Once-weekly epoetin alfa improves anemia and facilitates maintenance of ribavirin dosing in hepatitis C virus-infected patients receiving ribavirin plus interferon alfa

Abstract

In anemic HCV-infected patients treated with RBV/IFN, epoetin alfa increases Hb levels and maintains RBV dosing. Based on these results, epoetin alfa seems to be promising in the treatment of HCV treatment-related anemia. Further research is warranted to determine the potential impact on outcomes, including quality of life and sustained viral response rate.

Epoetin alpha improves the response to antiviral treatment in HCV-related chronic hepatitis

“…The results of previous studies [27,28,30,37,49,50,52,[56][57][58] and the present study have shown that the introduction of Epoetin Alpha therapy in patients treated with PEG-interferon alpha-2A and RBV for CH related to genotype 1b HCV infection leads to an improved adherence to treatment, and, consequently, to a significant improvement of SVR.…”

“…However, some studies have used decision analysis to estimate the cost-effectiveness of adjunctive therapy with erythropoietic growth factor (EGF) compared with that of standard care in the treatment of hepatitis C. The use of EGFs appears to be costeffective in patients with anaemia who are receiving combination therapy for HCV genotype 1, 2 or 3. Compared with The results of previous studies [27,28,30,37,49,50,52,[56][57][58] and the present study have shown that the introduction of Epoetin Alpha therapy in patients treated with PEG-interferon alpha-2A and RBV for CH related to genotype 1b HCV infection leads to an improved adherence to treatment, and, consequently, to a significant improvement of SVR.…”

“…In fact, patients can continue treatment with a standard optimal dose of peg-IFN and RBV and achieve positive therapeutic results with the persistence of high haemoglobin levels. This aspect plays an especially important role in patients with advanced hepatic disease, because of the possibility of achieving stabilization of hepatic disease, in terms of clinical, biochemical and histological features, with a consequent improvement in quality of life (QOL) and an increased chance of survival [25][26][27][28][29][30][31].…”

The effects of HCV infection and management on health-related quality of life

“…Several studies demonstrated the efficacy of rHuEPO in decreasing anemia in RBV-treated patients. 84,85 Another study confirmed similar efficacy for darbepoetin alpha, which was used for treatment of RBV-induced anemia. 86 Pockros et al 87 demonstrated that patients receiving rHuEPO who had the largest increases in hemoglobin concentrations during the course of the study also had the greatest improvements in HRQL.…”

Adverse event management

“…Studies indicate that therapy with erythropoietin at the dosage of 40,000 IU once a week elevates the level of Hb after one week of use and thus permits the maintenance of RBV dosage in patients that become anemic during combined therapy for hepatitis C [12,13]. In the study conducted by Afdhal et al, the initial dose of RBV was maintained in 88% of the patients who received erythropoietin during treatment for hepatitis C, and Hb levels increased (from 10.6 ± 0.9 to 13.2 ± 1.2 g/dL) in those same patients [13].…”