Full-Dose Peginterferon Alfa-2a and Low-Dose Ribavirin Treatment of Genotypes 1 and 4 Chronic Hepatitis CPatients With End-Stage Renal Disease

Abdulhadi-Ali, Mamdouh M.; Alsaudi, Dib; Agha, Adnan; Ibraheem-Alqahtani, Nasser; Furnari, Manuele; Savarino, Vincenzo; Giannini, Edoardo G.

doi:10.1016/j.cgh.2011.06.002

Cited by 2 publications

(2 citation statements)

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“…Three reports were excluded because they contained duplicate reports of the same patients and four did not fulfil the inclusion criteria; four were case reports. A total of eleven reports giving information on 287 unique patients on regular dialysis were included in our meta‐analysis . There was a 100% concordance between reviewers with respect to final inclusion and exclusion of studies reviewed based on the predefined inclusion and exclusion criteria.…”

Section: Resultsmentioning

confidence: 99%

Antiviral therapy (pegylated interferon and ribavirin) of hepatitis C in dialysis patients: meta‐analysis of clinical studies

Fabrizi

Dixit

Messa

et al. 2014

Journal of Viral Hepatitis

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Information on the antiviral treatment (pegylated interferon plus ribavirin) of chronic infection by hepatitis C virus (HCV) in patients on long-term dialysis is extremely limited. We evaluated the efficacy and safety of combination antiviral therapy (pegylated interferon plus ribavirin) in patients on long-term dialysis with chronic hepatitis C by performing a systematic review of the literature with a meta-analysis of clinical studies. The primary outcome was sustained virological response (SVR) (as a measure of efficacy); the secondary outcome was dropout rate (as a measure of tolerability). We used the random-effects model of DerSimonian and Laird, with heterogeneity and sensitivity analyses. We identified eleven clinical studies (287 unique patients), two of them being controlled clinical trials. The summary estimate for SVR and dropout rate was 0.60 (95% Confidence Intervals, 0.47; 0.71) and 0.18 (95% CI, 0.08; 0.35), respectively; studies being heterogeneous with regard to both the outcomes. Stratified analysis reported a higher SVR rate in controlled trials, 0.86 (95% CI, 0.27; 0.99). The most common sources of dropout were anaemia (11/46 = 23%) and infections (6/46 = 13%). Meta-regression analysis showed a detrimental impact of HCV genotype 1 (P = 0.036) and dropout (P = 0.0001) rate upon the frequency of SVR. Antiviral therapy based on pegylated interferon plus ribavirin for HCV gives encouraging results in terms of efficacy and safety among patients on long-term dialysis; such approach should be considered the current standard of care for HCV-infected individuals on regular dialysis.

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Section: Resultsmentioning

confidence: 99%

Antiviral therapy (pegylated interferon and ribavirin) of hepatitis C in dialysis patients: meta‐analysis of clinical studies

Fabrizi

Dixit

Messa

et al. 2014

Journal of Viral Hepatitis

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“…Thus, excessive dose reduction and discontinuation of therapy may be avoided by low and escalating dosing. One study showed that even higher sustained virologic response values can be achieved if patients with end‐stage renal diseases are treated with peginterferon plus low‐dose ribavirin [Rendina et al, ; Liu et al, ; Abdulhadi‐Ali et al, ]. This finding suggested that an appropriately high plasma concentration of ribavirin can be achieved in patients with reduced renal function (including elderly patients) even with a low dose of ribavirin.…”

Section: Discussionmentioning

confidence: 99%

Randomized trial of peginterferon alpha‐2b plus low and escalating dose of ribavirin in patients with chronic hepatitis C with high viral load genotype 1

Iwasaki

Araki

Taniguchi

et al. 2015

Journal of Medical Virology

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It has been reported that elderly patients with chronic hepatitis C infection cannot tolerate standard combination therapy. In this randomized, controlled trial, the efficacy and safety of peginterferon alpha-2b plus a low and escalating dose of ribavirin in chronic hepatitis C patients with high viral load genotype 1 were investigated. Sixty-two patients were randomized into combination therapy with standard ribavirin dosing (group 1) or low and escalating ribavirin dosing (group 2). Patients were evaluated for safety and efficacy of treatment. There was no significant difference in the prevalence of virological response between the groups throughout the treatment as well as 24 weeks after treatment. However, the response in patients ≥60 years of age was higher in group 1 than in group 2 at early treatment phase (P = 0.015). The prevalence of completion of therapy in patients ≥60 years of age tended to be higher in group 2 than in group 1 (50% vs. 0%, P = 0.055). There was no significant difference in dose modification of peginterferon alpha-2b between the groups. However, dose modification of ribavirin was significantly more frequent in group 1 than in group 2 (60% vs. 24%, P = 0.005). These data suggest that combination therapy with low and escalating dosing of ribavirin may be safer in elderly patients than that with standard dosing of ribavirin without impairing the treatment response.

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Full-Dose Peginterferon Alfa-2a and Low-Dose Ribavirin Treatment of Genotypes 1 and 4 Chronic Hepatitis CPatients With End-Stage Renal Disease

Cited by 2 publications

References 3 publications

Antiviral therapy (pegylated interferon and ribavirin) of hepatitis C in dialysis patients: meta‐analysis of clinical studies

Antiviral therapy (pegylated interferon and ribavirin) of hepatitis C in dialysis patients: meta‐analysis of clinical studies

Randomized trial of peginterferon alpha‐2b plus low and escalating dose of ribavirin in patients with chronic hepatitis C with high viral load genotype 1

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