Wednesday, July 20, 2011

Viral Load Lowered for Some Hepatitis C Pts Using Pitavastatin

By C. Vidya Shankar MD

NEW YORK (Reuters Health) Jul 18 - Lipid-lowering pitavastatin (Livalo) might improve viral clearance when used alongside interferon and ribavirin in chronic hepatitis C patients with abnormal lipid metabolism, a new pilot study from Japan shows.

Rates of sustained virologic response (i.e., undetectable HCV-RNA 24 weeks after treatment end) were 67% in the pitavastatin group vs. 48% in controls.

The improvement wasn't statistically significant, but the randomized trial included only 42 patients, the researchers said in a letter published online June 29th in the Journal of Hepatology.
Coauthor Dr. Shuhei Yoshida, of Beth Israel Deaconess Medical Center in Boston, told Reuters Health by email that the study was confined to patients with lipid abnormalities and so the results don't apply to HCV-infected patients with normal lipid metabolism.
Pitavastatin lowers patients' insulin resistance -- and the researchers point out that high insulin resistance in chronic hepatitis C impairs the response to therapy.
All of the patients had HCV genotype 1b and were receiving pegylated Interferon 2b and ribavirin. Twenty-one patients received add-on pitavastatin (1 to 2 mg/day) for 48 weeks while an equal number continued with the standard therapy.
The initial viral load was greater than 5.0 log IU/ml.

In the pitavastatin group, the viral levels were undetectable in 29% at 4 weeks, 57% at 8 weeks, 81% at 12 weeks, 86% at 24 weeks, and 86% at 48 weeks. The corresponding values in controls were 5%, 33%, 48%, 62% and 67%, respectively.

There were no significant adverse reactions with pitavastatin.
Just how pitavastatin acts to limit HCV replication isn't clear, Dr. Yoshida admitted in his email.
The researchers plan further studies with larger populations and more varied patients.
J Hepatology 2011

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