1. Ribavirin treatment for patients with chronic hepatitis C: results of a placebo-controlled study
- Author
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Peter Sillikens, Margaret F. Bassendine, Janice Main, Christine Lee, Nico Lelie, Geoffrey Dusheiko, Theo Cuypers, Suhra Rassam, Jonathan P Watson, Gunnar Norkrans, Christine J. Weegink, Henk W. Reesink, Aril Frydén, Ola Weiland, Paul Telfer, Howard C. Thomas, Amar P. Dhillon, Olle Reichard, and Other departments
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,Genotype ,Hepatitis C virus ,Biopsy ,viruses ,Population ,Placebo-controlled study ,Administration, Oral ,Hepacivirus ,medicine.disease_cause ,Placebo ,Gastroenterology ,Antiviral Agents ,law.invention ,chemistry.chemical_compound ,Randomized controlled trial ,Double-Blind Method ,law ,Internal medicine ,Ribavirin ,medicine ,Humans ,education ,Aged ,education.field_of_study ,Hepatology ,business.industry ,virus diseases ,Alanine Transaminase ,Middle Aged ,biochemical phenomena, metabolism, and nutrition ,medicine.disease ,Hepatitis C ,digestive system diseases ,Clinical trial ,Treatment Outcome ,chemistry ,Hepatocellular carcinoma ,Immunology ,Chronic Disease ,Female ,business - Abstract
BACKGROUND/AIMS: Small, uncontrolled studies of ribavirin for patients with chronic hepatitis C have reported efficacy in chronic hepatitis C. We have evaluated the efficacy and safety of a 24-week course of oral ribavirin in patients with chronic hepatitis C, compared to placebo. METHODS: A total of 114 patients were randomised to ribavirin or placebo. Ribavirin was administered in doses of 1000 or 1200 mg/day for 24 weeks. Efficacy was determined in the intention-to-treat population: 76 received ribavirin and 38 placebo. RESULTS: Ribavirin was significantly more effective than placebo in reducing and normalising serum ALT levels: 42/76 (55%) of ribavirin-treated patients vs 2/38 (5%) placebo recipients had either normalisation of the ALT levels or a reduction from baseline of at least 50% (p < 0.001). ALT levels were normal in 22/76 (29%) of ribavirin-treated patients vs 0/38 placebo recipients (p < 0.001). Twenty-four weeks after stopping ribavirin, the majority of patients had abnormal ALT levels. There was no difference between the treatment groups in reduction or disappearance of HCV-RNA levels. HCV RNA disappeared during treatment in 3% of ribavirin-treated patients and 3% of placebo recipients. More ribavirin than placebo patients showed improvement in total Knodell score (45% vs 31%), but these differences were not statistically significant. Analysis of each component of a histology activity index revealed no statistically significant differences between treatment groups. Ribavirin patients had fewer lymphoid aggregates than did placebo recipients at the post-treatment assessment (p = 0.05). Ribavirin was associated with reversible haemolytic anaemia: a fall in haemoglobin occurred in 3% of placebo- and 32% (25/78) of ribavirin-treated patients, respectively (p < 0.001). CONCLUSIONS: These data indicate that ribavirin was no more effective than placebo in reducing or eliminating HCV-RNA levels, and was not significantly more effective than placebo in improving hepatic histology after 6 months of treatment. The role of a 6-month treatment of chronic hepatitis C with ribavirin alone, without a significant effect on HCV RNA, is therefore limited
- Published
- 1996