Journal of Hepatology
Volume 49, Issue 2 , Pages 295-298, August 2008

Pioglitazone in chronic hepatitis C not responding to pegylated interferon-α and ribavirin☆

  • Kathrin Overbeck

      Affiliations

    • Division of Clinical Pathology, University Hospital, 24 rue Micheli-du-Crest, 1211 Geneva 4, Switzerland
    • Division of Gastroenterology and Hepatology, University Hospital, 24 rue Micheli-du-Crest, 1211 Geneva 4, Switzerland
    • ,
  • Daniel Genné

      Affiliations

    • Division of Therapeutic Education for Diabetes, Obesity and Chronic Diseases, University Hospital, 24 rue Micheli-du-Crest, 1211 Geneva 4, Switzerland
    • ,
  • Alain Golay

      Affiliations

    • Department of Medicine, City Hospital, 2300 La-Chaux-de-Fonds, Switzerland
    • ,
  • Francesco Negro

      Affiliations

    • Division of Clinical Pathology, University Hospital, 24 rue Micheli-du-Crest, 1211 Geneva 4, Switzerland
    • Division of Gastroenterology and Hepatology, University Hospital, 24 rue Micheli-du-Crest, 1211 Geneva 4, Switzerland
    • Corresponding Author InformationCorresponding author. Tel.: +41 22 3795800; fax: +41 22 3729366.
    • ,
  • on behalf of the Swiss Association for the Study of the Liver (SASL)

Received 29 February 2008; received in revised form 26 March 2008; accepted 26 March 2008. published online 22 May 2008.

Associate Editor: M.U. Mondelli

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.

Keywords: Hepatitis C non-responders, Retreatment, Insulin resistance, Pioglitazone, Chronic hepatitis

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☆ 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.

PII: S0168-8278(08)00307-3

doi:10.1016/j.jhep.2008.03.033

Journal of Hepatology
Volume 49, Issue 2 , Pages 295-298, August 2008

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