A significant reduction in serum alanine aminotransferase levels after 3-month iron reduction therapy for chronic hepatitis C: a multicenter, prospective, randomized, controlled trial in Japan.
BACKGROUND
Increasing evidence indicates that iron cytotoxicity plays an important role in the pathogenesis of chronic hepatitis C (CHC). However, the biochemical effects of iron reduction therapy on CHC remain to be confirmed in a controlled study. This study aimed to test whether iron removal by repeated phlebotomy improves serum alanine aminotransferase (ALT) levels in patients with CHC.


METHODS
Patients were randomly assigned to an iron reduction therapy or control group. The patients in the treatment group received 3-month iron reduction therapy by biweekly phlebotomy, while the patients in the control group were followed up for 3 months with regular blood tests alone.


RESULTS
Thirty-three patients completed the 3-month treatment, while 29 patients received the complete follow-up. The serum ALT levels were reduced from 118 +/- 79 to 73 +/- 39 IU/L in the treatment group, but did not change in the control group (106 +/- 45 versus 107 +/- 48 IU/L). Posttreatment enzyme activity was decreased significantly from the baseline. Furthermore, it was significantly lower than the 3-month control level. Although 5 patients withdrew from the study, none was affected by any side effects of repeated phlebotomy that required them to discontinue the treatment.


CONCLUSIONS
This short-term controlled trial demonstrated the biochemical efficacy and safety of iron reduction therapy for patients with CHC.
Yano
Motoyoshi
M
Third Department of Internal Medicine, Nagoya University School of Medicine, 65 Tsuruma-cho, Showa-ku, 466-8550, Nagoya, Japan.
Hayashi
Hisao
H
Yoshioka
Kentaro
K
Kohgo
Yutaka
Y
Saito
Hiroyuki
H
Niitsu
Yoshiro
Y
Kato
Junji
J
Iino
Shiro
S
Yotsuyanagi
Hiroshi
H
Kobayashi
Yoshimasa
Y
Kawamura
Kinya
K
Kakumu
Shinichi
S
Kaito
Masahiko
M
Ikoma
Jiro
J
Wakusawa
Shinya
S
Okanoue
Takeshi
T
Sumida
Yoshio
Y
Kimura
Fumiaki
F
Kajiwara
Eiji
E
Sata
Michio
M
Ogata
Kei
K
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood*; D002756:Cholagogues and Choleretics / Q000494:pharmacology / Q000627:therapeutic use; D005260:Female; D019698:Hepatitis C, Chronic / Q000201:enzymology* / Q000209:etiology; D006801:Humans; D019190:Iron Overload / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D018962:Phlebotomy; D011446:Prospective Studies; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use
D002756:Cholagogues and Choleretics; D014580:Ursodeoxycholic Acid; D000410:Alanine Transaminase