Thalidomide
for the Treatment of Chronic Hepatitis C in Nonresponders to Interferon Alfa and
Ribavirin
Thalidomide has immunomodulating
characteristics demonstrated in part by its anti-inflammatory effects that stem
from the drug’s ability to inhibit tumor necrosis alpha. In the current study, published in the American Journal of Gastroenterology
(February 2006), researchers investigated the efficacy and safety of a
24-week course of thalidomide 200 mg/day in eight patients with chronic
hepatitis C who were nonresponders
to interferon
alpha plus ribavirin.
Results
Serum aminotransferases and
gamma-glutamyltransferases decreased significantly (39% and 61%, respectively).
Tumor necrosis
factor-alpha in vitro production in mononuclear cells decreased with thalidomide
in all the subjects (p = 0.028).
A positive
correlation between biochemical and immunological parameters was observed with
higher increase of granzyme and perforin values in patients showing reduction
of aminotransferases.
Upregulation
of T-helper 1 cytokine expression as mean interferon gamma/IL-10 ratio was seen.
Thalidomide
was well tolerated at the dose used. In conclusion, the authors of this small pilot study write,
“Thalidomide was able to reduce liver enzymes in six out of eight patients with chronic hepatitis C
and to reduce tumor necrosis factor alpha production, representing a promising
new approach for the treatment of HCV infection.” These results warrant further, larger, controlled studies of
thalidomide as an HCV therapy for nonresponders to interferon/ribavirin.
Institute of
Infectious and Tropical Diseases, University
of Milan, Milan, Italy. 04/11/06 Reference
L Milazzo, M Biasin, N Gatti
and others. Thalidomide in the treatment of chronic hepatitis C unresponsive to
alfa-interferon and ribavirin. American
Journal of Gastroenterology 101(2): 399-402. February 2006.
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