Critical review of the use of erythropoietin in the treatment of anaemia during therapy for chronic hepatitis C

Article Article scientifique Article Critical review of the use of erythropoietin in the treatment of anaemia during therapy for chronic hepatitis C eng 2012 author Stickel F author Helbling Benjamin 699425 author Heim Matthias 72800 author Geier Alain 83615 author Hirschi C author Terziroli B author Wehr K author De Gottardi Andrea 565568 author Negro Francesco 96509 author Gerlach Tilman Joern 667414 77-87 10.1111/j.1365-2893.2011.01527.x 22239497 1352-0504 Combined pegylated interferon (PegIFN) and ribavirin represents the standard therapy for patients with chronic hepatitis C (CHC), which allows for sustained viral response (SVR) in up to 90% of patients depending on certain viral and host factors. Clinical studies have demonstrated the importance of adherence to therapy, that is, the ability of patients to tolerate and sustain a fully dosed therapy regimen. Adherence is markedly impaired by treatment-related adverse effects. In particular, haemolytic anaemia often requires dose reduction or termination of ribavirin treatment, which compromises treatment efficacy. Recent evidence points to a beneficial role of recombinant erythropoietin (EPO) in alleviating ribavirin-induced anaemia thereby improving quality of life, enabling higher ribavirin dosage and consequently improving SVR. However, no general consensus exists regarding the use of EPO for specific indications: its optimal dosing, treatment benefits and potential risks or cost efficiency. The Swiss Association for the Study of the Liver (SASL) has therefore organized an expert meeting to critically review and discuss the current evidence and to phrase recommendations for clinical practice. A consensus was reached recommending the use of EPO for patients infected with viral genotype 1 developing significant anaemia below 100 g/L haemoglobin and a haematocrit of <30% during standard therapy to improve quality of life and sustain optimal ribavirin dose. However, the evidence supporting its use in patients with pre-existing anaemia, non-1 viral genotypes, a former relapse or nonresponse, liver transplant recipients and cardiovascular or pulmonary disease is considered insufficient. Anemia/chemically induced/drug therapy Antiviral Agents/administration & dosage/adverse effects Erythropoietin/administration & dosage Hepatitis C, Chronic/complications/drug therapy Humans Interferons/administration & dosage Ribavirin/administration & dosage/adverse effects Treatment Outcome Dewey 616.07 137 Département de pathologie et immunologie 21F false 297 Etudes et traitement de l'hépatite C et B 554 Journal of viral hepatitis 19 2 df573305-0964-4e89-b87b-3d6e488f65e0 Article (Published version) Restricted Negro F J Viral Hepat 2012, 19(2) 77.pdf 93555 application/pdf restrictedAccess Faculté de médecine / Section de médecine fondamentale / Département de pathologie et immunologie

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Critical review of the use of erythropoietin in the treatment of anaemia during therapy for chronic hepatitis C	Journal of viral hepatitis			2012	672	0

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Helbling, Benjamin