Interferon alpha plus ketoprofen or interferon alpha plus ribavirin in chronic hepatitis C non-responder to interferon alpha alone: results of a pilot study

Background. Recently: in vitro and in vivo studies demonstrated that non-st eroidal anti-inflammatory drugs are able to enhance the activity of interfe ron alpha. Aim, To evaluate the efficacy and tolerability of ketoprofen (a non-steroid al anti-inflammatory drug) plus interferon alpha (group B) compared to inte rferon alpha plus ribavirin (group C) and interferon alpha alone (group A) in chronic hepatitis C non-responders after a 5-month course with interfero n alpha, Patients and Methods. Without stopping interferon alpha, 49 patients were r andomized to receive one of the three treatment regimens for 4 months. Results, Three patients discontinued the therapy One out of 16 patients in group A, 6/16 in group B and 5/14 in group 6, alanine aminotransferase retu rned to normal at the end of the therapies (B vs A: p=0.04); serum hepatiti s C virus-RNA became negative in I patient in group A and in 4 patients in both group B and group C. Six months after treatment normal alanine transfe rase and negative hepatitis C virus-RNA were observed in 3 patients in grou p B and 2 in group C. In these patients, liver histology significantly impr oved. Conclusions, These results indicate that a certain number of non-responder patients to interferon alpha can benefit from a combination therapy of inte rferon alpha plus ketoprofen that is at least as effective as the combinati on interferon alpha plus ribavirin.