Premium
Meloxicam as an adjuvant to peginterferon‐α‐2a and ribavirin treatment for genotype 1 chronic hepatitis C : A randomized trial
Author(s) -
Kagawa Tatehiro,
Kojima Seiichiro,
Shiraishi Koichi,
Hirose Shunji,
Arase Yoshitaka,
Takashimizu Shinji,
Watanabe Norihito,
Nagata Naruhiko,
Numata Makoto,
Shiozawa Hirokazu,
Nishizaki Yasuhiro,
Toki Mayu,
Sugita Teruji,
Nomura Kijuro,
Sakaguchi Takashi,
Atsukawa Kazuhiro,
Tajima Hiroto,
Tei Yoshihiro,
Inomoto Tsutomu,
Mine Tetsuya
Publication year - 2013
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.12046
Subject(s) - meloxicam , medicine , ribavirin , neutropenia , gastroenterology , adjuvant , randomized controlled trial , hepatitis c virus , immunology , virus , chemotherapy
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‐α‐2a (180 μg) and a weight‐based dose of ribavirin for 48 weeks. The meloxicam group received meloxicam (10 mg/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.