No beneficial effects of amantadine in treatment of chronic hepatitis C patients

Author(s):
Soest, H. van; Schaar, P.J. van der; Koek, G.H.; Vries, R.A. de; Ooteghem, N.A. van; Hoek, B. van (0000-0001-6527-764X); Drenth, J.P.H.; Vrolijk, J.M.; Lieverse, R.J.; Houben, P.; Veer, A.V.; Siersema, P.D.; Schipper, M.E.I.; Erpecum, K.J. van; Boland, G.J.
Published
2010
Publication type
Article / Letter to editor

Abstract

Background: Benefit of adding amantadine to antiviral therapy for hepatitis C is controversial. Aims: We aimed to examine whether such policy enhances sustained viral response in treatment-naive patients. Methods: 297 naive hepatitis C patients were randomized for treatment with amantadine 200 mg or placebo, combined with weight-based ribavirin and 12-day high-dose interferon alpha-2b induction therapy, followed by PEG-interferon alpha-2b (1.5 mu g/kg/week up to 26 weeks and thereafter, 1.0 mu g/kg/week until week 52). Treatment was discontinued if hepatitis C virus (HCV) RNA was positive at week 24. Results: 49% of patients were (former) drug users. Genotype 1 occurred in 45%, high viral load in 70% and severe fibrosis/cirrhosis in 32%, without differences between amantadine or placebo groups. 90 patients prematurely discontinued treatment, mainly because of grade 3 or 4 toxicity. Intention-to-treat analysis revealed sustained viral response in 47% and 51% of amantadine and placebo groups (p = 0.49). Amantadine did not enhance sustained viral response in patients with genotype 1 or high viral load nor did it improve primary non-response, breakthrough or relapse rates. Genotype non-1 and lower pre-treatment gamma GT levels were independent predictors for sustained viral response. Conclusion: Adding amantadine to antiviral therapy of previously untreated chronic hepatitis C patients has no beneficial effects. (C) 2009 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Amantadine Hepatitis C PEG-interferon Ribavirin placebo-controlled trial treatment-naive patients alpha-2a plus ribavirin initial treatment virus-infection randomized trial triple therapy double-blind influenza-a interferon
Date issued
2010-07-31
Language
English
Is part of
Digestive and Liver Disease (2010), Vol. 42, no. 7, p. 496-502
hdl
1887/100153
doi
10.1016/j.dld.2009.10.006