New Treatment Successful With Hepatitis C

5-18-96
SAN FRANCISCO, CA -- An inexpensive new treatment for hepatitis C, a disease that afflicts 1-2 percent of the population, is more effective than the standard therapy, according to a recent study.

The pilot study, recently completed at Penn State's Milton S. Hershey Medical Center, treated patients with amantadine, a drug that has been available in the United States since the 1960s. Thirty percent of the patients in the study responded to amantadine treatment.

Amantadine costs only $20 per month -- a tiny fraction of the cost of interferon, the conventional treatment for hepatitis C. Interferon costs approximately $500 per month, and must be administered for at least six months.

Jill P. Smith, M.D., associate professor of medicine at Hershey, discovered that amantadine is an effective alternative treatment for hepatitis C -- without the extensive side effects associated with interferon. Smith will present the results of her study on May 19 at San Francisco's Mosconi Convention Center as part of the annual meeting of the American Gastroenterological Association and the American Association for the Study of Liver Diseases.

Interferon's frequent side effects include a drop in white blood cell count and flu-like syndrome with aches, pains and fever. Hair loss, anemia, thyroid disease and severe depression occur less frequently.

Amantadine has fewer side effects, including: difficulty in concentration, constipation and rare cardiac symptoms in some elderly patients. Another drawback of interferon treatment is that only 50 percent of the patients respond to it, according to Smith. Half of those responders relapse after they stop the six months of therapy, dropping the effectiveness rate to approximately 25 percent.

The poor response, side effects and cost of interferon treatment prompted Smith to look for another drug.

Smith's study included 22 patients who were monitored over a four-year period. Only those who failed treatment with interferon were allowed into the study. As a control the same group of patients were monitored during two intervals of no treatment.

Patients received 100 milligrams twice a day. "We know this is a safe dose," said Smith.

Of the 22 patients, 20 completed the study and two dropped out due to chest pains and shortness of breath. Six of the 20 responded to treatment, 8 had a partial response, and 6 did not respond to amantadine.

"If we used a higher dose, or treated longer, it's possible the partial responders would have responded completely," said Smith.

She said the response to treatment might have been greater with a group of patients who had never been treated with interferon, since her study only treated those with interferon-resistant disease.

"We need support for further studies," said Smith. "It would be nice to have a multicenter control, making amantadine available to people across the country who have hepatitis C.

"There was no drug company support for this study," said Smith. "Most patients paid, luckily it was inexpensive."

She noted another benefit of amandatine -- it can be taken orally, instead of by injection, which is the only way to administer interferon. Interferon is usually self-administered, a drawback, according to Smith because "a lot of hepatitis C patients are former drug users and don't want to have anything to do with needles. Also contaminated needles are a threat to other household members."

Hepatitis C was only isolated and identified as a virus in 1989. Frequently those carrying the disease are unaware of it until they develop cirrhosis of the liver.

"Most people are asymptomatic," said Smith. "A lot find out when they go to donate blood."

Chronic fatigue may be the only symptom, according to Smith.

There are two primary ways that hepatitis C is transmitted. They are: transfusions with tainted blood, and contact with contaminated needles by IV drug users. Most of the tainted blood transfusions occurred before 1989 when blood banks began testing for hepatitis C.

"There's a lot we don't understand about the epidemiology of hepatitis C," said Smith. "Thirty to 40 percent of the patients don't know where or how they got the disease."

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Contact:
For more information, contact the Hershey Medical Center's Careline at
1-800-243-1455. Reporters can call 1-717-531-8606.