DOI: 10.1053/jhep.2000.8700. Iron reduction as an adjuvant to interferon therapy in patients with chronic hepatitis C who have previously not responded to interferon: A multicenter, prospective, randomized, controlled trial

Iron reduction as an adjuvant to interferon therapy in patients with chronic hepatitis C who have previously not responded to interferon: A multicenter, prospective, randomized, controlled trial

10.1053/jhep.2000.8700

Crossref journal-article

Ovid Technologies (Wolters Kluwer Health)

Hepatology (276)

Abstract

Hepatic iron concentration has consistently been observed as being directly correlated with the response to interferon therapy in chronic hepatitis C virus (HCV). We therefore conducted a randomized, controlled trial comparing iron reduction by phlebotomy with iron reduction followed by retreatment with interferon in 96 patients with chronic hepatitis C who had previously not responded to a course of interferon. During the initial phase when all patients were undergoing phlebotomy, we found that serum alanine transaminase (ALT) activities decreased but by less than 50% from baseline in 67 patients (89%), decreased by more than 50% in 12 patients (13%) and became normal in 9 patients (9%) with no overall change in HCV-RNA levels. Subsequently no patient in either treatment group achieved a sustained virologic response. Improvements in necroinflammatory changes were noted in liver biopsy specimens in those patients receiving phlebotomy plus interferon (mean index 8.59 vs. 7.37, P < .05). A slight but not statistically significant decrease in histologic activity index was noted in those subjects treated by phlebotomy alone (mean index 8.4 vs. 7.75, P not significant). We conclude that, although prior phlebotomy therapy does not improve the rate of sustained response to interferon retreatment, it does result in less liver injury manifested by a decrease in serum transaminase activity and a slight improvement in liver histopathology.

Bibliography

Di Bisceglie, A. M., Bonkovsky, H. L., Chopra, S., Flamm, S., Reddy, R. K., Grace, N., Killenberg, P., Hunt, C., Tamburro, C., Tavill, A. S., Ferguson, R., Krawitt, E., Banner, B., & Bacon, B. R. (2000). Iron reduction as an adjuvant to interferon therapy in patients with chronic hepatitis C who have previously not responded to interferon: A multicenter, prospective, randomized, controlled trial. Hepatology, 32(1), 135â138.

Authors 14

Adrian M. Di Bisceglie (first)
Herbert L. Bonkovsky (additional)
Sanjiv Chopra (additional)
Stephen Flamm (additional)
Rajender K. Reddy (additional)
Norman Grace (additional)
Paul Killenberg (additional)
Christine Hunt (additional)
Carlo Tamburro (additional)
Anthony S. Tavill (additional)
Roy Ferguson (additional)
Edward Krawitt (additional)
Barbara Banner (additional)
Bruce R. Bacon (additional)

References 27 Referenced 120

10.1016/S0168-8278(05)80657-9 / J Hepatol by Tremolada (1992)
10.1002/hep.510260701 / Hepatology (1997)
10.7326/0003-4819-127-10-199711150-00003 / Ann Intern Med by Marcellin (1997)
10.1056/NEJM199811193392101 / N Engl J Med by McHuchinson (1998)
10.1056/NEJM199811193392102 / N Engl J Med by Davis (1998)
{'key': '10.1053/jhep.2000.8700-BIB6', 'first-page': '419', 'volume': '103', 'author': 'Barton', 'year': '1995', 'journal-title': 'Anat Pathol'} / Anat Pathol by Barton (1995)
{'key': '10.1053/jhep.2000.8700-BIB7', 'first-page': '1367', 'volume': '91', 'author': 'Ikura', 'year': '1996', 'journal-title': 'Am J Gastroenterol'} / Am J Gastroenterol by Ikura (1996)
10.1016/S0168-8278(94)80017-0 / J Hepatol by Van Thiel (1994)
10.1016/0016-5085(95)90209-0 / Gastroenterology by Olynyk (1995)
10.1007/BF02091542 / Dig Dis Sci by Izumi (1996)
10.1097/00042737-199705000-00016 / Eur J Gastroenterol Hepatol by Fargion (1997)
10.1016/S0022-3476(94)70138-5 / J Pediatr by Clemente (1994)
10.1111/j.1365-2893.1995.tb00017.x / J Viral Hepatitis by Alter (1995)
10.7326/0003-4819-115-9-700 / Ann Intern Med by Shindo (1991)
10.1099/0022-1317-74-6-1093 / J Gen Virol by Stuyver (1993)
10.1099/0022-1317-76-5-1197 / J Gen Virol by Davidson (1995)
10.1002/hep.1840010511 / Hepatology by Knodell (1981)
{'key': '10.1053/jhep.2000.8700-BIB18', 'first-page': '9', 'volume': '33', 'author': 'Torrance', 'year': '1968', 'journal-title': 'S Afr J Med Sci'} / S Afr J Med Sci by Torrance (1968)
10.1016/S0168-8278(98)80308-5 / J Hepatol by Fong (1998)
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{'key': '10.1053/jhep.2000.8700-BIB21', 'first-page': '1557', 'volume': '43', 'author': 'Van Thiel', 'year': '1996', 'journal-title': 'Hepato-Gastroenterology'} / Hepato-Gastroenterology by Van Thiel (1996)
{'key': '10.1053/jhep.2000.8700-BIB22', 'first-page': '1831', 'volume': '92', 'author': 'Tsai', 'year': '1997', 'journal-title': 'Am J Gastroenterol'} / Am J Gastroenterol by Tsai (1997)
10.1002/hep.510310325 / Hepatology by Fontana (2000)
. Hemochromatosis and the iron overload syndromes. In, , eds. Hepatology: A Textbook of Liver Disease. Saunders: Philadelphia. 1996; 1439-1472. / Hepatology: A Textbook of Liver Disease by Bacon (1996)
10.1038/ng0896-399 / Nat Genet by Feder (1996)
10.1002/hep.510270631 / Hepatology by Smith (1998)
10.1016/S0016-5085(99)70236-2 / Gastroenterology by Kazemi-Shirazi (1999)

