Eight-week oral administration of meloxicam, a non-steroidal anti-inflammatory drug, prevents dose reduction of pegylated interferon α-2a in the treatment of chronic hepatitis C

• Published in: Hepatology research Vol. 38; no. 3; pp. 259 - 266
• Main Authors: Kagawa, Tatehiro, Shiozawa, Hirokazu, Kojima, Sei-ichiro, Takashimizu, Shinji, Nagata, Naruhiko, Numata, Makoto, Morino, Fumitoshi, Nishizaki, Yasuhiro, Mochizuki, Kaori, Watanabe, Norihito, Watanabe, Tetsu, Matsuzaki, Shohei, Mine, Tetsuya
• Format: Journal Article
• Language: English
• Published: Melbourne, Australia Blackwell Publishing Asia 01-03-2008
• Subjects: chronic hepatitis C; dose reduction; interferon; meloxicam; NSAID; treatment
• ISSN: 1386-6346; 1872-034X
• DOI: 10.1111/j.1872-034X.2007.00260.x

Aim:  We conducted a trial to evaluate whether eight‐week oral administration of meloxicam, a non‐steroidal anti‐inflammatory drug, would decrease the rate of the patients who required dose reduction of pegylated interferon α‐2a in the treatment of chronic hepatitis C.
Methods:  Sixty patients given weekly subcutaneous administration of pegylated interferon α‐2a at a dose of 180 μg for 48 weeks were allocated into the meloxicam group (n = 22) and the control group (n = 38) before interferon treatment. Meloxicam was given orally at a dose of 10 mg once a day for eight weeks from the start of interferon treatment.
Results:  The cumulative rate of dose‐reduction‐free patients was significantly higher in the meloxicam group (P < 0.05). Until week eight, 44.7% of the control group and 9.1% of the meloxicam group required dose reduction. Dose was modified by neutropenia in 31.6% and 18.2% of the control and meloxicam groups, respectively. Meloxicam relieved a declineof neutrophil count within the first eight weeks from 54.2% to 44.2% (P < 0.05). Multivariate analysis revealed that greater pretreatment neutrophil count and the use of meloxicam were independent factors associated with avoiding dose reduction. Sustained virological response was obtained in 52.6% of the patients. The multivariate logistic analysis revealed that viral serotype and viral load were the only independent factors associated with sustained virological response.
Conclusion:  Eight‐week administration of meloxicam prevented dose reduction of pegylated interferon by relieving a decline of neutrophil count in the treatment of chronic hepatitis C.