[1] To eliminate HCV, which establishes chronic infection in ~80% of infected individuals, interferon (IFN)-based treatments have been developed. The treatment of first choice at present for IFN-naïve patients of HCV genotype 1 with high viral load in Japan is pegylated interferon (PEG IFN), ribavirin

(RBV) and telaprevir (TVR) triple therapy, if it can be tolerated.[2] Although the sustained virological response (SVR) rate is much improved by the triple therapy, it is poorly tolerated due to a number of adverse events. Anemia is often a critical barrier to successful treatment for chronic hepatitis C patients on IFN therapy with RBV, forcing reduction or discontinuation of RBV administration. To overcome this obstacle, several groups reported employment SB203580 manufacturer of human recombinant erythropoietin (EPO) administration to alleviate anemia and thereby complete the therapy without RBV reduction in patients under IFN/RBV or PEG IFN/RBV combination therapy.[3-8] Most of the reports describe the successful role of EPO as an alternative to RBV dose reduction, and meta-analysis demonstrates that EPO administration can considerably enhance SVR with no adverse event due to EPO.[9] In triple therapy, Selumetinib ic50 anemia develops more frequently than in PEG IFN/RBV combination therapy, consequently resulting in poor adherence to RBV.[10,

11] Thus far, little is known about the efficacy of EPO to RBV-induced anemia in the triple therapy. In the present study, we examined whether EPO administration can alleviate anemia in hepatitis C patients on IFN therapy receiving both RBV and TVR, as observed in the PEG IFN/RBV combination therapy. The patients were given human recombinant epoetin-α at a dose of 12 000 or 24 000 IU/week, which is a relatively low dose compared with those used in previous reports, determined according

to the hemoglobin (Hb) decline from the baseline. The average adherence of the patients with EPO administration to RBV during the triple therapy phase was 97.5%, which was clearly higher than that of the phase III study of triple therapy,[10, 11] and no adverse event was observed. These findings indicate that low-dose EPO administration facilitates RBV adherence and can Mirabegron be a favorable alternative to RBV dose reduction. THE OBJECTIVE OF this study was to determine the safety of EPO administration and find whether it could prevent dose reduction of RBV due to anemia in triple therapy. Twenty-two patients (15 men and seven women, mean age of 56 years [range, 31–70]) with HCV genotype 1 infection and 5.0 log10 IU/mL or higher HCV RNA level were enrolled. All patients gave their informed consent before participating in the study. The study was approved by the ethics committee of Osaka National Hospital and conducted in accordance with good clinical practice and the Declaration of Helsinki. All patients received PEG IFN-α-2b (PegIntron; MSD, Tokyo, Japan) at a dose of 1.5 μg/kg/week s.c.