Interferon alfa2a induction therapy in combination with ribavirin and amantadine for the treatment of naive patients with chronic HCV infection |
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Authors: | Engler S Flechtenmacher C Wiedemann K H Gugler R Stremmel W Kallinowski B |
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Institution: | Department of Medicine, Division of Gastroenterology, Hepatology and Infectious Diseases, University Hospital of Heidelberg, Heidelberg;;Department of Pathology, University of Heidelberg, Heidelberg;;Department of Internal Medicine II, Hospital Barmherzige Brüder, Regensburg;;and Department of Internal Medicine I, Municipal Hospital Karlsruhe, Karlsruhe, Germany |
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Abstract: | Summary. Pilot studies have suggested that the addition of amantadine to interferon (IFN) is effective against hepatitis C virus (HCV). Furthermore, IFN induction therapy seems to improve virological response rates. In this open, randomized, multicentre trial we compared safety and efficacy of a triple therapy comprising IFN α 2a, ribavirin and amantadine using high induction doses (6 MU IFN α daily for the first 6 weeks) against a therapy with standard IFN α dosages over the entire treatment period plus amantadine and ribavirin. A total of 158 naive patients with chronic HCV infection were randomized 1:1. Group A ( n = 81): induction therapy with 6 MU IFN α daily for 6 weeks, followed by 6 MU three times a week (tiw) for 18 weeks and then 3 MU tiw until week 48. Group B ( n = 77): standard therapy with 6 MU IFN α tiw for 24 weeks, followed by 3 MU until week 48. All patients received oral ribavirin (10 mg/kg/day) and amantadine (200 mg/day). The triple therapy was safe and well tolerated. There were no significant differences between the groups with respect to biochemical response rates. Groups A and B did not differ in virological response rates at the end of treatment (33% vs 35%) or at the end of the 6 month follow up period (37% vs 39%). We could not detect favourable effects on sustained virological response rates using induction therapy, in either genotype 1 or non-1 infected patients. In summary, induction therapy with 6 MU IFN α daily did not result in increased overall response rates compared with standard IFN α dosages of 6 MU tiw. |
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Keywords: | amantadine chronic HCV induction therapy interferon 2a naive patients ribavirin |
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