An extended treatment protocol with pegylated interferon and ribavirin for hepatitis C recurrence after liver transplantation

Hashemi, Nikroo; Araya, Víctor; Tufail, Kashif; Thummalakunta, Laxmi; Feyssa, Eyob; Azhar, Ashaur; Niazi, Mumtaz; Ortíz, Jorge

doi:10.4254/wjh.v3.i7.198

Cited by 4 publications

(2 citation statements)

References 25 publications

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“…In their study, 15% of patients necessitated RBV dose reductions compared with approximately 40% of patients (range of between 24% and 92%) when PIFN/RBV was administered concurrently in studies evaluating similar patient populations post transplant. 24 , 25 , 26 , 27 , 28 Their study also demonstrated that RBV priming results in improved SVR rates compared with results of published trials performed using standard combination therapy −46% vs. 29% respectively. 23 , 26 While our study was discontinued prior to collection of SVR data, mean log 10 reductions from baseline in HCV RNA were significantly greater in the pre-dosing vs. the standard dosing arm at Day 1 [−0.34 ± 0.46 vs. 0.09 ± 0.32 ( P ≤ 0.003)].…”

Section: Discussionmentioning

confidence: 74%

“…They demonstrated that RBV priming both enhanced efficacy and improved adherence, and proposed that by administering medications in this sequential manner, patients have time to adjust to the side effects of each medication. In their study, 15% of patients necessitated RBV dose reductions compared with approximately 40% of patients (range of between 24% and 92%) when PIFN/RBV was administered concurrently in studies evaluating similar patient populations post transplant . Their study also demonstrated that RBV priming results in improved SVR rates compared with results of published trials performed using standard combination therapy −46% vs. 29% respectively .…”

Section: Discussionmentioning

confidence: 87%

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Randomised clinical trial: pre‐dosing with taribavirin before starting pegylated interferon vs. standard combination regimen in treatment‐naïve patients with chronic hepatitis C genotype 1

Palmer¹,

Rubin²,

Rustgi

2012

Aliment Pharmacol Ther

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SummaryBackgroundCombination therapy with the ribavirin (RBV) prodrug taribavirin (TBV) and pegylated interferon (PIFN) has produced lower rates of anaemia than with RBV and PIFN. Studies have demonstrated that the sharpest decline in viral load during TBV therapy occurs at Weeks 4 through 6, when TBV reaches steady-state blood levels.AimThe current proof-of-concept study was conducted to examine whether first-order viral kinetics could be influenced by pre-dosing TBV to steady state before introducing PIFN.MethodsTherapy-naïve patients with chronic hepatitis C virus (HCV) genotype 1 (G1) were randomised to receive (i) TBV 600 mg BID monotherapy for 4 weeks followed by combination therapy with PIFN [pre-dosing arm (n = 23)] or (ii) TBV administered concurrently with PIFN [standard dosing arm (n = 19)].ResultsMore patients achieved undetectable virus or a ≥2-log10 reduction of HCV RNA at Week 4 in the pre-dosing vs. the standard dosing arm [33% vs. 22% (P = 0.497)]. There was also a trend towards greater reduction in mean log10 change in HCV RNA in the pre-dosing vs. the standard dosing arm, which was statistically significant at Day 1 [−0.34 ± 0.46 vs. 0.09 ± 0.32 (P < 0.003)] but not at other time points up to Week 24. No significant difference was observed in the rates of anaemia (haemoglobin <10 g/dL) between study arms (4.5% vs. 5.3%).ConclusionsPre-dosing TBV prior to starting PIFN produces a trend towards improved efficacy although statistical significance was not reached in this small patient population. These results warrant larger clinical trials of TBV pre-dosing.

