Interferon-alpha in mixed cryoglobulinemia patients: a randomized, crossover-controlled trial.
The effects of interferon-alpha (IFN-alpha) on clinical and serologic manifestations of mixed cryoglobulinemia (MC) were investigated by randomized, crossover-controlled trial in 26 patients. The trial alternated 6 months with and 6 months without IFN-alpha therapy (2 x 10(6) IU daily for a month, then every other day for 5 months). In 22 patients, pretreatment steroid dosage remained unchanged during the study. Six patients dropped out (three because of side effects), whereas another 20 patients experienced a significant improvement of purpura (P < .02) and serum transaminases (P < .005) during IFN-alpha treatment. The presence of clinical improvement was supported by the outcome measurements of several immunologic parameters. In particular, serum cryoglobulins were significantly reduced (P < .04) during IFN-alpha therapy. A rebound phenomenon of clinical and serologic parameters was observed after IFN-alpha discontinuation. In addition, no variations were recorded during 6 months without therapy. Hepatitis C virus (HCV) RNA was detected in 91% (20/22) of our MC patients; in 2/13 cases HCV RNA was no longer detectable in serum samples after IFN-alpha therapy. Thus, IFN-alpha could be considered as treatment for MC in patients with HCV seropositivity.
Rheumatology Unit, University of Pisa, Italy.
C
C
Ferri
E
E
Marzo
G
G
Longombardo
F
F
Lombardini
L
L
La Civita
R
R
Vanacore
A M
AM
Liberati
R
R
Gerli
F
F
Greco
A
A
Moretti
M
M
Monti
P
P
Gentilini
S
S
Bombardieri
A L
AL
Zignego
D000410:Alanine Transaminase / Q000097:blood; D016516:CD4-CD8 Ratio; D003449:Cryoglobulinemia / Q000276:immunology / Q000382:microbiology / Q000628:therapy*; D005260:Female; D016174:Hepacivirus / Q000235:genetics; D006801:Humans; D016898:Interferon-alpha / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000032:analysis
D016898:Interferon-alpha; D012367:RNA, Viral; D000410:Alanine Transaminase