Efficacy of Alfacalcidol on PEG-IFN/ Ribavirin Combination Therapy for Elderly Patients With Chronic Hepatitis C: A Pilot Study
| Author | Masanori Atsukawa | en |
| Author | Akihito Tsubota | en |
| Author | Noritomo Shimada | en |
| Author | Chisa Kondo | en |
| Author | Norio Itokawa | en |
| Author | Ai Nakagawa | en |
| Author | Satomi Hashimoto | en |
| Author | Takeshi Fukuda | en |
| Author | Yoko Matsushita | en |
| Author | Hideko Kidokoro | en |
| Author | Yoshiyuki Narahara | en |
| Author | Katsuhisa Nakatsuka | en |
| Author | Katsuhiko Iwakiri | en |
| Author | Chiaki Kawamoto | en |
| Author | Choitsu Sakamoto | en |
| Issued Date | 2013-12-01 | en |
| Abstract | Background: Serum vitamin D concentration is reported to show a decrease in older age. Patients with chronic hepatitis C (CHC) in Japan are older on average than those in Western countries. Moreover, the outcome of pegylated-interferon (PEG-IFN)/ ribavirin therapy combined with vitamin D in elderly patients is unclear. Objectives: This pilot study explored the efficacy and safety of alfacalcidol as vitamin D source in PEG-IFN/ ribavirin combination therapy for elderly CHC patients infected with hepatitis C virus genotype 1b. Patients and Methods: Consecutive twenty CHC patients aged ≥ 65 years were enrolled in this pilot study. Fifteen patients met the inclusion criteria and received PEG-IFN/ ribavirin therapy combined with alfacalcidol. Four-week lead-in of oral alfacalcidol was conducted, and it was subsequently and concurrently administered in PEG-IFN/ ribavirin combination therapy (vitamin D group). Age, gender, and IL28B genotype-matched patients, who received PEG-IFN/ ribavirin alone, were saved as control group (n = 15) to compare the treatment outcome with the vitamin D group. Results: Subjects consisted of 14 males and 16 females, with a median age of 70 years (65-78). The serum 25 (OH) D3 concentration in females (20 ng/ml, 11-37) was significantly lower than males (27 ng/mL, 13-49) (P = 0.004). Sustained virological response (SVR) rates were 33.3% (5/15) in the control group and 80.0% (12/15) in the vitamin D group, respectively (P = 0.025). While no significant difference was shown in the (SVR) rate between the two groups among males (P = 0.592), in females the SVR rate was significantly higher in the vitamin D group (87.5%, 7/8) than the control group (25.0%, 2/8) (P = 0.041). The relapse rates in the groups with and without alfacalcidol were 7.7% (1/13) and 61.5% (8/13), respectively (P = 0.011). Interestingly, in females, the relapse in the control group was shown in 5 of 7 (71.4%), whereas in the vitamin D group the relapse rate was decreased (1/8, 12.5%) (P = 0.041). No specific adverse events were observed in the vitamin D group. Conclusions: PEG-IFN/ ribavirin combined with alfacalcidol may be effective and safe in elderly CHC patients. In particular, concomitant administration of alfacalcidol may lead to a reduced relapse rate, and consequently improving the SVR rate in elderly females. | en |
| DOI | https://doi.org/10.5812/hepatmon.14872 | en |
| Keyword | 1-hydroxycholecalciferol | en |
| Keyword | Vitamin D | en |
| Keyword | Ribavirin | en |
| Keyword | Aged | en |
| Keyword | Hepatitis C | en |
| Keyword | Chronic | en |
| Publisher | Brieflands | en |
| Title | Efficacy of Alfacalcidol on PEG-IFN/ Ribavirin Combination Therapy for Elderly Patients With Chronic Hepatitis C: A Pilot Study | en |
| Type | Research Article | en |
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