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Evaluation of the adverse effect of premature discontinuation of pegylated interferon α‐2b and ribavirin treatment for chronic hepatitis C virus infection: Results from Kyushu University Liver Disease Study
Author(s) -
Ogawa Eiichi,
Furusyo Norihiro,
Kajiwara Eiji,
Takahashi Kazuhiro,
Nomura Hideyuki,
Tanabe Yuichi,
Satoh Takeaki,
Maruyama Toshihiro,
Nakamuta Makoto,
Kotoh Kazuhiro,
Azuma Koichi,
Dohmen Kazufumi,
Shimoda Shinji,
Hayashi Jun
Publication year - 2012
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.2011.06965.x
Subject(s) - discontinuation , medicine , ribavirin , adverse effect , pegylated interferon , gastroenterology , hepatitis c , depression (economics) , hepatitis c virus , immunology , virus , economics , macroeconomics
Background and Aims: Pegylated interferon (PEG‐IFN) α‐2b and ribavirin (RBV) treatment of chronic hepatitis C virus (HCV) infection is associated with a substantially elevated risk of discontinuation. The aim of this study is to evaluate the reason for premature discontinuation during PEG‐IFN α‐2b and RBV treatment due to adverse effects in patients with chronic HCV infection. Methods: A total of 2871 Japanese patients who had chronic HCV infection treated with PEG‐IFN α‐2b and RBV were screened. We prospectively investigated the reasons for premature discontinuation of treatment classified by sex and age, and analyzed the timing of discontinuation. Results: Of the 2871 patients, 250 (8.7%) discontinued treatment because of adverse effects. The main reasons for premature discontinuation were neurovegetative symptoms ( n = 77, 30.8%), depression‐related syndrome ( n = 46, 18.4%), hematologic effects ( n = 41, 16.4%) and dermatologic effects ( n = 27, 10.8%). The rate of discontinuation of treatment for patients aged ≥ 65 years was significantly higher than for patients aged < 65 years, for both men ( P < 0.0001) and women ( P = 0.0121). Moreover, the frequency of discontinuation due to neurovegetative symptoms, depression‐related syndrome, and hematologic effects for men aged ≥ 65 years was significantly higher than for those aged < 65 years ( P = 0.0001, P = 0.0016, and P = 0.0170, respectively), but not for women. Conclusion: Premature discontinuation due to the adverse effects of PEG‐IFN α‐2b and RBV treatment by patients with chronic HCV infection is mainly due to neuropsychiatric symptoms and is more common for older than for younger patients.