ÿþ<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN" "http://www.w3.org/TR/html4/loose.dtd"> <html> <head> <meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1"> <title>EASL 2010 - Oral Presentations</title> <link rel="stylesheet" type="text/css" href="style.css"> </head> <body> <table width="750" align="center" border="0" cellspacing="0" cellpadding="0" class="MainTable"> <tr> <td><img src="http://www2.kenes.com/liver-congress2010/PublishingImages/top_ei.jpg" width="760" height="129" /></td> </tr> <tr> <td class="content"><h1>Oral Presentations</h1> <P><b>Session Title:</b> Parallel Session: HEPATITIS C: DRUG DEVELOPMENT<br><b>Presentation Date:</b> Apr 15, 2010</P><h2 align='left'><B>SILIBININ AS A RESCUE TREATMENT FOR HCV-INFECTED PATIENTS SHOWING SUBOPTIMAL VIROLOGIC RESPONSE TO STANDARD COMBINATION THERAPY</B></h2> <p align='left'><b>M. Biermer</b>, L. Stoehr, B. Schlosser, B. Fülöp, F. van Bömmel, T. Berg<br> <em>Medizinische Klinik mit Schwerpunkt Gastroenterologie und Hepatologie, Charite Campus Virchow, Berlin, Germany. *michael.biermer@charite.de</em></p><br> <p align='justify'>During standard antiviral treatment a significant proportion of hepatitis C patients show no complete virologic response despite a marked reduction of viral load in early stages of treatment (partial response). This minimal viremia may persist indicating the treatment termination as a consequence of viral nonresponse. Recently, high-dose intravenous silibinin has demonstrated significant antiviral activity. We were therefore interested whether patients with partial virologic response can be rescued by the on-treatment addition of high-dose intravenous silibinin infusions. <br> Eleven patients who received different interferon-based antiviral regimens qualified for the rescue strategy and received silibinin infusions between December 2008 and September 2009. All patients had received peginterferon alfa 2a / ribavirin and four patients additionally received an HCV specific protease inhibitor for the first four weeks of treatment. 9 out of 11 patients showed a plateau of HCV RNA levels ranging from detectable but not quantifiable (< 15 IU/mL) to 2015 IU/mL for at least eight weeks on continuous treatment (total treatment duration 16-30 weeks). The remaining two patients suffered a virologic rebound after cessation of the protease inhibitor (HCV RNA 484 IU/ml at week 6 (patient 1) and 6890 IU/ml at week 5 (patient 2). Every patient received silibinin infusions (1400 mg/day - in 500 ml NaCl) on two consecutive days.<br> Eight out of eleven patients achieved a complete suppression of viral replication below the limit of detection within the first week after silibinin. Three patients did initially not respond to silibinin, two of the responders showed a viral breakthrough (8 and 14 weeks after silibinin administration during continued SOC treatment) and up to now six patients have undetectable HCV-RNA levels eight to 40 weeks after silibinin administration with continued SOC. Silibinin infusions were generally well tolerated. All patients reported a transient sensation of heat, three patients reported painful bowel-movements, two with a single episode of vomiting. <br> A two days administration of high-dose intravenous silibinin might be an interesting approach to rescue patients with ongoing minimal residual viremia while on interferon-based therapy. Further follow-up is needed to confirm whether the response induced is long lasting and leads to SVR.<br></p> <br><a href="javascript://;" onclick="history.back()">Back</a><br> <p>&nbsp;</p> <p>&nbsp;</p></td> </tr> </table> </body> </html>