Can eicosapentaenoic acid maintain the original ribavirin dose or affect the response during the treatment course of chronic hepatitis C virus (HCV) patients?

Morsy, Khairy Hammam; Zaghloul, Amr; Mahmoud, Mohamed

doi:10.5152/tjg.2015.150280

Cited by 4 publications

(4 citation statements)

References 19 publications

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“…Recommend: to withhold treatment temporarily. Ribavirin Not directly studied but likely safe- Recommend : Continue Not directly studied but likely safe- Recommend : Continue NSI – Recommend : Continue [ [151] , [152] , [153] ] Not directly studied. Recommend: to withhold treatment temporaril Interferon-Beta 1 -Alpha Not directly studied but likely safe- Recommend : Continue Not directly studied but likely safe- Recommend : Continue NSI – Recommend : Continue [ 154 , 155 ] Increased risk of Hepatoxicity.…”

Section: Recommendationsmentioning

confidence: 99%

Managing hyperlipidaemia in patients with COVID-19 and during its pandemic: An expert panel position statement from HEART UK

Iqbal

Adam

et al. 2020

Atherosclerosis

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Background & aims The emergence of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which causes Coronavirus Disease 2019 (COVID-19) has resulted in a worldwide pandemic. SARS-CoV-2 is highly contagious and its severity highly variable. The fatality rate is unpredictable but is amplified by several factors including advancing age, atherosclerotic cardiovascular disease, diabetes mellitus, hypertension and obesity. A large proportion of patients with these conditions are treated with lipid lowering medication and questions regarding the safety of continuing lipid-lowering medication in patients infected with COVID-19 have arisen. Some have suggested they may exacerbate their condition. It is important to consider known interactions with lipid-lowering agents and with specific therapies for COVID-19. This statement aims to collate current evidence surrounding the safety of lipid-lowering medications in patients, who have COVID-19. We offer a consensus view based on current knowledge and we rated the strength and level of evidence for these recommendations. Methods Pubmed, Google scholar and Web of Science were searched extensively for articles using search terms: SARS-CoV-2, COVID-19, coronavirus, Lipids, Statin, Fibrates, Ezetimibe, PCSK9 monoclonal antibodies, nicotinic acid, bile acid sequestrate, nutraceuticals, red yeast rice, Omega-3-Fatty acids, Lomitapide, hypercholesterolaemia, dyslipidaemia and Volanesorsen. Results & Conclusions : There is no evidence currently that lipid lowering therapy is unsafe in patients with COVID-19 infection. Lipid-lowering therapy should not be interrupted because of the pandemic or in patients at increased risk of COVID-19 infection. In patients with confirmed COVID-19, care should be taken to avoid drug interactions, between lipid-lowering medications and drugs that may be used to treat COVID-19, especially in patients with abnormalities in liver function tests.

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Section: Recommendationsmentioning

confidence: 99%

Managing hyperlipidaemia in patients with COVID-19 and during its pandemic: An expert panel position statement from HEART UK

Iqbal

Adam

et al. 2020

Atherosclerosis

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“…Meanwhile, antiviral dosage reduction risks compromising the therapeutic response. The anti-anemia efficacy of several other compounds, such as eicosapentaenoic acid, pentoxifylline, high-dose vitamin C, and high-dose vitamin E, have been examined in clinical studies [3,4]. However, the results have been controversial, leaving erythropoietin as the only empirically Rapid CO breath test screening of drugs for protective effects on ribavirin-induced hemolysis in a rabbit model: a pilot study accepted intervention for anemia secondary to antiviral treatment.…”

Section: Introductionmentioning

confidence: 99%

Rapid CO breath test screening of drugs for protective effects on ribavirin-induced hemolysis in a rabbit model: a pilot study

