Clinical

Combination regimen helps quell refractory hepatitis C

Last Updated: 2003-05-14 15:49:00 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Triple therapy for chronic hepatitis C using alpha interferon, ribavirin and amantadine may be effective in many patients who do not respond to alpha interferon alone, Italian researchers report in the May issue of Gut.

Lead investigator Dr. Luigio E. Adinolfi told Reuters Health that although half of chronic hepatitis C patients do not show a response to interferon, "there are no recommended therapeutic options for these subjects, who remain at risk of progression of the disease."

Dr. Adinolfi and colleagues at the Second University of Naples studied 114 such patients, who were randomized to 3 treatment groups. All received interferon alpha 2b and ribavirin 1000 mg/day.

In the first group, the interferon dosage was 3 million units (MU) 3 times a week; the two other groups received 3 MU daily for the first 4 weeks and then 3 MU 3 times a week. The third group was also given oral amantadine hydrochloride 200 mg per day.

At the end of the 12-month treatment period, the response was 25% in the first group, 29% in the second and 68% in the triple therapy group (p < 0.005). Follow-up a year later showed corresponding sustained responses to be 2%, 4% and 25% (p < 0.002).

The researchers call for larger trials. Summing up, Dr. Adinolfi said the study demonstrates "that amantadine acts synergistically with interferon and ribavirin in chronic hepatitis C patients, who were non-responders to interferon alone, without any increase of side effects."

Gut 2003;52;701-705.