Document Detail


Indications and limitations for aged patients with chronic hepatitis C in pegylated interferon alfa-2b plus ribavirin combination therapy.
MedLine Citation:
PMID:  21145907     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND & AIMS: This study investigated the efficacy and adverse effects of pegylated interferon (Peg-IFN) plus ribavirin therapy in aged patients with chronic hepatitis C (CH-C).
METHODS: A total of 1040 naïve patients with CH-C (genotype 1, n=759; genotype 2, n=281), of whom 240 (23%) over 65 years old (y.o.), were treated with Peg-IFN alfa-2b plus ribavirin and assessed after being classified into five categories, according to age.
RESULTS: The discontinuance rate was higher for patients over 70 y.o. (36%), the most common reason being anemia. In the presence of genotype 1, the SVR rate was similar (42-46%) among patients under 65 y.o. and declined (26-29%) among patients over 65 y.o. For patients over 65 y.o., being male (Odds ratio, OR, 3.5, p=0.035) and EVR (OR, 83.3, p<0.001) were significant factors for SVR, in multivariate analysis. The Peg-IFN dose was related to EVR, and when EVR was attained, 76-86% of patients over 65 y.o. achieved SVR. SVR was not achieved (0/35, 0/38, respectively) if a 1-log decrease and a 2-log decrease were not attained at week 4 and week 8, respectively. In the presence of genotype 2, the SVR rate was similar (70-71%) among patients under 70 y.o. and declined among patients over 70 y.o. (43%).
CONCLUSIONS: Aged patients up to 65 y.o. with genotype 1 and 70 y.o. with genotype 2 can be candidates for Peg-IFN plus ribavirin therapy. The response-guided therapy can be applied for aged patients with genotype 1.
Authors:
Tsugiko Oze; Naoki Hiramatsu; Takayuki Yakushijin; Kiyoshi Mochizuki; Masahide Oshita; Hideki Hagiwara; Eiji Mita; Toshifumi Ito; Hiroyuki Fukui; Yoshiaki Inui; Taizo Hijioka; Masami Inada; Kazuhiro Kaytayama; Shinji Tamura; Harumasa Yoshihara; Atsuo Inoue; Yasuharu Imai; Michio Kato; Takuya Miyagi; Yuichi Yoshida; Tomohide Tatsumi; Shinichi Kiso; Tatsuya Kanto; Akinori Kasahara; Tetsuo Takehara; Norio Hayashi
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Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2010-12-09
Journal Detail:
Title:  Journal of hepatology     Volume:  54     ISSN:  1600-0641     ISO Abbreviation:  J. Hepatol.     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-03-18     Completed Date:  2011-07-15     Revised Date:  2012-08-24    
Medline Journal Info:
Nlm Unique ID:  8503886     Medline TA:  J Hepatol     Country:  England    
Other Details:
Languages:  eng     Pagination:  604-11     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
Affiliation:
Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Suita, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Aged
Antiviral Agents / administration & dosage*,  adverse effects
Cohort Studies
Drug Therapy, Combination
Female
Genotype
Hepacivirus / classification,  genetics
Hepatitis C, Chronic / drug therapy*,  virology
Humans
Interferon-alpha / administration & dosage*,  adverse effects
Male
Middle Aged
Polyethylene Glycols / administration & dosage*,  adverse effects
RNA, Viral / blood
Recombinant Proteins
Retrospective Studies
Ribavirin / administration & dosage*,  adverse effects
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antiviral Agents; 0/Interferon-alpha; 0/Polyethylene Glycols; 0/RNA, Viral; 0/Recombinant Proteins; 0/peginterferon alfa-2b; 36791-04-5/Ribavirin; 99210-65-8/interferon alfa-2b
Comments/Corrections
Comment In:
J Hepatol. 2011 Apr;54(4):597-8   [PMID:  21167854 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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