[Ursodeoxycholic acid in the therapy of chronic hepatitis after treatment with interferon]. / L'acido ursodesossicolico nella terapia delle epatiti croniche virali dopo trattamento con interferone.

UNLABELLED: Interferon alfa is to day the only therapy of proven benefit for the treatment and control of chronic hepatitis C. Therefore only 25% of patients receive from it a sustained biochemical and serological response; often when the treatment is stopped there is a flare up of ALT and reappearance of HCV-RNA in the serum. The most common schedule is 6 MU t.i w. for twelve months; after this there is no codified treatment for relapse prevention. The aim of this study was to evaluate if ursodeoxycholic acid (UDCA) administration after a cycle of IFN therapy was able to prevent relapse of the disease. METHODS: We studied 36 patients whose mean age was 31.5 +/- 5.7 affected by chronic hepatitis C and treated with IFN alpha for one year. Only twenty of them received an end term therapy response and were therefore enrolled in a double blind study with two arms: Arm A treated with UDCA 300 mg b. i. d. for twelve months and Arm B treated with placebo. ALT value and HVC-RNA levels were evaluated at baseline, during and after treatment. RESULTS: Patients treated with UDCA showed a lower percentage of relapse in comparison with patients treated with placebo. CONCLUSIONS: This effect was probably due to a double mechanism: the first of biochemical type because a reduction in the intrahepatic concentration of hydrophobic biliary acids, the second immunological due to a lower expression of HLA class I and II antigens.

[Efficacy of insulin Lispro in the control of late postprandial hypoglycemia: comparison with regular human insulin]. / Efficacia dell'insulina lispro nel controllo della ipoglicemia postprandiale tardiva: confronto con la insulina umana regolare.

BACKGROUND: Lispro insulin a recently developed analogue of human insulin, is more rapidly adsorbed and has a lower duration of activity as compared with regular insulin. This implies a glycemic profile closer to the physiologic one with a reduction of early post-prandial hyperglycemic peak and of drop in late postprandial glycemia. This results in a reduction of mild or severe hypoglycemia occurring during treatment with regular human insulin. METHODS: This was designed to evaluate the efficacy of Lispro insulin in the metabolic control in subjects treated with regular insulin who were prone to late hypoglycemia. Fifteen subjects, 6 males and 9 females, range of age 18-54 years with insulin-dependent diabetes mellitus (IDDM) have been studied. These subjects were treated with regular insulin at meals plus intermediate in the evening. Regular insulin was substituted with Lispro insulin. The glycemic profile and HbA1c have been evaluated at determined intervals. Also body mass index and the number of hypoglycemic events during treatment were recorded. Significance of differences was assessed by paired Student's "t"-test. RESULTS: Lispro insulin reduced the peaks of early postprandial hyperglycemic peak and, in particular, the late glycemic drop, Lispro insulin reduced also HbA1c levels thus suggesting a better metabolic control. Moreover the number of hypoglycemic events was significantly reduced. CONCLUSIONS: In conclusion, Lispro insulin is safe and more efficient than regular human insulin.