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TITLE: The roles of amantadine, rimantadine, ursodeoxycholic
acid, and NSAIDs, alone or in combination with alpha interferons,
in the treatment of chronic hepatitis C.
Although alpha interferons are currently the standard treatments
for chronic hepatitis C, they are effective in only 15% to 20% of
patients. This low success rate has prompted research into new
approaches for maximizing responses to alpha interferons. A variety
of drugs have been investigated alone or in combination with alpha
interferons. Of these agents, ribavirin is currently the most
promising adjuvant, and the combination therapy of ribavirin plus
recombinant interferon alfa-2b is reviewed in detail elsewhere in
this issue (see Davis article, pp. 49-55; and McHutchison article,
pp. 57-65). This article reviews the literature concerning studies
of amantadine, rimantadine, ursodeoxycholic acid (UDCA), and
nonsteroidal anti-inflammatory drugs (NSAIDs), which are the most
commonly used alternatives to ribavirin. As of this writing,
virologic response rates have been unsatisfactory when these agents
are used as monotherapies. Furthermore, combining alpha interferons
with either UDCA or NSAIDs does not appear to improve sustained
virologic response rates. However, combination regimens composed of
an alpha interferon plus amantadine, or an alpha interferon plus
rimantadine, or triple therapy with either amantadine or
rimantadine plus an alpha interferon and ribavirin, warrant further
investigation.
AUTHOR: Younossi ZM, Perrillo RP, Department of
Gastroenterology, Cleveland Clinic Foundation, Ohio 44195, USA.
SOURCE: Semin Liver Dis 1999;19 Suppl 1:95-102
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