Dates

Type	When
Created	21 years, 5 months ago (March 19, 2004, 1:38 p.m.)
Deposited	9 months ago (Dec. 1, 2024, 6:27 a.m.)
Indexed	9 months ago (Dec. 2, 2024, 12:03 a.m.)
Issued	25 years, 2 months ago (July 1, 2000)
Published	25 years, 2 months ago (July 1, 2000)
Published Print	25 years, 2 months ago (July 1, 2000)

Funders 0

None

BibTeX

@article{Di_Bisceglie_2000, title={Iron reduction as an adjuvant to interferon therapy in patients with chronic hepatitis C who have previously not responded to interferon: A multicenter, prospective, randomized, controlled trial}, volume={32}, ISSN={0270-9139}, url={http://dx.doi.org/10.1053/jhep.2000.8700}, DOI={10.1053/jhep.2000.8700}, number={1}, journal={Hepatology}, publisher={Ovid Technologies (Wolters Kluwer Health)}, author={Di Bisceglie, Adrian M. and Bonkovsky, Herbert L. and Chopra, Sanjiv and Flamm, Stephen and Reddy, Rajender K. and Grace, Norman and Killenberg, Paul and Hunt, Christine and Tamburro, Carlo and Tavill, Anthony S. and Ferguson, Roy and Krawitt, Edward and Banner, Barbara and Bacon, Bruce R.}, year={2000}, month=jul, pages={135–138} }

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  "abstract": "<jats:sec>\n            <jats:title/>\n            <jats:p>Hepatic iron concentration has consistently been observed as being directly correlated with the response to interferon therapy in chronic hepatitis C virus (HCV). We therefore conducted a randomized, controlled trial comparing iron reduction by phlebotomy with iron reduction followed by retreatment with interferon in 96 patients with chronic hepatitis C who had previously not responded to a course of interferon. During the initial phase when all patients were undergoing phlebotomy, we found that serum alanine transaminase (ALT) activities decreased but by less than 50% from baseline in 67 patients (89%), decreased by more than 50% in 12 patients (13%) and became normal in 9 patients (9%) with no overall change in HCV-RNA levels. Subsequently no patient in either treatment group achieved a sustained virologic response. Improvements in necroinflammatory changes were noted in liver biopsy specimens in those patients receiving phlebotomy plus interferon (mean index 8.59 vs. 7.37, <jats:italic toggle=\"yes\">P</jats:italic> &lt; .05). A slight but not statistically significant decrease in histologic activity index was noted in those subjects treated by phlebotomy alone (mean index 8.4 vs. 7.75, <jats:italic toggle=\"yes\">P</jats:italic> not significant). We conclude that, although prior phlebotomy therapy does not improve the rate of sustained response to interferon retreatment, it does result in less liver injury manifested by a decrease in serum transaminase activity and a slight improvement in liver histopathology.</jats:p>\n          </jats:sec>",
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