A national French survey on the use of growth factors as adjuvant treatment of chronic hepatitis C
✍ Scribed by Thierry Thévenot; Jean-François Cadranel; Vincent Di Martino; Alexandre Pariente; Xavier Causse; Christophe Renou; Hervé Hagege; Jacques Denis; Françoise Lunel-Fabiani
- Publisher
- John Wiley and Sons
- Year
- 2007
- Tongue
- English
- Weight
- 119 KB
- Volume
- 45
- Category
- Article
- ISSN
- 0270-9139
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✦ Synopsis
We conducted a national retrospective survey on hospital practitioners to evaluate the magnitude of erythropoietin (EPO) or granulocyte colony-stimulating factor (G-CSF) prescriptions in patients treated for chronic hepatitis C. Four hundred seventy-one questionnaires were sent, and 274 practitioners (58.2%) responded. Forty-six percent of practitioners used EPO, and 31% used G-CSF. The total number of HCV-infected patients receiving antiviral therapy per year was estimated at 6,630 patients, of whom 8.8% and 4% received EPO and G-CSF, respectively. EPO- was the main EPO molecule prescribed at a median dose of 30,000 IU/wk (range: 2,000-80,000). The indications for prescribing EPO varied greatly, including "fragile patients" (34%), "low" Hb level (8-11 g/dL) (19%), "rapid decline" in Hb level (2-5 g/dL during the first month of therapy) (12%), and symptomatic anemic patients (7%). G-CSF was mainly prescribed for a "low" level of neutrophils ranging from 400 to 750 neutrophils/mm 3 . In multivariate analysis, independent predictors of EPO and G-CSF prescription were age of practitioner less than 45 years (EPO: OR ؍ 1.96, P ؍ 0.03; G-CSF: OR ؍ 2.27, P ؍ 0.004), practice in university hospital (EPO: OR ؍ 5.89, P < 0.0001; G-CSF: OR ؍ 2.39, P ؍ 0.003), and the high number of CHC treated/year (EPO: OR ؍ 6.18, P < 0.0001; G-CSF: OR ؍ 2.58, P ؍ 0.002). Conclusion: Our survey reveals an important rate of EPO and G-CSF prescriptions but with considerable disparity in the schedule of injections, the molecules used, and above all the indications. The suitable role of EPO and G-CSF as complements to HCV therapy urgently needs to be clarified. (HEPATOLOGY 2007;45:377-383.
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