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

Author(s): Bertino G, Ardiri A, Boemi PM, Calvagno GS, Ruggeri IM, Speranza A, Santonocito MM, Ierna D, Bruno CM, Valenti M, Boemi R, Naimo S, Neri S

Affiliation(s): Hepatology Unit, Department of Internal Medicine and Systemic Diseases, University of Catania, S. Marta Hospital, Via Gesualdo Clementi, 36, 95124 Catania, Italy. gaetanobertinounict@libero.it

Publication date & source: 2010-10, Eur J Clin Pharmacol., 66(10):1055-63. Epub 2010 Jul 22.

Publication type: Comparative Study; Multicenter Study; Randomized Controlled Trial

BACKGROUND: The conventional antiviral treatment of chronic hepatitis related to hepatitis C virus (HCV) often leads to anemia. In this case, it is necessary to reduce ribavirin dose or stop treatment, thus reducing the rate of sustained virological response. AIM: We investigated whether epoetin alpha administration improves treatment adherence and leads to higher percentage of response at the end of therapy and sustained virological response. METHODS: Two hundred and fourteen individuals with genotype 1b HCV-related chronic hepatitis underwent treatment with pegylated (peg)-interferon alpha-2A 180 mug once weekly and ribavirin 1,000-1,200 mg/day; 174 were responders. Forty individuals completed treatment with no hemoglobin reduction; 134 developed anemia during therapy. Anemic responders were distributed randomly into two groups: group 1 continued therapy with epoetin alpha addiction; group 2 continued antiviral therapy with ribavirin reduction only. RESULTS: Patients in group 1 achieved better control of hemoglobin levels (13.8 +/- 1.2 g/dl at the end of therapy) than those in group 2 (11.5 +/- 0.8 g/dl). Sustained virological response was 59.7% in group 1 compared with 34.4% in group 2 (p<0.01). CONCLUSIONS: In patients with 1b HCV-related chronic hepatitis who develop anemia during antiviral treatment, administration of epoetin alpha increases hemoglobin levels and the end-of-treatment rate and sustains virological response by improving treatment adherence.

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