RESEARCH - The utility of TNF blockade in orphan diseases

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The use of etanercept in patients with chronic hepatitis C induced hepatitis

has been evaluated. A 24 week randomised control trial of etanercept (25 mg

subcutaneously twice a week) (n = 19) versus placebo (n = 25) was carried

out in patients on a background of interferon and ribavirin. At 24 weeks,

more patients receiving etanercept exhibited normal alanine aminotransferase

(ALT) in the absence of serum HCV RNA. Thus 58% of patients treated with

etanercept exhibited normal or absent ALT and HCV RNA levels compared with

28% of the placebo treated group. The data support the rationale for use of

etanercept in hepatitis C induced hepatitis.

Infliximab has also been used in patients with rheumatic diseases who also

have chronic hepatitis B and C. After more than one year of treatment, no

worsening in liver function or virological status was observed. In contrast,

a patient with positive hepatitis B virus surface antigen developed

fulminant hepatitis two weeks after receiving a second infliximab infusion

for the treatment of refractory adult onset Still's disease.

http://ard.bmjjournals.com/cgi/content/full/63/suppl_2/ii79

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Mayo Clinic in Rochester

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s Hopkins Medicine

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