Critical review of the use of erythropoietin in the treatment of anaemia during therapy for chronic hepatitis C

Stickel, F; Helbling, B; Heim, M; Geier, A; Hirschi, C; Terziroli, B; Wehr, K; De Gottardi, A; Negro, F; Gerlach, T (2012). Critical review of the use of erythropoietin in the treatment of anaemia during therapy for chronic hepatitis C. Journal of viral hepatitis, 19(2), pp. 77-87. Oxford: Blackwell Science 10.1111/j.1365-2893.2011.01527.x

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Combined pegylated interferon (PegIFN) and ribavirin represents the standard therapy for patients with chronic hepatitis C (CHC), which allows for sustained viral response (SVR) in up to 90% of patients depending on certain viral and host factors. Clinical studies have demonstrated the importance of adherence to therapy, that is, the ability of patients to tolerate and sustain a fully dosed therapy regimen. Adherence is markedly impaired by treatment-related adverse effects. In particular, haemolytic anaemia often requires dose reduction or termination of ribavirin treatment, which compromises treatment efficacy. Recent evidence points to a beneficial role of recombinant erythropoietin (EPO) in alleviating ribavirin-induced anaemia thereby improving quality of life, enabling higher ribavirin dosage and consequently improving SVR. However, no general consensus exists regarding the use of EPO for specific indications: its optimal dosing, treatment benefits and potential risks or cost efficiency. The Swiss Association for the Study of the Liver (SASL) has therefore organized an expert meeting to critically review and discuss the current evidence and to phrase recommendations for clinical practice. A consensus was reached recommending the use of EPO for patients infected with viral genotype 1 developing significant anaemia below 100 g/L haemoglobin and a haematocrit of <30% during standard therapy to improve quality of life and sustain optimal ribavirin dose. However, the evidence supporting its use in patients with pre-existing anaemia, non-1 viral genotypes, a former relapse or nonresponse, liver transplant recipients and cardiovascular or pulmonary disease is considered insufficient.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Hepatology

UniBE Contributor:

Stickel, Felix and De Gottardi, Andrea

ISSN:

1352-0504

Publisher:

Blackwell Science

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 14:22

Last Modified:

17 Mar 2015 21:01

Publisher DOI:

10.1111/j.1365-2893.2011.01527.x

PubMed ID:

22239497

Web of Science ID:

000299097400029

URI:

https://boris.unibe.ch/id/eprint/7732 (FactScience: 213058)

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