Limitation of combination therapy of interferon and ribavirin for older patients with chronic hepatitis C

被引:118
|
作者
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
机构
[1] Okayama Univ, Grad Sch Med Dent & Pharmaceut Sci, Dept Gastroenterol & Hepatol, Okayama 7008558, Japan
[2] Kurashiki Cent Hosp, Dept Gastroenterol, Kurashiki, Okayama, Japan
[3] Hiroshima City Hosp, Dept Med, Hiroshima, Japan
[4] Okayama Saiseikai Gen Hosp, Dept Med, Okayama, Japan
[5] Kagawa Prefectural Cent Hosp, Dept Med, Takamatsu, Kagawa, Japan
[6] Mitoyo Gen Hosp, Dept Med, Mitoya, Japan
[7] Fukuyama City Hosp, Dept Med, Fukuyama, Hiroshima, Japan
[8] Mihara Red Cross Hosp, Dept Med, Mihara, Japan
[9] Teraoka Mem Hosp, Dept Med, Fukuyama, Hiroshima, Japan
关键词
D O I
10.1002/hep.20984
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
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.
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页码:54 / 63
页数:10
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