Combination of fluvastatin with pegylated interferon/ribavirin therapy reduces viral relapse in chronic hepatitis C infected with HCV genotype 1b.

Abstract

BACKGROUND AND AIM:

Although the anti-hepatitis C virus (HCV) effect of statins in vitro and clinical efficacy of fluvastatin combined with Pegylated interferon (PEG-IFN)/ribavirin therapy for chronic hepatitis C (CHC) have been reported, the details of clinical presentation are largely unknown. We focused on viral relapse that influences treatment outcome, and performed a post-hoc analysis by using data from a randomized controlled trial.

METHODS:

Thirty-four patients in the fluvastatin group and 33 patients in the non-fluvastatin group who achieved virological response (complete early virological response [cEVR] or late virological response [LVR]) with PEG-IFN/ribavirin therapy were subjected to this analysis. Factors contributing to viral relapse were identified by using multiple logistic regression analysis.

RESULTS:

Relapse rate in patients with cEVR was significantly lower in the fluvastatin group (2 of 23, 8.7%) than in the non-fluvastatin group (9 of 26, 34.6%; P = 0.042). The use of fluvastatin decreased relapse rate in patients with LVR (27.3% vs 57.1%), though not significantly. Overall, relapse rate was significantly lower in the fluvastatin group (14.7%; 5 of 34) than in the non-fluvastatin group (39.4%; 13 of 33; P = 0.027). Multivariate analysis identified absence of fluvastatin (P = 0.027, odds ratio [OR] = 3.98, 95% confidence interval [CI] = 1.05-15.11) and low total ribavirin dose (P = 0.002, OR = 2.41, 95% CI = 1.38-4.19) as independent factors contributing to relapse.

CONCLUSION:

The concomitant addition of fluvastatin significantly suppressed viral relapse, resulting in the improvement of sustained virological response rate, in PEG-IFN/ribavirin therapy for CHC patients with HCV genotype 1b and high viral load.

• Authors: Masanori Atsukawa, Akihito Tsubota, Chisa Kondo, Norio Itokawa, Yoshiyuki Narahara, Katsuhisa Nakatsuka, Satomi Hashimoto, Takeshi Fukuda, Yoko Matsushita, Hideko Kidokoro, Tamaki Kobayashi, Hidenori Kanazawa, Choitsu Sakamoto
• Journal: Journal of gastroenterology and hepatology (J Gastroenterol Hepatol) Vol. 28 Issue 1 Pg. 51-6 (Jan 2013) ISSN: 1440-1746 [Electronic] Australia
• PMID: 22989264 (Publication Type: Journal Article, Randomized Controlled Trial)
• Copyright: © 2012 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.

Chemical References

• Antiviral Agents
• Fatty Acids, Monounsaturated
• Hydroxymethylglutaryl-CoA Reductase Inhibitors
• Indoles
• Interferon alpha-2
• Interferon-alpha
• RNA, Viral
• Recombinant Proteins
• Polyethylene Glycols
• Ribavirin
• Fluvastatin
• peginterferon alfa-2b

Topics

• Adult
• Aged
• Aged, 80 and over
• Antiviral Agents (therapeutic use)
• Confidence Intervals
• Drug Therapy, Combination
• Fatty Acids, Monounsaturated (therapeutic use)
• Female
• Fluvastatin
• Hepacivirus (genetics)
• Hepatitis C, Chronic (blood, drug therapy)
• Humans
• Hydroxymethylglutaryl-CoA Reductase Inhibitors (therapeutic use)
• Indoles (therapeutic use)
• Interferon alpha-2
• Interferon-alpha (therapeutic use)
• Logistic Models
• Male
• Middle Aged
• Multivariate Analysis
• Odds Ratio
• Polyethylene Glycols (therapeutic use)
• RNA, Viral (blood)
• Recombinant Proteins (therapeutic use)
• Recurrence
• Ribavirin (therapeutic use)