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

H. van Soest, P.J. van der Schaar, G.H. Koek, R.A. de Vries, N.A. van Ooteghem, B. van Hoek, J.P. Drenth, J.M. Vrolijk, R.J. Lieverse, P. Houben, A. van der Sluys Veer, P.D. Siersema, M.E. Schipper, K.J. van Erpecum, G.J. Boland

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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 200mg or placebo, combined with weight-based ribavirin and 12-day high-dose interferon alpha-2b induction therapy, followed by PEG-interferon alpha-2b (1.5mug/kg/week up to 26 weeks and thereafter, 1.0mug/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 gammaGT 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.
Original languageEnglish
Pages (from-to)496-502
JournalDigestive and Liver Disease
Volume42
Issue number7
DOIs
Publication statusPublished - 1 Jan 2010

Cite this

van Soest, H., van der Schaar, P. J., Koek, G. H., de Vries, R. A., van Ooteghem, N. A., van Hoek, B., Drenth, J. P., Vrolijk, J. M., Lieverse, R. J., Houben, P., van der Sluys Veer, A., Siersema, P. D., Schipper, M. E., van Erpecum, K. J., & Boland, G. J. (2010). No beneficial effects of amantadine in treatment of chronic hepatitis C patients. Digestive and Liver Disease, 42(7), 496-502. https://doi.org/10.1016/j.dld.2009.10.006