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Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 87%

Randomised clinical trial: pre‐dosing with taribavirin before starting pegylated interferon vs. standard combination regimen in treatment‐naïve patients with chronic hepatitis C genotype 1

Palmer¹,

Rubin²,

Rustgi

2012

Aliment Pharmacol Ther

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Management of Recurrent Hepatitis C in Orthotopic Liver Transplant Recipients

Karnik

Shetty

2013

Infectious Disease Clinics of North America

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Pharmacoeconomic Assessment of Using Interferon-Free Regimens for Chronic Hepatitis C After Liver Transplantation

Сухорук¹,

Эсауленко²

2016

RJTAO

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ГБОУ ВПО «Санкт-Петербургский государственный педиатрический медицинский университет» Минздрава России, Санкт-Петербург, Российская Федерация В статье проведен анализ существующих схем комбинированной противовирусной терапии хрониче-ского гепатита С после трансплантации печени. Проведение противовирусной терапии с использованием пролонгированных интерферонов и рибавирина низкоэффективно и высокозатратно. Доказано клини-ческое и экономическое преимущество безинтерферонового режима лечения пациентов, инфицирован-ных вирусом гепатита С 1-го генотипа, с использованием дасабувира, паритапревира, бустированного ритонавиром, омбитасвира (Викейра Пак) и рибавирина. Регистрация и внедрение в клиническую прак-тику новых препаратов прямого противовирусного действия позволит существенно расширить арсенал средств для лечения возвратной HCV-инфекции, в том числе у пациентов, инфицированным вирусом гепатита С 2-го и 3-го генотипа.Ключевые слова: хронический гепатит С, трансплантация печени, безинтерфероновый режим, анализ затрат. PHARMACOECONOMIC ASSESSMENT OF USING INTERFERON-FREE REGIMENS FOR CHRONIC HEPATITIS C AFTER LIVER TRANSPLANTATION A.A. Sukhoruk, E.V. Esaulenko Saint Petersburg State Pediatric Medical University, Saint Petersburg, Russian FederationThis article contains analysis of current combination treatment regimens for chronic hepatitis C after liver transplantation. Antiviral therapy with long-acting interferons and ribavirin is of low effi ciency and high costs. The clinical and economic benefi ts of interferon-free treatment regimen for patients infected with genotype 1 HCV using dasabuvir, paritaprevir boosted with ritonavir, ombitasvir (Viekira Pak) and ribavirin have been shown. Registration and introduction into clinical practice of new direct-acting antiviral drugs will signifi cantly expand the arsenal of tools for the treatment of recurrent HCV infections, in particular in patients infected with hepatitis C virus genotypes 2 and 3. Key words: chronic hepatitis C, liver transplantation, interferon-free regimen, cost-analysis.Для корреспонденции: Сухорук Анастасия Александровна. Адрес: 194100, Санкт-Петербург, ул. Литовская, д. 2. Тел. (812) 717-28-68. E-mail: infection-gpmu@mail.ru. АКТУАЛЬНОСТЬПрогрессирование хронического гепатита С (ХГС) в цирроз печени и гепатоцеллюлярную кар-циному приводит к инвалидизации, снижению продолжительности и качества жизни пациентов. Именно цирроз печени в исходе ХГС к настояще-му времени стал наиболее частым показанием для трансплантации печени (ТП). По данным ФГБУ «Российский научный центр радиологии и хирур-гических технологий», 29-35% пациентов в листе ожидания на ОТП имеют цирроз печени в исходе ХГС [1,2].При выполнении ТП данной группе пациентов кроме общих проблем (дефицит донорских орга-

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An extended treatment protocol with pegylated interferon and ribavirin for hepatitis C recurrence after liver transplantation

Abstract: Recurrent HCV after LT can be safely treated with extended virological response-guided therpy using PEG/RBV, but requires close monitoring for treatment-related adverse effects, particularly cytopenias.

Cited by 4 publications

References 25 publications

Randomised clinical trial: pre‐dosing with taribavirin before starting pegylated interferon vs. standard combination regimen in treatment‐naïve patients with chronic hepatitis C genotype 1

Randomised clinical trial: pre‐dosing with taribavirin before starting pegylated interferon vs. standard combination regimen in treatment‐naïve patients with chronic hepatitis C genotype 1

Management of Recurrent Hepatitis C in Orthotopic Liver Transplant Recipients

Pharmacoeconomic Assessment of Using Interferon-Free Regimens for Chronic Hepatitis C After Liver Transplantation

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