Zhang

Wu³

et al. 2016

J. Breath Res.

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Hemolytic anemia is a major side effect of ribavirin antiviral treatment for chronic hepatitis C. Ribavirin dose reduction may compromise the antiviral response and erythropoietin can take several weeks to alleviate anemia. The purpose of the present study was to screen potentially protective drugs against ribavirin-induced hemolytic anemia in a rabbit model, using our modified CO breath test for measuring erythrocyte (RBC) lifespan, the gold standard diagnostic index of hemolysis. Fifteen rabbits were divided randomly into five groups (N = 3/group): one vehicle control group, one ribavirin (only)-treated (RBV) group, and three groups initially treated with ribavirin only, followed by a combination of ribavirin with prednisone (RBV + Pred), polyene phosphatidyl choline (RBV + PPC), or reduced glutathione (RBV + GSH). RBC lifespan was calculated from accumulated CO measured in a closed rebreath apparatus, blood volume measured by the Evan's blue dye (EBD) dilution test, and hemoglobin concentration data. The RBC lifespan was normal in the vehicle control group (44-60 d), but reduced significantly in all of the ribavirin-treated groups before the addition of screened drugs (17-35 d). RBC lifespan rebounded significantly with the addition of glutathione, but not with the addition of prednisone or polyene phosphatidyl choline. A similar overall drug effect pattern was seen in the hemoglobin concentration and reticulocyte count data. In conclusion, the results of this pilot study indicate that reduced glutathione can attenuate ribavirin-induced hemolytic anemia, and that the RBC lifespan measured with our modified rapid CO breath test is feasible and reliable for use in animal studies.

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“…The most striking feature of n-3 PUFA therapy in HCV was discovered when the efficacy of EPA was evaluated against ribavirin (RBV) associated hemolytic anemia. When EPA was supplemented with the standard combination therapy of peginterferon (PEG-IFN) and ribavirin (RBV), patients receiving EPA, required reduced RBV doses compared to the non-EPA group, and also showed decreased RBV-induced hemolysis, although rates of virological response are yet to be elucidated [85]. Therefore, it is encouraging that EPA can lower dependency on drugs in even such morbid disorders.…”

Section: Hepatitismentioning

confidence: 99%

Modulatory Potentials of n-3 Polyunsaturated Fatty Acids in Inflammatory Diseases

Uppin¹,

Acharya²,

Talahalli³

2020

Apolipoproteins, Triglycerides and Cholesterol

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Inflammatory diseases (bronchitis, irritable bowel diseases, psoriasis, chronic obstructive pulmonary disease, rheumatoid arthritis, conjunctivitis, hepatitis, rhinitis, etc.) are increasingly becoming the cause of health concern across the world. For both developed and developing countries, the public health cost attached to the management of these complications is increasing each year. Control of diet is one of the critical strategies to improve the therapeutic potentials of clinically proven drugs. Among the dietary factors, bioactive lipids, particularly polyunsaturated fatty acids, elicit essential effects of modulating signaling pathways that could provide a beneficial effect in individuals suffering from various inflammatory complications. Among the polyunsaturated fatty acids, both n-3 and n-6 fatty acids exhibit differential effects, and their dietary ratio plays a significant role in the overall impact in an individual. This is most evident with the fact that the decrease in the n-3 intake in recent times has significantly contributed to the severity of chronic inflammation. The mechanism by which these fatty acids and bioactive unsaponifiable embedded in the dietary oils modulate the critical genes, thereby alter the pathology of inflammatory complications is under study for many decades. In this chapter, the role of polyunsaturated fatty acids and their modulatory effects on some of the significant inflammatory complications are discussed.

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Can eicosapentaenoic acid maintain the original ribavirin dose or affect the response during the treatment course of chronic hepatitis C virus (HCV) patients?

Cited by 4 publications

References 19 publications

Managing hyperlipidaemia in patients with COVID-19 and during its pandemic: An expert panel position statement from HEART UK

Managing hyperlipidaemia in patients with COVID-19 and during its pandemic: An expert panel position statement from HEART UK

Rapid CO breath test screening of drugs for protective effects on ribavirin-induced hemolysis in a rabbit model: a pilot study

Modulatory Potentials of n-3 Polyunsaturated Fatty Acids in Inflammatory Diseases

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