Gastroenterology

New Insights into the Management
of Anemia in HCV

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New Insights into the Management of Anemia in HCV

Download a PDF of the Tx Reporter

Dear Colleague,

Anemia is a common side effect of standard hepatitis C treatment with peginterferon and ribavirin and often necessitates dose reductions that can adversely affect treatment efficacy. Historically, anemia has been managed by dose reduction, which has the potential to reduce sustained virologic response rates, particularly during the first 12 weeks of therapy. Thus, managing anemia is a challenge.

Erythropoietin (EPO) has increasingly been used off-label for the management of anemia in hepatitis C patients, since it significantly improves hemoglobin levels and allows for maintenance of ribavirin dose, which may improve response rates. However, this adjunctive therapy is associated with its own potential side effects and significant additional costs to the patient's treatment regimen.

This Tx Reporter was developed by a faculty of distinguished researchers in hepatitis C. Here you will learn about the clinical importance of anemia and ways to address its sometimes challenging management. This newsletter will also address the unique needs of special populations, such as those with co-morbid conditions and advanced disease. The advantages and disadvantages of using EPO in hepatitis C patients with anemia are described. We also provide information related to the development of an analog of ribavirin that has shown a low prevalence of anemia.

We hope you find this publication insightful and helpful to your patient care.

Sincerely,

CO-CHAIRS
Michael P. Manns, MD Medical Director Professor of Medicine Director of the Department of Gastroenterology, Hepatology, and Endocrinology Medical School of Hannover Hannover, Germany	John G. McHutchison, MD, FRACP Professor of Medicine Duke University School of Medicine Director, Gastroenterology/ Hepatology Research Duke Clinical Research Institute Durham, North Carolina
FACULTY
Robert S. Brown, Jr, MD, MPH Associate Professor of Medicine and Surgery Columbia University Medical Center New York, New York	Mitchell L. Shiffman, MD Chief, Hepatology Medical Director, Liver Transplant Program Virginia Commonwealth University Medical Center Richmond, Virginia
Rajender Reddy, MD Professor of Medicine and Surgery Director of Hepatology Medical Director of Liver Transplantation University of Pennsylvania Medical Center Philadelphia, Pennsylvania	John B. Wong, MD Chief, Division of Clinical Decision Making, Informatics, and Telemedicine Tufts-New England Medical Center Tufts University School of Medicine Boston, Massachusetts

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TARGET AUDIENCE

This activity is designed for gastroenterologists, hepatologists, and other physicians who treat patients with HCV infection.

ACTIVITY GOAL

The goal of this activity is to provide state-of-the-science information on evolving therapies for consideration and integration into the practices of clinicians with the intent of benefiting patients with HCV infection.

LEARNING OBJECTIVES

Analyze treatment-associated anemia side effects in HCV patients to assess their impact on diminished quality of life, reduced treatment adherence, and suboptimal patient outcomes.
Formulate strategies for minimizing and managing anemia associated with anti-HCV therapy to achieve optimal outcomes in patients with HCV.

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CME INFORMATION

Statement of Accreditation

Projects In Knowledge is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Credit Designation

Projects In Knowledge designates this educational activity for a maximum of 1.0 Category 1 credit toward the AMA Physician's Recognition Award. Each physician should claim only those credits that he/she actually spent in the activity.

This activity is planned and implemented as an independent CME activity in accordance with the ACCME Essential Areas and Policies.

Contract for Mutual Responsibility in CME/CE
Projects In Knowledge has developed the contract to demonstrate our commitment to providing the highest quality professional education to clinicians, and to help clinicians set educational goals to challenge and enhance their learning experience.
For more information on the contract, click here.

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DISCLOSURE INFORMATION

The Disclosure Policy of Projects In Knowledge requires that presenters comply with the Standards for Commercial Support. All faculty are required to disclose any personal interest or relationship they or their spouse/partner have with the supporters of this activity or any commercial interest that is discussed in their presentation. Any discussions of unlabeled/unapproved uses of drugs or devices will also be disclosed in the course materials.

For complete prescribing information on the products discussed during this CME/CE activity, please see your current Physicians' Desk Reference (PDR).

