Plasma exchange and interferon-alpha pharmacokinetics in patients with hepatitis C virus-associated systemic vasculitis

被引:23
作者
Hausfater, P
Cacoub, P
Assogba, U
Lebon, P
Piette, JC
机构
[1] CHU Pitie Salpetriere, Dept Internal Med, Paris, France
[2] CHU Pitie Salpetriere, Dept Internal Med, Paris, France
[3] CHU Pitie Salpetriere, Plasma Exchange Unit, Paris, France
[4] Univ Paris 05, Dept Virol, Hop St Vincent de Paul, Paris, France
来源
NEPHRON | 2002年 / 91卷 / 04期
关键词
hepatitis C virus; mixed cryoglobulinemia; vasculitis; polyarteritis nodosa; interferon-alpha; pharmacokinetics;
D O I
10.1159/000065023
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Different types of vasculitis have been reported in association with hepatitis C virus (HCV) infection, i.e. type II mixed cryoglobulinemia and polyarteritis nodosa (PAN). Therapeutic approach of such severely symptomatic patients include interferon-alpha (IFN) plus plasma exchange (PE). There are no data on IFN pharmacokinetic changes related to PE. Patients and Methods: We studied 7 HCV-infected patients (mean age: 57 years) presenting with symptomatic type II mixed cryoglobulinemia (n = 5) or biopsy-proven PAN (n = 2). All patients underwent subcutaneous IFN therapy with concomitant PE. Serum IFN concentration was measured in serial samples on days with and without PE. Results: Without PE, IFN C-max (range: 100-750 IU/ml) was obtained 3-6 h after subcutaneous injection, followed by a 3- to 9-hour plateau. IFN concentration declined subsequently reaching a residual concentration 24 h after injection, ranging from 20 to 40 IU/ml. PE performed 6 h after IFN administration resulted in increased IFN clearance in that the concentration-time IFN-alpha area under the curve decreased from 3,005 IU.h/ml (1,563-4,614) on days without PE to 2,142 IU.h/ml (973-4,123) on day with PE. Conclusions: In patients with HCV-associated vasculitis, PIE increase IFN clearance. Combined IFN-alpha and PE therapy schedule have to be further studied to optimize its biological activity. Copyright (C) 2002 S. Karger AG, Basel.
引用
收藏
页码:627 / 630
页数:4
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