Depression and Side Effects with Pegylated Interferon Plus Ribavirin Therapy in Patients with Chronic Hepatitis C

2.50
Hdl Handle:
http://hdl.handle.net/10755/156878
Type:
Presentation
Title:
Depression and Side Effects with Pegylated Interferon Plus Ribavirin Therapy in Patients with Chronic Hepatitis C
Abstract:
Depression and Side Effects with Pegylated Interferon Plus Ribavirin Therapy in Patients with Chronic Hepatitis C
Conference Sponsor:Sigma Theta Tau International
Conference Year:2002
Conference Date:July, 2002
Author:Levine, Cheryl
P.I. Institution Name:University of Texas at Houston
Title:Associate Professor
Objective: The purpose of this study was to evaluate the relationship between depression and physical side effects during pegylated interferon plus ribavirin therapy in chronic hepatitis C patients. Design: Descriptive study Population, Sample, Setting, Years: The sample included 19 patients (14 males, 5 females) who were either non-responders (n=11) or relapsers (n=8) to a prior treatment of combination or monotherapy for chronic hepatitis C. Duration of therapy in these patients ranged from 16 to 36 weeks (mean 24.0 +/- 5.96). Setting was a Hepatitis C Clinic in an academic medical center in the southeastern USA. Variables Studied: Measurement of the variables was done using the Symptom Score Sheet (S3) for severity of side effects and the Beck Depression Index (BDI) for depression. Methods: Subjects were monitored using the S3 and BDI questionnaires prior to beginning pegylated interferon plus ribavirin therapy and at week 2, week 4 and then every 4 weeks during treatment. Findings: Severity of side effects increased from baseline (mean 7.1 +/- 7.3) to 2 weeks of treatment (mean 11.7 +/- 9.1) and increased further at 4 weeks of treatment (mean 12.8 +/- 10.3). Of the 10 subjects who have completed 20 or more weeks of treatment, 4 had peak side effects at 8 to 16 weeks with significant decreases in severity of side effects after that time point. The other 6 patient°¦s side effect scores plateaued or slightly improved after the 4 weeks of treatment. A similar pattern was present in depression scores (baseline mean 5.8 +/- 5.3; week 2 mean 8.5 +/- 7.2; week 4 mean 10.7 +/- 9.6). Regression analysis revealed that 69% of the variance in the severity of side effects during treatment was explained by the average BDI score during treatment (F=40.8, p=.0001). Further analysis was done to evaluate the impact of the use of antidepressants prior to treatment and nondetectable virus after 12 weeks of treatment. Compared to the 13 patients not on antidepressants at the beginning of treatment, the 6 subjects who were on antidepressants had more severe average side effects (S3 mean 14.0 +/- 10.4 vs. mean 4.9 +/- 4.8) and more depression (BDI mean 9.4 +/- 6.9 vs. 4.5 +/- 4.1) prior to treatment. This difference continued during treatment with the patients on antidepressants prior to treatment having higher average S3 (mean 20.6 +/- 12.7 vs. 10.2 +/- 6.3) and average BDI (mean 16.8 +/- 9.7 vs. mean 7.5 +/- 4.7) scores during treatment. In the 9 patients whose virus was nondetectable at 12 weeks, the average side effects (S3 mean 17.7 +/- 10.1 vs. mean 9.7 +/- 8.3) and depression (BDI mean 15.2 +/- 8.2 vs 6.1 +/- 4.1) scores were higher than subjects (n=10) who continued to have detectable virus. Conclusions: This analysis of patients on pegylated interferon plus ribavirin therapy revealed that the side effects tended to be cumulative during the first 4 to 16 weeks of medication. Depression followed a similar pattern with increased severity in patients on antidepressants prior to HCV treatment. In addition, the majority of the variation in severity of side effects was explained by the patient's depression. Implications: Patients who suffered the most severe side effects and required the most support during treatment were those with increased depression, especially those who showed signs of depression or were on treatment for depression prior to initiation of treatment. The benefit of antidepressant therapy on side effect management warrants further investigation.

