Pioglitazone in chronic hepatitis C not responding to pegylated interferon-alpha and ribavirin.
OBJECTIVE
Insulin resistance reduces the response to interferon alfa-based therapy of chronic hepatitis C patients. It has been speculated that improvement of insulin sensitivity might increase the chances of responding to treatment of such individuals.


METHODS
We started a multicenter clinical trial of retreatment of chronic hepatitis C patients, who had failed to respond to the pegylated interferon alfa/ribavirin combination, with a triple therapy consisting in these same antivirals plus an insulin-sensitizer (pioglitazone) (The INSPIRED-HCV study).


RESULTS
None of the first five patients fulfilling the inclusion criteria and included in the trial achieved a satisfactory virological response after 12 weeks of retreatment, despite the fact that in at least three of them the insulin resistance score improved. As a result, the study was terminated.


CONCLUSIONS
Different schedules are warranted to improve insulin sensitivity prior to attempting retreatment of chronic hepatitis C patients with insulin resistance.
Division of Clinical Pathology, University Hospital, 24 rue Micheli-du-Crest, 1211 Geneva 4, Switzerland.
Kathrin
K
Overbeck
Daniel
D
Genné
Alain
A
Golay
Francesco
F
Negro
D000998:Antiviral Agents / Q000008:administration & dosage*; D024882:Drug Resistance, Viral; D004359:Drug Therapy, Combination; D005260:Female; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007333:Insulin Resistance; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D000077205:Pioglitazone; D011092:Polyethylene Glycols / Q000008:administration & dosage*; D011994:Recombinant Proteins; D012254:Ribavirin / Q000008:administration & dosage*; D045162:Thiazolidinediones / Q000008:administration & dosage*
D000998:Antiviral Agents; D007004:Hypoglycemic Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D045162:Thiazolidinediones; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a; D000077205:Pioglitazone