Robert S. Brown, Jr, MD, MPH, has received grant/research support from Valeant Pharmaceuticals International.

Michael P. Manns, MD, has received grant/research support from Boehringer Ingelheim Pharmaceuticals Inc, Bristol-Myers Squibb Company, Gilead Sciences, Inc, Novartis Pharmaceuticals Corporation, Roche Pharmaceuticals, and Schering-Plough Corporation; is a consultant for Boehringer Ingelheim Pharmaceuticals Inc, Bristol-Myers Squibb Company, Gilead Sciences, Inc, Idenix Pharmaceuticals Inc, Novartis Pharmaceuticals Corporation, Roche Pharmaceuticals, Schering-Plough Corporation, and Valeant Pharmaceuticals International; is on the speakers bureaus of Bristol-Myers Squibb Company, Gilead Sciences, Inc, GlaxoSmithKline, Roche Pharmaceuticals, and Schering-Plough Corporation; and is a member of advisory boards for Bristol-Myers Squibb Company, Gilead Sciences, Inc, Idenix Pharmaceuticals Inc, and Novartis Pharmaceuticals Corporation.

John G. McHutchison, MD, FRACP, has received grant/research support from Akros Pharma Inc, Amgen Inc, Bayer Pharmaceuticals, BioMedicines, Inc, Bristol-Myers Squibb Company, Coley Pharmaceuticals, Inc, Fujisawa Healthcare, Inc, Gilead Sciences, Inc, Human Genome Sciences, IDUN Pharmaceuticals, Inc, Isis Pharmaceuticals, Inc, Ortho Diagnostic Systems, Inc, Prometheus Laboratories, Inc, Ribozyme Pharmaceuticals, Inc, Roche Pharmaceuticals, Schering-Plough Corporation, SciClone Pharmaceuticals, Triangle Pharmaceuticals Inc, Valeant Pharmaceuticals International, and Vertex Pharmaceuticals Incorporated; is a consultant for Valeant Pharmaceuticals International; and is a consultant for and on the speakers bureaus and advisory boards of Amgen Inc, Anadys Pharmaceuticals, Inc, Centocor, Inc, GlaxoSmithKline, Idenix Pharmaceuticals Inc, InterMune Inc, Isis Pharmaceuticals Inc, National Genetics Institute, Inc, Novartis Pharmaceuticals Inc, Pfizer Inc, Prometheus Laboratories, Ribozyme Pharmaceuticals, Inc, Schering-Plough Corporation, and XTL Biopharmaceuticals Ltd.

Rajender Reddy, MD, has received grant/research support from Roche Pharmaceuticals, SciClone Pharmaceuticals, Valeant Pharmaceuticals International, and Wyeth Pharmaceuticals; is a consultant for Roche Pharmaceuticals and Valeant Pharmaceuticals International; is on the speakers bureau of Roche Pharmaceuticals; is a member of the advisory boards for Ortho-Biotech Products, LP, and Roche Pharmaceuticals; and has received honoraria from Roche Pharmaceuticals.

Mitchell L. Shiffman, MD, has received grant/research support from InterMune Inc, Ortho-Biotech Products, LP, Roche Pharmaceuticals, Schering-Plough Corporation, and Valeant Pharmaceuticals International; and is a consultant for InterMune Inc, Roche Pharmaceuticals, and Valeant Pharmaceuticals International.

John B. Wong, MD, has received grant/research support and honoraria from Schering-Plough Corporation; and receives royalties from UpToDate.

There will be a discussion of the unlabeled/unapproved uses of epoetin alfa and viramidine.

Peer Reviewer has disclosed no significant relationships.

Projects In Knowledge's staff members have no significant relationships to disclose.

Conflicts of interest are thoroughly vetted by the Executive Committee of Projects In Knowledge. All conflicts are resolved prior to the beginning of the activity by the Trust In Knowledge peer review process.

The opinions expressed in this activity are those of the faculty and do not necessarily reflect those of Projects In Knowledge.

This CME activity is provided by Projects In Knowledge solely as an educational service. Specific patient care decisions are the responsibility of the clinician caring for the patient.

This independent CME activity is supported by an educational grant from
Valeant Pharmaceuticals International.

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