Repository Posting Date:
26-Oct-2011
Date of Publication:
Jul-2002
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleDepression and Side Effects with Pegylated Interferon Plus Ribavirin Therapy in Patients with Chronic Hepatitis Cen_GB
dc.identifier.urihttp://hdl.handle.net/10755/156878-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Depression and Side Effects with Pegylated Interferon Plus Ribavirin Therapy in Patients with Chronic Hepatitis C</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2002</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">July, 2002</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Levine, Cheryl</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Texas at Houston</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Associate Professor</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">clevine@son1.nur.uth.tmc.edu</td></tr><tr><td colspan="2" class="item-abstract">Objective: The purpose of this study was to evaluate the relationship between depression and physical side effects during pegylated interferon plus ribavirin therapy in chronic hepatitis C patients. Design: Descriptive study Population, Sample, Setting, Years: The sample included 19 patients (14 males, 5 females) who were either non-responders (n=11) or relapsers (n=8) to a prior treatment of combination or monotherapy for chronic hepatitis C. Duration of therapy in these patients ranged from 16 to 36 weeks (mean 24.0 +/- 5.96). Setting was a Hepatitis C Clinic in an academic medical center in the southeastern USA. Variables Studied: Measurement of the variables was done using the Symptom Score Sheet (S3) for severity of side effects and the Beck Depression Index (BDI) for depression. Methods: Subjects were monitored using the S3 and BDI questionnaires prior to beginning pegylated interferon plus ribavirin therapy and at week 2, week 4 and then every 4 weeks during treatment. Findings: Severity of side effects increased from baseline (mean 7.1 +/- 7.3) to 2 weeks of treatment (mean 11.7 +/- 9.1) and increased further at 4 weeks of treatment (mean 12.8 +/- 10.3). Of the 10 subjects who have completed 20 or more weeks of treatment, 4 had peak side effects at 8 to 16 weeks with significant decreases in severity of side effects after that time point. The other 6 patient&deg;&brvbar;s side effect scores plateaued or slightly improved after the 4 weeks of treatment. A similar pattern was present in depression scores (baseline mean 5.8 +/- 5.3; week 2 mean 8.5 +/- 7.2; week 4 mean 10.7 +/- 9.6). Regression analysis revealed that 69% of the variance in the severity of side effects during treatment was explained by the average BDI score during treatment (F=40.8, p=.0001). Further analysis was done to evaluate the impact of the use of antidepressants prior to treatment and nondetectable virus after 12 weeks of treatment. Compared to the 13 patients not on antidepressants at the beginning of treatment, the 6 subjects who were on antidepressants had more severe average side effects (S3 mean 14.0 +/- 10.4 vs. mean 4.9 +/- 4.8) and more depression (BDI mean 9.4 +/- 6.9 vs. 4.5 +/- 4.1) prior to treatment. This difference continued during treatment with the patients on antidepressants prior to treatment having higher average S3 (mean 20.6 +/- 12.7 vs. 10.2 +/- 6.3) and average BDI (mean 16.8 +/- 9.7 vs. mean 7.5 +/- 4.7) scores during treatment. In the 9 patients whose virus was nondetectable at 12 weeks, the average side effects (S3 mean 17.7 +/- 10.1 vs. mean 9.7 +/- 8.3) and depression (BDI mean 15.2 +/- 8.2 vs 6.1 +/- 4.1) scores were higher than subjects (n=10) who continued to have detectable virus. Conclusions: This analysis of patients on pegylated interferon plus ribavirin therapy revealed that the side effects tended to be cumulative during the first 4 to 16 weeks of medication. Depression followed a similar pattern with increased severity in patients on antidepressants prior to HCV treatment. In addition, the majority of the variation in severity of side effects was explained by the patient's depression. Implications: Patients who suffered the most severe side effects and required the most support during treatment were those with increased depression, especially those who showed signs of depression or were on treatment for depression prior to initiation of treatment. The benefit of antidepressant therapy on side effect management warrants further investigation.<br/><br/></td></tr></table>en_GB
dc.date.available2011-10-26T15:13:44Z-
dc.date.issued2002-07en_GB
dc.date.accessioned2011-10-26T15:13:44Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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