By Liz Highleyman

Several studies have shown that chronic hepatitis C patients are at elevated risk of insulin resistance and diabetes -- a condition in which the body does not respond properly to insulin -- and that insulin resistance is associated with poor response to interferon-based therapy.

As reported in the August 2008 Journal of Hepatology, researchers at University Hospital in Geneva, Switzerland, conducted a study to determine whether improving insulin sensitivity might lead to better response in hepatitis C patients who experienced prior treatment failure.

In this multicenter trial (dubbed the INSPIRED-HCV study), chronic hepatitis C patients who had previously failed to respond to pegylated interferon alfa plus ribavirin were re-treated with the same combination regimen, with the addition of the insulin-sensitizing drug pioglitazone (Actos).

Results

• None of the first 5 patients included in the trial achieved a satisfactory virological response after 12 weeks of re-treatment.

• This was the case even though 3 of them experienced improved insulin resistance scores.

• On account of this lack of effect, the study was terminated early.

Nevertheless, the authors suggested, "Different schedules [of drug dosing] are warranted to improve insulin sensitivity prior to attempting retreatment of chronic hepatitis C patients with insulin resistance.

8/29/08

Reference
K Overbeck, D Genne, A Golay, and others (on behalf of the Swiss Association for the Study of the Liver). Pioglitazone in chronic hepatitis C not responding to pegylated interferon-alpha and ribavirin. Journal of Hepatology 49(2): 295-298. August 2008.