The roles of amantadine, rimantadine, ursodeoxycholic acid, and NSAIDs, alone or in combination with alpha interferons, in the treatment of chronic hepatitis C

Although alpha interferons are currently the standard treatments for chroni c hepatitis C, they are effective in only 15% to 20% of patients. This low success rare has prompted research into new approaches for maximizing respo nses to alpha interferons. A variety of drugs have been investigated alone or in combination with alpha interferons. Of these agents, ribavirin is cur rently the most promising adjuvant, and the combination therapy of ribaviri n plus recombinant interferon alfa-2b is reviewed in detail elsewhere ii? t his issue (see Davis article, pp. 49-55; and McHutchison article, pp. 57-65 ). This article reviews the literature concerning studies, of amantadine, r imantadine, ursodeoxycholic acid (UDCA), and nonsteroidal anti-inflammatory drugs (NSAIDs), which are the most commonly used alternatives to ribavirin . As of this writing, virologic response rates have been unsatisfactory whe n these agents are used as monotherapies. Furthermore, combining alpha inte rferons with either UDCA or NSAIDs does not appear to improve sustained vir ologic response rates. However; combination regimens composed of an alpha i nterferon plus amantadine, or an alpha interferon plus rimantadine, or trip le therapy with either amantadine or rimantadine plus an alpha interferon a nd ribavirin, warrant further investigation.