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Combination of fluvastatin with pegylated interferon/ribavirin therapy reduces viral relapse in chronic hepatitis C infected with HCV genotype 1b
Author(s) -
Atsukawa Masanori,
Tsubota Akihito,
Kondo Chisa,
Itokawa Norio,
Narahara Yoshiyuki,
Nakatsuka Katsuhisa,
Hashimoto Satomi,
Fukuda Takeshi,
Matsushita Yoko,
Kidokoro Hideko,
Kobayashi Tamaki,
Kanazawa Hidenori,
Sakamoto Choitsu
Publication year - 2013
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.1440-1746.2012.07267.x
Subject(s) - fluvastatin , ribavirin , medicine , pegylated interferon , combination therapy , odds ratio , gastroenterology , hepatitis c virus , hepatitis c , immunology , virus , simvastatin
Background and Aim Although the anti‐hepatitis C virus ( HCV ) effect of statins in vitro and clinical efficacy of fluvastatin combined with Pegylated interferon ( PEG‐IFN) /ribavirin therapy for chronic hepatitis C ( CHC ) have been reported, the details of clinical presentation are largely unknown. We focused on viral relapse that influences treatment outcome, and performed a post‐hoc analysis by using data from a randomized controlled trial. Methods Thirty‐four patients in the fluvastatin group and 33 patients in the non‐fluvastatin group who achieved virological response (complete early virological response [c EVR ] or late virological response [ LVR ]) with PEG‐IFN /ribavirin therapy were subjected to this analysis. Factors contributing to viral relapse were identified by using multiple logistic regression analysis. Results Relapse rate in patients with c EVR was significantly lower in the fluvastatin group (2 of 23, 8.7%) than in the non‐fluvastatin group (9 of 26, 34.6%; P = 0.042). The use of fluvastatin decreased relapse rate in patients with LVR (27.3% vs 57.1%), though not significantly. Overall, relapse rate was significantly lower in the fluvastatin group (14.7%; 5 of 34) than in the non‐fluvastatin group (39.4%; 13 of 33; P = 0.027). Multivariate analysis identified absence of fluvastatin ( P = 0.027, odds ratio [ OR ] = 3.98, 95% confidence interval [ CI ] = 1.05–15.11) and low total ribavirin dose ( P = 0.002, OR = 2.41, 95% CI = 1.38–4.19) as independent factors contributing to relapse. Conclusion The concomitant addition of fluvastatin significantly suppressed viral relapse, resulting in the improvement of sustained virological response rate, in PEG ‐ IFN /ribavirin therapy for CHC patients with HCV genotype 1b and high viral load.