Antiviral re-treatment of IFN-Ribavirin non-responders for recurrent post-transplantation hepatitis C

[Guest guest]

http://www3.interscience.wiley.com/journal/123362729/abstract?CRETRY=1 & SRETRY=0

Clinical Transplantation

Early View (Articles online in advance of print)

Published Online: 21 Apr 2010

© 2010 Wiley & Sons A/S

Antiviral re-treatment of IFN-Ribavirin non-responders for recurrent

post-transplantation hepatitis C

Süleyman Yedibela a,*, Resit Demir a,*, iel Melling a , Ünal Aydin b ,

Detlef Schuppan c , Volker Müller a , Werner Hohenberger a and

Schönleben a

a Department of General Surgery, University of Erlangen-Nuremberg,

Krankenhausstr, Erlangen, Germany , b Department of General Surgery, Faculty of

Medicine, Gaziantep University, Gaziantep, Turkey and c Beth Israel Deaconess

Medical Center, Boston, MA, USA

Corresponding author: Süleyman Yedibela, MD, Department of General Surgery,

Universuty of Erlangen-Nuremberg, Krankenhausstr. 12, D-91054 Erlangen, Germany.

Tel.: ++49 9131 8533330

Fax: ++49 9131 8539227

e-mail: Sueleyman.Yedibela@...

*Both authors contributed equally to this work.

ABSTRACT

Yedibela S, Demir R, Melling N, Aydin Ü, Schuppan D, Müller V, Hohenberger W,

Schönleben F. Antiviral re-treatment of IFN-Ribavirin non-responders for

recurrent post-transplantation hepatitis C.

Clin Transplant 2010 DOI: 10.1111/j.1399-0012.2010.01201.x.

© 2010 Wiley & Sons A/S.

Abstract: Background: The aim of the study was to compare the efficacy and

tolerability of pegylated interferon (PEG-IFN) plus ribavirin (RIB) and PEG-IFN

monotherapy after unsuccessful initial therapy with interferon-α2b (IFN) plus

RIB after recurrent post-transplantation hepatitis C.

Methods: Twenty-four patients with either no response (n = 10) or relapse (n =

14) after treatment with IFN plus RIB were prospectively randomized in the two

treatment arms: 1) PEG-IFN monotherapy at a dosage of 0.8 μg/kg per week (n =

12) and 2) PEG-IFN (0.8 μg/kg per week) plus RIB (800–1200 mg/d) (n = 12).

Results: Twenty-one patients (86%) were treated for at least six months. Three

patients are still being treated. At the end of therapy, 18 patients (75%) were

HCV RNA negative. Five (45%) patients in PEG-IFN and five (50%) in PEG-IFN plus

RIB arms had sustained virological response. Two patients (10%) died from

recurrent hepatocellular carcinoma. The histologic activity indices

significantly improved in both treatment arms. In the PEG-IFN arm, one patient

experienced an acute rejection and discontinued therapy.

Conclusions: Both treatment arms showed to be effective, well tolerated and lead

to an improvement in histologic outcome. Because of lower rates in side effects

and equal outcome, PEG-IFN monotherapy is an adequate option for antiviral

re-treatment.

Accepted for publication 23 October 2009

DIGITAL OBJECT IDENTIFIER (DOI)

10.1111/j.1399-0012.2009.01201

[Guest guest]

http://www3.interscience.wiley.com/journal/123362729/abstract?CRETRY=1 & SRETRY=0

Clinical Transplantation

Early View (Articles online in advance of print)

Published Online: 21 Apr 2010

© 2010 Wiley & Sons A/S

Antiviral re-treatment of IFN-Ribavirin non-responders for recurrent

post-transplantation hepatitis C

Süleyman Yedibela a,*, Resit Demir a,*, iel Melling a , Ünal Aydin b ,

Detlef Schuppan c , Volker Müller a , Werner Hohenberger a and

Schönleben a

a Department of General Surgery, University of Erlangen-Nuremberg,

Krankenhausstr, Erlangen, Germany , b Department of General Surgery, Faculty of

Medicine, Gaziantep University, Gaziantep, Turkey and c Beth Israel Deaconess

Medical Center, Boston, MA, USA

Corresponding author: Süleyman Yedibela, MD, Department of General Surgery,

Universuty of Erlangen-Nuremberg, Krankenhausstr. 12, D-91054 Erlangen, Germany.

Tel.: ++49 9131 8533330

Fax: ++49 9131 8539227

e-mail: Sueleyman.Yedibela@...

*Both authors contributed equally to this work.

ABSTRACT

Yedibela S, Demir R, Melling N, Aydin Ü, Schuppan D, Müller V, Hohenberger W,

Schönleben F. Antiviral re-treatment of IFN-Ribavirin non-responders for

recurrent post-transplantation hepatitis C.

Clin Transplant 2010 DOI: 10.1111/j.1399-0012.2010.01201.x.

© 2010 Wiley & Sons A/S.

Abstract: Background: The aim of the study was to compare the efficacy and

tolerability of pegylated interferon (PEG-IFN) plus ribavirin (RIB) and PEG-IFN

monotherapy after unsuccessful initial therapy with interferon-α2b (IFN) plus

RIB after recurrent post-transplantation hepatitis C.

Methods: Twenty-four patients with either no response (n = 10) or relapse (n =

14) after treatment with IFN plus RIB were prospectively randomized in the two

treatment arms: 1) PEG-IFN monotherapy at a dosage of 0.8 μg/kg per week (n =

12) and 2) PEG-IFN (0.8 μg/kg per week) plus RIB (800–1200 mg/d) (n = 12).

Results: Twenty-one patients (86%) were treated for at least six months. Three

patients are still being treated. At the end of therapy, 18 patients (75%) were

HCV RNA negative. Five (45%) patients in PEG-IFN and five (50%) in PEG-IFN plus

RIB arms had sustained virological response. Two patients (10%) died from

recurrent hepatocellular carcinoma. The histologic activity indices

significantly improved in both treatment arms. In the PEG-IFN arm, one patient

experienced an acute rejection and discontinued therapy.

Conclusions: Both treatment arms showed to be effective, well tolerated and lead

to an improvement in histologic outcome. Because of lower rates in side effects

and equal outcome, PEG-IFN monotherapy is an adequate option for antiviral

re-treatment.

Accepted for publication 23 October 2009

DIGITAL OBJECT IDENTIFIER (DOI)

10.1111/j.1399-0012.2009.01201