A survey of adverse events in 11241 patients with chronic viral hepatitis treated with alfa interferon

被引：402

作者：

Fattovich, G ^{[1
]}

Giustina, G ^{[1
]}

Favarato, S ^{[1
]}

Ruol, A ^{[1
]}

Macarri, G ^{[1
]}

Orlandi, F ^{[1
]}

Iaquinto, G ^{[1
]}

Ambrosone, L ^{[1
]}

Francavilla, A ^{[1
]}

Pastore, G ^{[1
]}

Santantonio, MT ^{[1
]}

Romagno, D ^{[1
]}

Bolondi, L ^{[1
]}

Sofia, S ^{[1
]}

Marchesini, A ^{[1
]}

Pisi, E ^{[1
]}

Mazzella, G ^{[1
]}

Roda, E ^{[1
]}

Attaro, L ^{[1
]}

Chiodo, F ^{[1
]}

Mori, F ^{[1
]}

Verucchi, G ^{[1
]}

Lanzini, A ^{[1
]}

Salmi, A ^{[1
]}

Calvi, B ^{[1
]}

Bozzetti, F ^{[1
]}

Radaeli, E ^{[1
]}

Bernasconi, M ^{[1
]}

Pilleri, G ^{[1
]}

Bacca, D ^{[1
]}

Romano, G ^{[1
]}

Mastrapasqua, G ^{[1
]}

Cozzolongo, R ^{[1
]}

Cacopardo, B ^{[1
]}

Nunnari, A ^{[1
]}

Blasi, A ^{[1
]}

Sala, LO ^{[1
]}

Minoli, G ^{[1
]}

Sangiovanni, A ^{[1
]}

Spinzi, GC ^{[1
]}

Colombo, A ^{[1
]}

Camassa, M ^{[1
]}

Riva, D ^{[1
]}

Maggi, G ^{[1
]}

Boccia, S ^{[1
]}

Gualandi, G ^{[1
]}

Nucci, A ^{[1
]}

Pacini, F ^{[1
]}

Marino, N ^{[1
]}

Mazzotta, F ^{[1
]}

机构：

[1] UNIV PADUA,IST MED CLIN,MED CLIN 2A,I-35100 PADUA,ITALY

来源：

JOURNAL OF HEPATOLOGY | 1996年 / 24卷 / 01期

关键词：

chronic viral hepatitis; interferon alfa; side effects;

D O I：

10.1016/S0168-8278(96)80184-X

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Aims: The aim of this study was to assess the incidence of fatal, life-threatening side effects and the de novo appearance of non-hepatic morbidity during interferon alfa therapy for chronic viral hepatitis. The relationship of these adverse events to actual total dose and duration of interferon was also evaluated. Methods: We conducted a retrospective study at 73 Italian centers of 11 241 consecutive patients with chronic viral hepatitis who underwent interferon alfa treatment. Results: Five patients died during interferon therapy due to liver failure (n=4) or complications arising from sepsis. Life-threatening side effects were observed in eight patients: two cases where depression developed and led to a suicide attempt and six patients with bone marrow suppression (granulocytes (500/ mm(3) or platelets <25 000/mm(3)). These symptoms and signs completely disappeared after interferon withdrawal. During interferon treatment, 131 patients developed the following de novo non-hepatic disorders: symptomatic thyroid disease (n=71), impotence (n=5), systemic autoimmune disease (n=5), immune-mediated dermatologic disease (n=14), diabetes mellitus (n=10), cardiovascular disease (n=7), psychosis n=10), seizures (n=4), peripheral neuropathy (n=3) and hemolytic anemia (n=2). Most of these complications are reversible or can be ameliorated. Fatal or life-threatening side effects were not related to actual total dose or duration of interferon alfa, while the majority of patients with de novo non-hepatic morbidity received medium/high doses (>200 million units) of interferon alfa or were treated for periods longer than 16 weeks (68% and 80%, respectively). Conclusions: Treatment with interferon alfa may have fatal or life-threatening side effects, their incidence in this study being low (0.04% and 0.07%, respectively) and perhaps no different than in untreated patients with chronic viral hepatitis. Moreover ne novo non-hepatic morbidity occurred in 1.2% of patients, and the dose and duration of interferon therapy seem important in determining the frequency of this complication, The development of clinically-overt thyroid disease was most common.

引用

页码：38 / 47

页数：10

共 23 条

[1] REVERSIBLE CARDIAC DYSFUNCTION ASSOCIATED WITH INTERFERON ALFA THERAPY IN AIDS PATIENTS WITH KAPOSIS SARCOMA
DEYTON, LR
WALKER, RE
KOVACS, JA
HERPIN, B
PARKER, M
MASUR, H
FAUCI, AS
LANE, HC
[J]. NEW ENGLAND JOURNAL OF MEDICINE, 1989, 321 (18) : 1246 - 1249
[2] DURAND JM, 1991, LANCET, V338, P1268
[3] DEVELOPMENT OF TYPE-1 DIABETES-MELLITUS DURING INTERFERON-ALFA THERAPY FOR CHRONIC HCV HEPATITIS
FABRIS, P
BETTERLE, C
FLOREANI, A
GREGGIO, NA
DELAZZARI, F
NACCARATO, R
CHIARAMONTE, M
[J]. LANCET, 1992, 340 (8818) : 548 - 548
[4] AUTOANTIBODIES DURING ALPHA-INTERFERON THERAPY FOR CHRONIC HEPATITIS-B
FATTOVICH, G
BETTERLE, C
BROLLO, L
PEDINI, B
GIUSTINA, G
REALDI, G
ALBERTI, A
RUOL, A
[J]. JOURNAL OF MEDICAL VIROLOGY, 1991, 34 (02) : 132 - 135
[5] GARANCINI P, 1991, EUR J EPIDEMIOL, V7, P55
[6] FATAL HEPATIC DECOMPENSATION ASSOCIATED WITH INTERFERON ALFA
JANSSEN, HLA
BROUWER, JT
NEVENS, F
SANCHEZTAPIAS, JM
CRAXI, A
HADZIYANNIS, S
[J]. BRITISH MEDICAL JOURNAL, 1993, 306 (6870) : 107 - 108
[7] SUICIDE ASSOCIATED WITH ALFA-INTERFERON THERAPY FOR CHRONIC VIRAL-HEPATITIS
JANSSEN, HLA
BROUWER, JT
VANDERMAST, RC
SCHALM, SW
[J]. JOURNAL OF HEPATOLOGY, 1994, 21 (02) : 241 - 243
[8] SEIZURES ASSOCIATED WITH LOW-DOSE ALPHA-INTERFERON
JANSSEN, HLA
BERK, L
VERMEULEN, M
SCHALM, SW
[J]. LANCET, 1990, 336 (8730) : 1580 - 1580
[9] KASSIANIDES C, 1988, VIRAL HEPATITIS LIVE, P840
[10] DEVELOPMENT OF THYROID-DISEASE DURING THERAPY OF CHRONIC VIRAL-HEPATITIS WITH INTERFERON ALFA
LISKERMELMAN, M
DIBISCEGLIE, AM
USALA, SJ
WEINTRAUB, B
MURRAY, LM
HOOFNAGLE, JH
[J]. GASTROENTEROLOGY, 1992, 102 (06) : 2155 - 2160

← 1 2 3 →