title: Does Epoetin Beta Still Have a Place in Peginterferon Alpha-2a Plus Ribavirin Treatment Strategies for Chronic Hepatitis C?
abstract: To investigate the impact of epoetin beta (EPO) on sustained virological response (SVR) in hepatitis C virus (HCV)-infected patients treated with peginterferon-ribavirin (RBV). Controlled, randomized, pragmatic multicenter study to assess 2 strategies, ie, the use (EPO group) or nonuse (control group) of EPO in terms of achieving SVR in treatment-naive, genotype non-2/non-3 HCV-infected patients receiving a 48-week treatment regimen of pegylated interferon α-2a (peg-IFN) plus RBV (randomization 2:1). The single-nucleotide polymorphisms of interferon lambda 3 (IFNL3) (rs12979860 and rs8099917), interferon lambda 4 (IFNL4) (ss469415590), and inosine triphosphatase (ITPA) (rs1127354 and rs7270101) were determined retrospectively. Two hundred twenty-seven patients were included in the study. In the global population (n = 227), the overall SVR rate was 52% (118/227). Nonresponse and relapse occurred in respectively 46/227 (20.3%) and 42/227 (18.5%) patients. In the intention-to-treat analysis, 55.5% of patients with anemia (n = 164) had a SVR, specifically 57.4% in the EPO group versus 52.4% in the control group, but the difference was not statistically significant. In the anemic population, independent factors associated with SVR were IFNL3 and IFNL4 polymorphisms, pretreatment HCV RNA level, iron level, and aspartate aminotransferase/alanine aminotransferase (AST/ALT) ratio. EPO has little impact on SVR in patients treated with peg-IFN+RBV and should be recommended only for patients with severe anemia.
authors.affiliation: 1 Department of Virology, University Hospital of Angers , Angers, France .|2 HIFIH Research Unit, Faculty of Medicine, UPRES 3859, SFR 4208, University of Angers , Angers, France .
authors.forename: Pascal
authors.initials: P
authors.lastname: Veillon
authors.affiliation: 2 HIFIH Research Unit, Faculty of Medicine, UPRES 3859, SFR 4208, University of Angers , Angers, France .|3 Department of Hepatology and Gastroenterology, University Hospital of Angers , Angers, France .
authors.forename: Isabelle
authors.initials: I
authors.lastname: Fouchard-Hubert
authors.affiliation: 4 Department of Hepatology and Transplantation, University Hospital of Montpellier , Montpellier, France .
authors.forename: Dominique
authors.initials: D
authors.lastname: Larrey
authors.affiliation: 5 Gastroenterology and Nutrition, University Hospital of Caen , Caen, France .
authors.forename: Manh Thông
authors.initials: MT
authors.lastname: Dao
authors.affiliation: 6 Department of Hepatology and Gastroenterology, University Hospital of Tours , Chambray-les-Tours, France .
authors.forename: Louis
authors.initials: L
authors.lastname: D'alteroche
authors.affiliation: 7 Department of Hepatology, Physiopathology and Treatment of Viral Hepatitis, Hospital of Beaujon , Clichy, France .
authors.forename: Nathalie
authors.initials: N
authors.lastname: Boyer-Darrigand
authors.affiliation: 8 INSERM UMR-850, Department of Pharmacology, Toxicology and Pharmacovigilance, University Hospital of Limoges , Limoges, France .
authors.forename: Nicolas
authors.initials: N
authors.lastname: Picard
authors.affiliation: 1 Department of Virology, University Hospital of Angers , Angers, France .|2 HIFIH Research Unit, Faculty of Medicine, UPRES 3859, SFR 4208, University of Angers , Angers, France .
authors.forename: Hélène
authors.initials: H
authors.lastname: Le Guillou-Guillemette
authors.affiliation: 9 Micro and Nanomedecines biomimetics, INSERM UMRS 1066, University of Angers , Angers, France .
authors.forename: Patrick
authors.initials: P
authors.lastname: Saulnier
authors.affiliation: 1 Department of Virology, University Hospital of Angers , Angers, France .|2 HIFIH Research Unit, Faculty of Medicine, UPRES 3859, SFR 4208, University of Angers , Angers, France .
authors.forename: Alexandra
authors.initials: A
authors.lastname: Ducancelle
authors.affiliation: 10 Department of Hepatology and Gastroenterology, University Hospital of Limoges , INSERM UMR 1092, Limoges, France .
authors.forename: Véronique
authors.initials: V
authors.lastname: Loustaud-Ratti
authors.affiliation: 1 Department of Virology, University Hospital of Angers , Angers, France .|2 HIFIH Research Unit, Faculty of Medicine, UPRES 3859, SFR 4208, University of Angers , Angers, France .
authors.forename: Françoise
authors.initials: F
authors.lastname: Lunel-Fabiani
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000235:genetics / Q000276:immunology; D000740:Anemia / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000821:virology; D000998:Antiviral Agents / Q000627:therapeutic use*; D001219:Aspartate Aminotransferases / Q000235:genetics / Q000276:immunology; D004359:Drug Therapy, Combination; D004921:Erythropoietin / Q000627:therapeutic use*; D005260:Female; D015870:Gene Expression; D005838:Genotype; D016174:Hepacivirus / Q000187:drug effects / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use*; D007372:Interferons; D007378:Interleukins / Q000235:genetics / Q000276:immunology; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D020641:Polymorphism, Single Nucleotide; D011755:Pyrophosphatases / Q000235:genetics / Q000276:immunology; D012367:RNA, Viral / Q000037:antagonists & inhibitors* / Q000096:biosynthesis; D011994:Recombinant Proteins / Q000627:therapeutic use; D012008:Recurrence; D012254:Ribavirin / Q000627:therapeutic use*; D016896:Treatment Outcome; D019562:Viral Load / Q000187:drug effects; D000095022:Interferon Lambda; D000097630:Inosine Triphosphatase
chemical_list: D000410:Alanine Transaminase; D000998:Antiviral Agents; D001219:Aspartate Aminotransferases; D004921:Erythropoietin; D016898:Interferon-alpha; D007372:Interferons; D007378:Interleukins; D011092:Polyethylene Glycols; D011755:Pyrophosphatases; D012367:RNA, Viral; D011994:Recombinant Proteins; D012254:Ribavirin; C000624353:interferon-lambda, human; D000095022:Interferon Lambda; C579163:IFNL4 protein, human; C103998:epoetin beta; C511829:ITPA protein, human; D000097630:Inosine Triphosphatase; C100416:peginterferon alfa-2a