Meloxicam as an adjuvant to peginterferon-α-2a and ribavirin treatment for genotype 1 chronic hepatitis C: A randomized trial

被引:0
作者
Kagawa, Tatehiro [1 ]
Kojima, Sei-ichiro [2 ]
Shiraishi, Koichi [1 ]
Hirose, Shunji [1 ]
Arase, Yoshitaka [1 ]
Takashimizu, Shinji [2 ]
Watanabe, Norihito [2 ]
Nagata, Naruhiko [3 ]
Numata, Makoto [3 ]
Shiozawa, Hirokazu [4 ]
Nishizaki, Yasuhiro [4 ]
Toki, Mayu [5 ]
Sugita, Teruji [5 ]
Nomura, Kijuro [6 ]
Sakaguchi, Takashi [7 ]
Atsukawa, Kazuhiro [7 ]
Tajima, Hiroto [8 ]
Tei, Yoshihiro [8 ]
Inomoto, Tsutomu [9 ]
Mine, Tetsuya [1 ]
机构
[1] Tokai Univ, Sch Med, Dept Internal Med, Div Gastroenterol, Isehara, Kanagawa 2591193, Japan
[2] Tokai Univ, Hachioji Hosp, Dept Internal Med, Div Gastroenterol, Hachioji, Tokyo, Japan
[3] Tokai Univ, Oiso Hosp, Dept Internal Med, Div Gastroenterol, Nakagun, Japan
[4] Tokai Univ, Tokyo Hosp, Dept Internal Med, Div Gastroenterol, Tokyo 151, Japan
[5] Yamachika Mem Hosp, Odawara, Japan
[6] Nomura Shokakinaika, Chigasaki, Kanagawa, Japan
[7] Hiratsuka City Hosp, Hiratsuka, Kanagawa, Japan
[8] Japan Med Alliance Ebina Gen Hosp, Ebina, Kanagawa, Japan
[9] Yugawara Kosei Nenkin Hosp, Ashigarashimogun, Japan
关键词
adjuvant; chronic hepatitis C; cyclooxygenase-2; inhibitor; interferon; meloxicam; neutropenia; NONSTEROIDAL ANTIINFLAMMATORY DRUG; PEGYLATED-INTERFERON-ALPHA; VIROLOGICAL RESPONSE; VIRUS-INFECTION; PLUS RIBAVIRIN; THERAPY; COMBINATION; KETOPROFEN; CYCLOOXYGENASE-2; TELAPREVIR;
D O I
10.1111/hepr.12046
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Aim: In this multicenter, randomized trial, we evaluated the effectiveness of meloxicam - a non-steroidal anti-inflammatory drug - as an adjuvant for enhancing antiviral efficacy and preventing neutropenia during the treatment of patients with genotype 1 chronic hepatitis C using peginterferon and ribavirin. Methods: A total of 60 patients were randomly assigned, in a 1:1 ratio, to either the meloxicam or the control group after stratification by neutrophil count. Both groups received weekly peginterferon-alpha-2a (180g) and a weight-based dose of ribavirin for 48 weeks. The meloxicam group received meloxicam (10mg/day) for the first 8 weeks after initiation of treatment. Results: Through intent-to-treat analysis, we found that the sustained virological response rate in the meloxicam group (19/30, 63.3%) was significantly higher than in the control group (11/30, 36.7%, P<0.05). The relapse rate was more than twice as high (45%) in the control group than in the meloxicam group (19.0%); however, this difference was not statistically significant. The rate of neutrophil decrease, calculated by dividing the lowest value observed during the first 8 weeks by pretreatment count, was significantly smaller in the meloxicam group (55.1 +/- 14.3%) than in the control group (62.3 +/- 9.6%, P<0.05). Conclusion: Meloxicam enhanced antiviral efficacy and reduced the decline in neutrophil counts for the peginterferon and ribavirin treatment of genotype 1 chronic hepatitis C. This drug could be a reasonable adjuvant for the treatment of patients with chronic hepatitis C. The present study including a small number of patients warrants larger clinical trials.
