title: 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.
abstract: 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.
authors.affiliation: Third Department of Internal Medicine, Nagoya University School of Medicine, 65 Tsuruma-cho, Showa-ku, 466-8550, Nagoya, Japan.
authors.forename: Motoyoshi
authors.initials: M
authors.lastname: Yano
authors.forename: Hisao
authors.initials: H
authors.lastname: Hayashi
authors.forename: Kentaro
authors.initials: K
authors.lastname: Yoshioka
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kohgo
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Saito
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Niitsu
authors.forename: Junji
authors.initials: J
authors.lastname: Kato
authors.forename: Shiro
authors.initials: S
authors.lastname: Iino
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yotsuyanagi
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Kinya
authors.initials: K
authors.lastname: Kawamura
authors.forename: Shinichi
authors.initials: S
authors.lastname: Kakumu
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kaito
authors.forename: Jiro
authors.initials: J
authors.lastname: Ikoma
authors.forename: Shinya
authors.initials: S
authors.lastname: Wakusawa
authors.forename: Takeshi
authors.initials: T
authors.lastname: Okanoue
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Sumida
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Kimura
authors.forename: Eiji
authors.initials: E
authors.lastname: Kajiwara
authors.forename: Michio
authors.initials: M
authors.lastname: Sata
authors.forename: Kei
authors.initials: K
authors.lastname: Ogata
mesh_terms: 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
chemical_list: D002756:Cholagogues and Choleretics; D014580:Ursodeoxycholic Acid; D000410:Alanine Transaminase