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

doi:10.1016/j.dld.2009.10.006

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

^*Corresponding author for this work

Interne Geneeskunde

Research output: Contribution to journal › Article › Academic › peer-review

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 language	English
Pages (from-to)	496-502
Journal	Digestive and Liver Disease
Volume	42
Issue number	7
DOIs	https://doi.org/10.1016/j.dld.2009.10.006
Publication status	Published - 1 Jan 2010

Access to Document

10.1016/j.dld.2009.10.006

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

@article{d50b6fe3df7f4be6b5c461fe26b749e9,

title = "No beneficial effects of amantadine in treatment of chronic hepatitis C patients",

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.",

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

year = "2010",

month = jan,

day = "1",

doi = "10.1016/j.dld.2009.10.006",

language = "English",

volume = "42",

pages = "496--502",

journal = "Digestive and Liver Disease",

issn = "1590-8658",

publisher = "Elsevier Science",

number = "7",

}

van Soest, H, van der Schaar, PJ, Koek, GH, de Vries, RA, van Ooteghem, NA, van Hoek, B, Drenth, JP, Vrolijk, JM, Lieverse, RJ, Houben, P, van der Sluys Veer, A, Siersema, PD, Schipper, ME, van Erpecum, KJ & Boland, GJ 2010, 'No beneficial effects of amantadine in treatment of chronic hepatitis C patients', Digestive and Liver Disease, vol. 42, no. 7, pp. 496-502. https://doi.org/10.1016/j.dld.2009.10.006

TY - JOUR

T1 - No beneficial effects of amantadine in treatment of chronic hepatitis C patients

AU - van Soest, H.

AU - van der Schaar, P.J.

AU - Koek, G.H.

AU - de Vries, R.A.

AU - van Ooteghem, N.A.

AU - van Hoek, B.

AU - Drenth, J.P.

AU - Vrolijk, J.M.

AU - Lieverse, R.J.

AU - Houben, P.

AU - van der Sluys Veer, A.

AU - Siersema, P.D.

AU - Schipper, M.E.

AU - van Erpecum, K.J.

AU - Boland, G.J.

PY - 2010/1/1

Y1 - 2010/1/1

N2 - 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.

AB - 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.

U2 - 10.1016/j.dld.2009.10.006

DO - 10.1016/j.dld.2009.10.006

M3 - Article

C2 - 20018575

SN - 1590-8658

VL - 42

SP - 496

EP - 502

JO - Digestive and Liver Disease

JF - Digestive and Liver Disease

IS - 7

ER -