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Amantadine

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  • micky
    Amantadine Monotherapy Unsuccessful in Treatment of Chronic Hepatitis C By Brian Boyle, MD Patients with chronic Hepatitis C have recently enjoyed an improved
    Message 1 of 1 , Mar 22, 2001
      Amantadine Monotherapy Unsuccessful in Treatment of Chronic Hepatitis
      C

      By Brian Boyle, MD

      Patients with chronic Hepatitis C have recently enjoyed an improved
      efficacy in treatment with pegylated-interferon or combination
      therapy with interferon and ribavirin. However, a significant subset
      of patients fails these therapies, either because of poor
      tolerability or insufficient efficacy against certain HCV genotypes,
      and these failures pose a difficult treatment problem.

      Amantadine hydrochloride was first suggested as a controversial
      treatment option for HCV in 1997, but was reported to be poorly
      tolerated with little efficacy. However, these studies were performed
      in heterogeneous populations that included both HCV treatment naïve
      and experienced patients. In the March 1, 2001 issue of Clinical
      Infectious Diseases, Di Martino and others report on a prospective,
      pilot study of amantadine hydrochloride monotherapy that was
      performed in ten patients with chronic active hepatitis C documented
      by histological testing. The enrolled patients had previously failed
      to respond to 12 months of interferon (7 patients) or interferon-
      ribavirin (3 patients) therapy. Nine were infected with HCV genotype
      1. The mean HCV RNA load was 5.8 log10 copies/mL and the serum
      alanine aminotransferase (ALT) was 1.5 fold greater than normal in
      all patients.

      The patients were given amantadine (100mg orally twice a day)
      monotherapy for 12 months. HCV RNA did not become undetectable or
      significantly decrease in any patient and, in fact, there was a trend
      toward increases in HCV RNA from baseline and to the end of therapy.
      Further, while a decrease in ALT levels occurred initially in most
      patients, it was generally not sustained.

      Amantadine therapy was poorly tolerated in this study with only 2 of
      the patients completing the full 12 month treatment course. 4
      patients had amantadine therapy discontinued at 3 months due to a
      significant increase in ALT levels. Other major adverse events
      included vertigo, insomnia,nervousness and depression and led to
      study discontinuation in 4 patients.

      This failure of amantadine monotherapy in this study confirms the
      findings of previous studies and illustrates the need for additional
      agents for the treatment of HCV infection.

      3/19/01

      Reference
      V Di Martino and others. Treatment of Chronic Hepatitis C with
      Amantadine Hydrochloride in Patients Who Had Not Responded to
      Previous Interferon-a and/or Ribavirin. Clinical Infectious Diseases.
      2001; 32:830-1.

      Copyright 2001 by HIV and Hepatitis Treatment Advocates and HIV and
      Hepatitis.com. All Rights Reserved.
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