Pioglitazone in chronic hepatitis C not responding to pegylated interferon-α and ribavirin☆
Received 29 February 2008; received in revised form 26 March 2008; accepted 26 March 2008. published online 22 May 2008.
Background/Aims
Insulin resistance reduces the response to interferon alfa-based therapy of chronic hepatitis C patients. It has been speculated that improvement of insulin sensitivity might increase the chances of responding to treatment of such individuals.
Methods
We started a multicenter clinical trial of retreatment of chronic hepatitis C patients, who had failed to respond to the pegylated interferon alfa/ribavirin combination, with a triple therapy consisting in these same antivirals plus an insulin-sensitizer (pioglitazone) (The INSPIRED-HCV study).
Results
None of the first five patients fulfilling the inclusion criteria and included in the trial achieved a satisfactory virological response after 12 weeks of retreatment, despite the fact that in at least three of them the insulin resistance score improved. As a result, the study was terminated.
Conclusions
Different schedules are warranted to improve insulin sensitivity prior to attempting retreatment of chronic hepatitis C patients with insulin resistance.
1Division of Clinical Pathology, University Hospital, 24 rue Micheli-du-Crest, 1211 Geneva 4, Switzerland
2Division of Gastroenterology and Hepatology, University Hospital, 24 rue Micheli-du-Crest, 1211 Geneva 4, Switzerland
3Division of Therapeutic Education for Diabetes, Obesity and Chronic Diseases, University Hospital, 24 rue Micheli-du-Crest, 1211 Geneva 4, Switzerland
4Department of Medicine, City Hospital, 2300 La-Chaux-de-Fonds, Switzerland
☆ F. Negro has been an advisor for Roche. This study was partially supported by unrestricted educational grants from Roche Parma AG, Switzerland and Takeda Pharma AG Switzerland.
ABSTRACT