RESUMEN
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.
Asunto(s)
Hepatitis C Crónica/terapia , Interferón-alfa/administración & dosificación , Adulto , Anciano , Relación Dosis-Respuesta a Droga , Esquema de Medicación , Femenino , Estudios de Seguimiento , Hepacivirus/efectos de los fármacos , Humanos , Interferón alfa-2 , Pruebas de Función Hepática , Masculino , Persona de Mediana Edad , ARN Viral/sangre , Proteínas Recombinantes , Resultado del Tratamiento , Replicación Viral/efectos de los fármacosRESUMEN
Rats were exposed to either 80 escapable shocks or yoked inescapable shocks and then injected with several hypnotic doses of sodium pentobarbital, midazolam, or ethanol; their sleep-time duration was compared with that of naive controls. Inescapable shock exposure resulted in a significant increase in ethanol-induced sleep time compared with the escapable shock and naive control groups. Both escape and yoked groups showed an increase in barbiturate-induced sleep time compared with controls, although no difference was observed for midazolam. Acute stress (twenty 5-s inescapable shocks) did not alter the depressant-induced sleep time for any of the drugs tested. These results illustrate the importance of psychological aspects of stress and its influence on the potency of certain depressants.
