Hepatitis C Clinical Trial
Official title:
Prophylactic Treatment of Peginterferon-associated Psychopathology. A Double-blind Placebo-controlled Trial on the Effects of Escitalopram (Lexapro®) in Patients Treated With Peginterferon and Ribavirin (POPS Study)
The treatment of chronic hepatitis C with peginterferon and ribavirin is highly effective
but is hampered by peginterferon-induced psychopathology.
Prevention of peginterferon-induced psychopathology with selective serotonin reuptake
inhibitors (SSRI's) (paroxetine) has been shown to be effective in patients treated with
interferon for malignant disease. The aim is to study the effects of prophylactic treatment
with escitalopram (another SSRI) on peginterferon-associated psychopathology in patients
treated with peginterferon and ribavirin for chronic hepatitis C.
The treatment of chronic hepatitis C with peginterferon and ribavirin is highly effective
but is hampered by peginterferon-induced psychopathology.
Prevention of peginterferon-induced psychopathology with SSRI's (paroxetine) has been shown
to be effective in patients treated with interferon for malignant disease. The aim is to
study the effects of prophylactic treatment with escitalopram on peginterferon-associated
psychopathology in patients treated with peginterferon and ribavirin for chronic hepatitis
C.
Design: double blind, randomized controlled trial with two arms, maximum 40 patients per
arm. Patients, starting with peginterferon and ribavirin, will be randomized to receive
escitalopram therapy 10 mg per day (however, 5 mg in the first two weeks) or placebo.
Study population and selection: eighty patients receiving peginterferon alfa-2a (Pegasys 180
microgram) and ribavirin (Copegus 400 mg twice daily) will be included in the study.
Aims of the study:
1. to asses whether prophylactic treatment with escitalopram avoids significantly the
occurrence of peginterferon-induced psychiatric disturbance; defined as an increase of
two points on observer-based rating scales reflecting anxiety (BAS:BriefAnxietyScale),
loss of concentration, depression and loss of impulse control (Montgomery and Asberg
Depression Rating Scale: MADRS), and
2. to assess the frequency of major depression according to DSM IV criteria, in the
escitalopram and placebo-treated patients.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator), Primary Purpose: Prevention
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