Suzuki Mitsuyoshi, Inage Eisuke, Minowa Kei, Saito Nobutomo, Naritaka Nakayuki, Tsubahara Mayuko, Ohtsuka Yoshikazu, Tokita Akifumi, Shimizu Toshiaki
Department of Pediatrics, Juntendo University School of Medicine, Tokyo, Japan.
Pediatr Int. 2012 Aug;54(4):528-31. doi: 10.1111/j.1442-200X.2012.03603.x. Epub 2012 Apr 19.
Ribavirin-related anemia is a serious side-effect of the pegylated interferon and ribavirin therapy used for hepatitis C, and may be cause for a reduction in ribavirin dose or even cessation of treatment. The aim of this study was to evaluate the prophylactic effects of oral eicosapentaenoic acid (EPA) supplementation on ribavirin-induced hemolytic anemia in pediatric and young adult patients.
Twelve chronic hepatitis C patients ranging in age from 3 to 21 years (mean, 13.9 ± 5.1 years) who received pegylated interferon α-2b and ribavirin combination therapy were randomized to either the control group (n = 6) or EPA group (n = 6). Blood samples were collected before, and at 4, 8, and 16 weeks after treatment to measure clinical laboratory parameters.
The reduction in hemoglobin levels of the EPA group was significantly ameliorated at 8 and 16 weeks when compared to the control group (P < 0.05). There was no significant difference in plasma ribavirin concentrations between the two groups during the treatment. However, one patient in the control group had a reduction in ribavirin dose.
EPA supplementation prevented ribavirin-induced hemolytic anemia during combination therapy with pegylated interferon α-2b and ribavirin in pediatric and young adult patients.
利巴韦林相关贫血是丙型肝炎聚乙二醇干扰素和利巴韦林联合治疗的一种严重副作用，可能导致利巴韦林剂量减少甚至治疗中断。本研究旨在评估口服二十碳五烯酸（EPA）对儿童和年轻成年患者利巴韦林诱导的溶血性贫血的预防作用。
12例年龄在3至21岁（平均13.9±5.1岁）接受聚乙二醇干扰素α-2b和利巴韦林联合治疗的慢性丙型肝炎患者被随机分为对照组（n = 6）和EPA组（n = 6）。在治疗前以及治疗后4、8和16周采集血样以测量临床实验室参数。
与对照组相比，EPA组在治疗8周和16周时血红蛋白水平的降低得到显著改善（P < 0.05）。治疗期间两组血浆利巴韦林浓度无显著差异。然而，对照组有1例患者的利巴韦林剂量减少。
在儿童和年轻成年患者聚乙二醇干扰素α-2b和利巴韦林联合治疗期间，补充EPA可预防利巴韦林诱导的溶血性贫血。
