Limitation of combination therapy of interferon and ribavirin for older patients

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Limitation of combination therapy of interferon and ribavirin for older

patients with chronic hepatitis C.

Iwasaki Y, Ikeda H, Araki Y, Osawa T, Kita K, Ando M, Shimoe T, Takaguchi K,

Hashimoto N, Kobatake T, Tomita M, Kawaguchi M, Kobashi H, Sakaguchi K,

Shiratori Y.

Department of Gastroenterology and Hepatology, Okayama University Graduate

School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan.

In contrast to the United States, Japanese patients with chronic hepatitis C

currently treated with interferon are generally 10 to 15 years older. Older

patients, however, tend to experience more frequent adverse events. This

study was conducted to clarify the effect of patient age on the efficacy and

safety of combination therapy. We consecutively enrolled 208 patients with

naive chronic hepatitis C. Patients were classified into three groups

according to age: younger than 50 years of age (n = 52); 50 to 59 years old

(n = 83); and 60 years of age or older (n = 73). Interferon alpha-2b therapy

was administered daily for 2 weeks, followed by 3 times per week for 22

weeks, while ribavirin was administered daily. Of the 208 study patients,

discontinuation of therapy or dose reduction was required in 116 (56%) and

was more frequent in older patient groups: 38%, 48%, and 77% for the <50,

50-59, and >/=60-year-old patient groups, respectively (P < .001).

Multivariate analysis showed patient age to be independently associated with

adherence to therapy. A sustained virological response was achieved in 77

(37%) patients, with genotype, viral load, and adherence to therapy

associated with this achievement. A tendency toward a lower sustained

virological response rate was seen in the older patients. In conclusion,

patient age is an important factor contributing to the safety of combination

therapy. Thus, treatment schedule should be modified, or other therapeutic

modalities should be considered for older patients with chronic hepatitis C.

(HEPATOLOGY 2006;43:54-63.).

PMID: 16374855 [PubMed - in process]

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

6374855 & dopt=Abstract

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