Department of Gastroenterology, Kanazawa Medical University, Uchinada, Ishikawa, Japan.
J Gastroenterol Hepatol. 2013 Jun;28(6):1015-8. doi: 10.1111/jgh.12137.
Aphthous stomatitis is one of the adverse effects associated with interferon (IFN) that forces dose reduction of IFN and there is no established therapy. This study was aimed to investigate whether irsogladine maleate, which enhances the functions of intercellular communication through the gap junctions, is effective for the treatment of aphthous stomatitis developed in hepatitis C virus (HCV) patients on pegylated-interferon (PEG-IFN) and ribavirin.
Nineteen patients with HCV were treated with PEG-IFN and ribavirin for 48 weeks. Ten out of 19 patients developed aphthous stomatitis during treatment with PEG-IFN and ribavirin. Within 1-2 weeks after development of aphthous stomatitis, 4 mg irsogladine maleate was orally administered daily to all patients and the therapeutic and adverse effects of irsogladine maleate were examined on every week. The degree of aphthous stomatitis was evaluated by Common Terminology Criteria for Adverse Events (CTCAE) version 4.0.
Out of 10 patients, aphthous stomatitis was evaluated as grade 3 in three patients (30%) and grade 2 in seven patients (70%) by CTCAE. CTCAE grade was improved to 0 after 1 week in six patients, after 2 weeks in two patients, and after 3 weeks in two patients after the start of administration of irsogladine maleate. Aphthous stomatitis has not recurred in patients who had been on irsogladine maleate continuously during treatment of PEG-IFN and ribavirin.
Irsogladine maleate is effective for the treatment of aphthous stomatitis developing during PEG-IFN and ribavirin administration in HCV patients.
阿弗他口炎是干扰素(IFN)相关的不良反应之一,会迫使 IFN 剂量减少,但目前尚无既定的治疗方法。本研究旨在探讨马来酸伊索昔啶是否有效,该药通过缝隙连接增强细胞间通讯功能,是否可用于治疗接受聚乙二醇干扰素(PEG-IFN)和利巴韦林治疗的丙型肝炎病毒(HCV)患者发生的阿弗他口炎。
19 例 HCV 患者接受 PEG-IFN 和利巴韦林治疗 48 周。19 例中有 10 例在 PEG-IFN 和利巴韦林治疗期间发生阿弗他口炎。在发生阿弗他口炎后 1-2 周内,所有患者每日口服 4 mg 马来酸伊索昔啶,并每周检查马来酸伊索昔啶的治疗效果和不良反应。采用 CTCAE 版本 4.0 评估阿弗他口炎的严重程度。
根据 CTCAE,10 例患者中有 3 例(30%)为 3 级,7 例(70%)为 2 级。在开始使用马来酸伊索昔啶后 1 周,6 例患者、2 周后 2 例、3 周后 2 例 CTCAE 分级改善至 0。在继续使用马来酸伊索昔啶的患者中,PEG-IFN 和利巴韦林治疗期间未再发生阿弗他口炎。
马来酸伊索昔啶对治疗接受 PEG-IFN 和利巴韦林治疗的 HCV 患者发生的阿弗他口炎有效。