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

Journal European Journal of Clinical Pharmacology
Publisher Springer Berlin / Heidelberg
ISSN 0031-6970 (Print) 1432-1041 (Online)
Category Pharmacoepidemiology and Prescription
DOI 10.1007/s00228-010-0868-4
Subject Collection Biomedical and Life Sciences
SpringerLink Date Friday, July 23, 2010

Gaetano  Bertino 1,4 , Annalisa Ardiri 1, Patrizia Maria Boemi 1, Giuseppe Stefano Calvagno 1, Irene Maria Ruggeri 2, Annalisa Speranza 1, Maria Milena Santonocito 1, Dario Ierna 1, Cosimo Marcello Bruno 1, Maria Valenti 1, Roberta Boemi 1, Simona Naimo 1 and Sergio Neri 3

(1) Hepatology Unit, Department of Internal Medicine and Systemic Diseases, University of Catania, S. Marta Hospital, Via Gesualdo Clementi, 36, 95124 Catania, Italy
(2) Emergency Department ARNAS Civic Hospital, Palermo, Italy
(3) Department of Internal Medicine and Systemic Diseases, Policlinic of Catania, University of Catania, Catania, Italy
(4) Largo E. Amari n.1 - C.A.P. 95030 S. Agata Li Battiati (Catania), Sicily, Italy

Received: 21 May 2010 Accepted: 6 July 2010 Published online: 22 July 2010

Abstract

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 μg 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 tthose 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.

Keywords Epoetin alpha - Peg-interferon alpha-2A - Ribavirin - Genotype 1b HCV-related chronic hepatitis

Source