Evaluation of oral cannabinoid-containing medications for the management of interferon and ribavirin-induced anorexia, nausea and weight loss in patients treated for chronic hepatitis C virus.

Abstract

OBJECTIVES:

The systemic and cognitive side effects of hepatitis C virus (HCV) therapy may be incapacitating, necessitating dose reductions or abandonment of therapy. Oral cannabinoid-containing medications (OCs) ameliorate chemotherapy-induced nausea and vomiting, as well as AIDS wasting syndrome. The efficacy of OCs in managing HCV treatment-related side effects is unknown.

METHODS:

All patients who initiated interferon-ribavirin therapy at The Ottawa Hospital Viral Hepatitis Clinic (Ottawa, Ontario) between August 2003 and January 2007 were identified using a computerized clinical database. The baseline characteristics of OC recipients were compared with those of nonrecipients. The treatment-related side effect response to OC was assessed by c2 analysis. The key therapeutic outcomes related to weight, interferon dose reduction and treatment outcomes were assessed by Student's t test and c2 analysis.

RESULTS:

Twenty-five of 191 patients (13%) initiated OC use. Recipients had similar characteristics to nonrecipients, aside from prior marijuana smoking history (24% versus 10%, respectively; P=0.04). The median time to OC initiation was seven weeks. The most common indications for initiation of OC were anorexia (72%) and nausea (32%). Sixty-four per cent of all patients who received OC experienced subjective improvement in symptoms. The median weight loss before OC initiation was 4.5 kg. A trend toward greater median weight loss was noted at week 4 in patients eventually initiating OC use (-1.4 kg), compared with those who did not (-1.0 kg). Weight loss stabilized one month after OC initiation (median 0.5 kg additional loss). Interferon dose reductions were rare and did not differ by OC use (8% of OC recipients versus 5% of nonrecipients). The proportions of patients completing a full course of HCV therapy and achieving a sustained virological response were greater in OC recipients.

CONCLUSIONS:

The present retrospective cohort analysis found that OC use is often effective in managing HCV treatment-related symptoms that contribute to weight loss, and may stabilize weight decline once initiated.

• Authors: Cecilia T Costiniuk, Edward Mills, Curtis L Cooper
• Journal: Canadian journal of gastroenterology = Journal canadien de gastroenterologie (Can J Gastroenterol) Vol. 22 Issue 4 Pg. 376-80 (Apr 2008) ISSN: 0835-7900 [Print] Canada
• PMID: 18414712 (Publication Type: Comparative Study, Controlled Clinical Trial, Journal Article)

Chemical References

• Antiviral Agents
• Cannabinoids
• Ribavirin
• Interferons

Topics

• Adult
• Anorexia (chemically induced, drug therapy)
• Antiviral Agents (adverse effects)
• Cannabinoids (pharmacology, therapeutic use)
• Dose-Response Relationship, Drug
• Female
• Hepatitis C, Chronic (drug therapy)
• Humans
• Interferons (adverse effects)
• Male
• Middle Aged
• Nausea (chemically induced, drug therapy)
• Retrospective Studies
• Ribavirin (adverse effects)
• Treatment Outcome
• Weight Loss (drug effects)