引用
收藏
页码:925 / 932
页数:8
相关论文
共 26 条
[21]   IL28B is associated with response to chronic hepatitis C interferon-α and ribavirin therapy [J].
Suppiah, Vijayaprakash ;
Moldovan, Max ;
Ahlenstiel, Golo ;
Berg, Thomas ;
Weltman, Martin ;
Abate, Maria Lorena ;
Bassendine, Margaret ;
Spengler, Ulrich ;
Dore, Gregory J. ;
Powell, Elizabeth ;
Riordan, Stephen ;
Sheridan, David ;
Smedile, Antonina ;
Fragomeli, Vincenzo ;
Mueller, Tobias ;
Bahlo, Melanie ;
Stewart, Graeme J. ;
Booth, David R. ;
George, Jacob .
NATURE GENETICS, 2009, 41 (10) :1100-U74
[22]  
TANAKA T, 1994, HEPATOLOGY, V19, P1347, DOI 10.1002/hep.1840190605
[23]   Genome-wide association of IL28B with response to pegylated interferon-α and ribavirin therapy for chronic hepatitis C [J].
Tanaka, Yasuhito ;
Nishida, Nao ;
Sugiyama, Masaya ;
Kurosaki, Masayuki ;
Matsuura, Kentaro ;
Sakamoto, Naoya ;
Nakagawa, Mina ;
Korenaga, Masaaki ;
Hino, Keisuke ;
Hige, Shuhei ;
Ito, Yoshito ;
Mita, Eiji ;
Tanaka, Eiji ;
Mochida, Satoshi ;
Murawaki, Yoshikazu ;
Honda, Masao ;
Sakai, Akito ;
Hiasa, Yoichi ;
Nishiguchi, Shuhei ;
Koike, Asako ;
Sakaida, Isao ;
Imamura, Masatoshi ;
Ito, Kiyoaki ;
Yano, Koji ;
Masaki, Naohiko ;
Sugauchi, Fuminaka ;
Izumi, Namiki ;
Tokunaga, Katsushi ;
Mizokami, Masashi .
NATURE GENETICS, 2009, 41 (10) :1105-U81
[24]   Acetylsalicylic acid inhibits hepatitis C virus RNA and protein expression through cyclooxygenase 2 signaling pathways [J].
Trujillo-Murillo, Karina ;
Rincon-Sanchez, Ana Rosa ;
Martinez-Rodriguez, Herminia ;
Bosques-Padilla, Francisco ;
Ramos-Jimenez, Javier ;
Barrera-Saldana, Hugo A. ;
Rojkind, Marcos ;
Rivas-Estilla, Ana Maria .
HEPATOLOGY, 2008, 47 (05) :1462-1472
[25]   Virological response in patients with hepatitis C virus genotype 1b and a high viral load -: Impact of peginterferon-α-2a plus ribavirin dose reductions and host-related factors [J].
Yamada, Gotaro ;
Iino, Shiro ;
Okuno, Tadao ;
Omata, Masao ;
Kiyosawa, Kendo ;
Kumada, Hiromitsu ;
Hayashi, Norio ;
Sakai, Takahiro .
CLINICAL DRUG INVESTIGATION, 2008, 28 (01) :9-16
[26]   Tenoxicam, a non-steroid anti-inflammatory drug, is unable to increase the response rate in patients with chronic hepatitis C treated by alpha interferon [J].
Zarski, JP ;
Maynard-Muet, M ;
Chousterman, S ;
Baud, M ;
Barnoud, R ;
Abergel, A ;
Bacq, Y ;
Combis, JM ;
Causse, X ;
Tran, A ;
Oberti, F ;
Minello, A ;
Bresson-Hadni, S ;
Bailly, F ;
Raabe, JJ ;
Leroy, V ;
Hamici, L ;
Hicham, T ;
Girardin, MFS .
HEPATOLOGY, 1998, 27 (03) :862-867