Tuesday, October 26, 2010

Seizures During Pegylated Interferon and Ribavirin

Seizures During Pegylated Interferon and Ribavirin Therapy for Chronic Hepatitis C: Observations From the WIN-R Trial.
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"Seizures occur infrequently in patients receiving PEG-IFNα-2b plus ribavirin, and appear to be associated with other risk factors including antidepressant use"
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Ahmed F, Jacobson IM, Herrera JL, Brand M, Wasserman RB, Fixelle AM, Rustgi VK, Albert C, Brown R, Brass C; for the WIN-R Study Group.
*Division of Gastroenterology, Aga Khan university, Karachi, Pakistan †Weill Medical College of Cornell University ‡Division of Gastroenterology, University of South Alabama, Mobile, AL §Connecticut Gastroenterology Consultants, New Haven, CT ∥Infectious Disease Doctors, Walnut Creek, CA ¶Gastroenterology Consultants, Atlanta, GA ♯Georgetown University, Fairfax, VA **Northside Forsyth Drive, Cumming, GA ††Columbia University College of Physicians and Surgeons, New York, NY ‡‡Schering-Plough Corp, now Merck & Co, Inc, Whitehouse Station, NJ.

Abstract
BACKGROUND:
Seizures are reported as an uncommon side effect of interferon therapy.

AIM: To determine the frequency and presentation of seizures occurring during pegylated interferon-α (PEG-IFNα) and ribavirin therapy for chronic hepatitis C.

METHODS: Patients were identified using data from the WIN-R trial database, a US multicenter study comparing fixed (800 mg) versus weight-based (800 to 1400 mg) daily dosing of ribavirin in combination with PEG-IFNα-2b (1.5 μg/kg/wk).

RESULTS: Of the 4913 enrolled patients, 8 (0.16%) had a seizure. Three patients had a grand mal seizure and the seizure type was unknown in 5 patients. At the time of seizure, 6 patients were taking antidepressants (including 3 on bupropion), 1 was hyponatremic, and 1 had consumed a significant amount of alcohol. One patient had a history of seizures. Neuroimaging and electroencephalographic studies were negative. Antiepileptic medications were continued in the patient with a history of seizures and initiated in 1 patient. PEG-IFNα-2b plus ribavirin therapy was continued in 2 patients following seizure and neither experienced a recurrent seizure.

CONCLUSIONS: Seizures occur infrequently in patients receiving PEG-IFNα-2b plus ribavirin, and appear to be associated with other risk factors including antidepressant use.

PMID: 20930643 [PubMed - as supplied by publisher]

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