNA became undetectable after treatment in only one patient, but was detectable again three months after treatment cessation. These results provide no convincing evidence that the combination of IFN-a2b with ketoprofen improves the response to IFN in patients nonresponsive to IFN alone. ) et l'ARN sérique du virus de l'hépatite C (HCV) ont été analysés avant, puis tout au long du traitement. Les aminotransférases sériques ne se sont normalisées chez aucun des patients après le traitement associatif. Aucune différence significative n'a été notée quant aux taux sériques moyens d'ALT et d'AST avant et après l'administration de kétoprofène. L'ARN du HCV sérique est devenu indécelable après le traitement chez un seul patient, mais était à nouveau décelable trois mois après la fin du traitement. Ces résultats n'offrent aucune preuve concluante que le traitement associatif IFN-a2b et kétoprofène améliore la réponse à l'IFN chez les patients qui ne répondent pas à l'IFN seul. Gastroenterology, Department of Medicine, University of British Columbia, Vancouver, British Columbia Correspondence and reprints: Dr Frank H Anderson, Vancouver Hospital & Health Sciences Centre, Room 206, 700 West 10th Avenue, Vancouver, Received for publication October 24, 1996. Accepted February 6, 1997 HEPATOLOGY O ver the past few years interferon (IFN)-alpha has been widely used to treat chronic infection with hepatitis C virus (HCV). A short term response, however, is seen in only approximately 40% to 50% of treated patients (1,2), and the percentage of patients achieving a long term response is significantly less. In a recent multicentre study only 22% of patients treated with IFN for 18 months were able to maintain a long term response, as reflected by normal serum aminotransferase, more than 18 months after discontinuing therapy (2). To improve the efficacy of IFN therapy, numerous strategies employing adjuvant therapy have been proposed. Medications such as ursodeoxycholic a...

Ulcerative colitis (UC) reportedly has a seasonal variation of exacerbations. No seasonal variation of relapses in Crohn's disease (CD) has been reported. A retrospective study of the monthly distribution in the relapses of inflammatory bowel disease (IBD) demonstrated seasonality in both UC and CD. From 1971-93, 226 patients (CD=139, UC=87) with regular follow-ups for at least 13 consecutive months were analyzed. In the study period, 592 relapses occurred in CD patients and 300 in UC patients. The peak relapse seasons were autumn and winter and the lowest was summer, for both CD and UC. The seasonal pattern was independent of sex. These results support the view that seasonal factors may be involved in the relapse of IBD.

The acute form of radiation intestinal injury is usually transient and self-limited, while chronic injury is permanent and progressive, and its management is unsatisfactory. As reported recently, however, several treatment options are available to control symptoms reasonably in most cases. Some approaches are of particular interest due to their efficacy, availability and simplicity. More clinical evaluations are required to confirm this initial enthusiasm.