RESUMO
BACKGROUND/AIMS: We examined the effectiveness of escalating the dose of interferon-alpha-2b in subjects with chronic hepatitis C who did not respond to usual treatment with 3,000,000 units 3 times a week. METHODOLOGY: Treatment was started with 3,000,000 units of interferon-alpha-2b 3 times a week. If serum alanine aminotransferase activity was not normal at 12 weeks, the dose was increased to 3,000,000 units daily. If serum alanine aminotransferase activity was not normal after 12 weeks, the dose was increased to 5,000,000 units daily. RESULTS: Fifty-one subjects started treatment. Twenty-nine subjects had their dose increased to 3,000,000 units daily and only 1 responded (3%, 95% confidence interval 0-10.9%) while 41% (95% confidence interval 21.4-60.6%) had to discontinue treatment at this dose because of adverse events or intolerance. Of 14 subjects who had their dose increased to 5,000,000 units daily, none (95% confidence interval 0-3.6%) responded, while 43% (95% confidence interval 13.5-72.5%) had to discontinue treatment. CONCLUSIONS: Escalating doses of interferon-alpha-2b are not effective and are associated with increased toxicity and intolerance in patients with chronic hepatitis who do not respond to initial treatment with 3,000,000 units 2 times a week.
Assuntos
Hepatite C Crônica/terapia , Interferon-alfa/administração & dosagem , Adulto , Idoso , Relação Dose-Resposta a Droga , Esquema de Medicação , Feminino , Seguimentos , Hepacivirus/efeitos dos fármacos , Humanos , Interferon alfa-2 , Testes de Função Hepática , Masculino , Pessoa de Meia-Idade , RNA Viral/sangue , Proteínas Recombinantes , Resultado do Tratamento , Replicação Viral/efeitos dos fármacosRESUMO
The persistence of smoking habits results in a worse prognosis of patients with chronic airflow limitation. Some authors consider that oxygen therapy at home (OTH) is meaningless if the patient does not give up smoking. To assess the number of smokers in a group of 65 patients on OTH, a questionnaire on smoking habits was administered and the CO concentration in the expired air was measured. 27.7% of the study patients smoked; 12.3% admitted that they smoked on being questioned and the remaining 15.4% were identified by CO concentrations in the expired air equal to or higher than 10 ppm. There were no significant differences between the groups of smokers and nonsmokers regarding age and pulmonary function, but the rate of those declaring a poor compliance with OTH was higher among smokers.
