https://scholars.lib.ntu.edu.tw/handle/123456789/581977
標題: | A pilot study of add-on oral hypoglycemic agents in treatment-naïve genotype-1 chronic hepatitis C patients receiving peginterferon alfa-2b plus ribavirin | 作者: | Hsu C.-S. SHIH-JER HSU Lin H.H. TAI-CHUNG TSENG Wang C.-C. DING-SHINN CHEN JIA-HORNG KAO |
關鍵字: | Hepatitis C virus; Insulin resistance; Oral hypoglycemic agents; Pegylated interferon; Randomized controlled trial; Sustained virological response | 公開日期: | 2014 | 出版社: | Elsevier | 卷: | 113 | 期: | 10 | 起(迄)頁: | 716-721 | 來源出版物: | Journal of the Formosan Medical Association | 摘要: | Background/Purpose: Insulin resistance (IR) affects sustained virological response (SVR) to peginterferon alfa plus ribavirin (PR) in patients with chronic hepatitis C (CHC). Whether add-on oral hypoglycemic agents (OHAs) to PR improve SVR remains unclear; therefore, we conducted a prospective, randomized pilot trial on 23 consecutive patients with genotype 1 CHC and IR in Taiwan. Methods: Patients were randomized to receive acarbose (Arm A; n=7) or metformin (Arm B; n=6) or pioglitazone (Arm C; n=5) in addition to peginterferon alfa-2b (1.5μg/kg/week) plus ribavirin (1000-1200mg/day) or just PR (Arm D; n=5). The primary end point was SVR, and secondary end points were viral clearance at Weeks 17, 29, and 53. There were no differences among all arms at baseline. Results: Using intent-to-treat analysis, SVR was observed in 66.7% (4/6), 83.3% (5/6), 66.7% (4/6), and 60% (3/5) in Arms A, B, C, and D, respectively. SVR was higher in female patients receiving OHA [90% (9/10)] than in male patients [50% (4/8)]. Results of per protocol analysis showed that SVR was 80.0% (4/5) in Arm A, 100% (5/5) in Arm B, 66.7% (4/6) in Arm C, and 60% (3/5) in Arm D. Patients receiving OHA had a higher rapid virologic response: 11/18 (61%) versus 2/5 (40%). Complete early virologic response was comparable between patients receiving OHA and PR [15/18 (83%) vs. 4/5 (80%)]. Conclusion: Our preliminary data show add-on OHAs to PR might achieve better early viral kinetics and SVR. However, further larger studies are needed to confirm these findings. ? 2014. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84922622860&doi=10.1016%2fj.jfma.2014.05.007&partnerID=40&md5=441e7e4809b106b5578de992ae53b7cf https://scholars.lib.ntu.edu.tw/handle/123456789/581977 |
ISSN: | 0929-6646 | DOI: | 10.1016/j.jfma.2014.05.007 | SDG/關鍵字: | acarbose; metformin; peginterferon alpha2b plus ribavirin; pioglitazone; 2,4 thiazolidinedione derivative; acarbose; alpha interferon; antidiabetic agent; antivirus agent; macrogol derivative; metformin; peginterferon alpha2b; pioglitazone; recombinant protein; ribavirin; add on therapy; adult; aged; anemia; Article; clinical article; controlled study; coughing; drug efficacy; drug withdrawal; female; fever; follow up; gastrointestinal symptom; headache; hepatitis C; Hepatitis C virus genotype 1; human; hyperglycemia; hyperlipidemia; hyperthyroidism; insulin resistance; intention to treat analysis; male; middle aged; multicenter study; outcome assessment; pancreatitis; pancytopenia; pilot study; prospective study; pruritus; randomized controlled trial; rash; Taiwan; treatment duration; treatment response; vertigo; viral clearance; drug combination; drug effects; genetics; genotype; Hepacivirus; Hepatitis C, Chronic; multidrug resistance; procedures; sex difference; virology; virus load; Acarbose; Adult; Aged; Antiviral Agents; Drug Resistance, Multiple, Viral; Drug Therapy, Combination; Female; Genotype; Hepacivirus; Hepatitis C, Chronic; Humans; Hypoglycemic Agents; Insulin Resistance; Interferon-alpha; Male; Metformin; Middle Aged; Pilot Projects; Polyethylene Glycols; Prospective Studies; Recombinant Proteins; Ribavirin; Sex Factors; Thiazolidinediones; Viral Load |
顯示於: | 臨床醫學研究所 |
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