Seizures During Pegylated Interferon and Ribavirin

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Seizures During Pegylated Interferon and Ribavirin

Seizures During Pegylated Interferon and Ribavirin Therapy for Chronic Hepatitis C: Observations From the WIN-R Trial.

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"Seizures occur infrequently in patients receiving PEG-IFNα-2b plus ribavirin, and appear to be associated with other risk factors including antidepressant use"

..Ahmed F, son IM, Herrera JL, Brand M, Wasserman RB, Fixelle AM, Rustgi VK, Albert C, Brown R, Brass C; for the WIN-R Study Group.*Division of Gastroenterology, Aga Khan university, Karachi, Pakistan †Weill Medical College of Cornell University ‡Division of Gastroenterology, University of South Alabama, Mobile, AL §Connecticut Gastroenterology Consultants, New Haven, CT ∥Infectious Disease Doctors, Walnut Creek, CA ¶Gastroenterology Consultants, Atlanta, GA ♯town University, Fairfax, VA **Northside Forsyth Drive, Cumming, GA ††Columbia University College of Physicians and Surgeons, New York, NY ‡‡Schering-Plough Corp, now Merck & Co, Inc, Whitehouse Station, NJ.AbstractBACKGROUND: Seizures are reported as an uncommon side effect of interferon

therapy.AIM: To determine the frequency and presentation of seizures occurring during pegylated interferon-α (PEG-IFNα) and ribavirin therapy for chronic hepatitis C.METHODS: Patients were identified using data from the WIN-R trial database, a US multicenter study comparing fixed (800 mg) versus weight-based (800 to 1400 mg) daily dosing of ribavirin in combination with PEG-IFNα-2b (1.5 μg/kg/wk).RESULTS: Of the 4913 enrolled patients, 8 (0.16%) had a seizure. Three patients had a grand mal seizure and the seizure type was unknown in 5 patients. At the time of seizure, 6 patients were taking antidepressants (including 3 on bupropion), 1 was hyponatremic, and 1 had consumed a significant amount of alcohol. One patient had a history of seizures. Neuroimaging and electroencephalographic studies were negative. Antiepileptic medications were continued in the patient with a

history of seizures and initiated in 1 patient. PEG-IFNα-2b plus ribavirin therapy was continued in 2 patients following seizure and neither experienced a recurrent seizure.CONCLUSIONS: Seizures occur infrequently in patients receiving PEG-IFNα-2b plus ribavirin, and appear to be associated with other risk factors including antidepressant use.PMID: 20930643

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