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Hepatology
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Hepatology
Article . 2007 . Peer-reviewed
License: Wiley TDM
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Hepatology
Article . 2007
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A national French survey on the use of growth factors as adjuvant treatment of chronic hepatitis C

Authors: Thévenot, Thierry; Cadranel, Jean-François; Di Martino, Vincent; Pariente, Alexandre; Causse, Xavier; Renou, Christophe; Hagege, Hervé; +2 Authors

A national French survey on the use of growth factors as adjuvant treatment of chronic hepatitis C

Abstract

We conducted a national retrospective survey on hospital practitioners to evaluate the magnitude of erythropoietin (EPO) or granulocyte colony-stimulating factor (G-CSF) prescriptions in patients treated for chronic hepatitis C. Four hundred seventy-one questionnaires were sent, and 274 practitioners (58.2%) responded. Forty-six percent of practitioners used EPO, and 31% used G-CSF. The total number of HCV-infected patients receiving antiviral therapy per year was estimated at 6,630 patients, of whom 8.8% and 4% received EPO and G-CSF, respectively. EPO-β was the main EPO molecule prescribed at a median dose of 30,000 IU/wk (range: 2,000-80,000). The indications for prescribing EPO varied greatly, including “fragile patients” (34%), “low” Hb level (8-11 g/dL) (19%), “rapid decline” in Hb level (2-5 g/dL during the first month of therapy) (12%), and symptomatic anemic patients (7%). G-CSF was mainly prescribed for a “low” level of neutrophils ranging from 400 to 750 neutrophils/mm3. In multivariate analysis, independent predictors of EPO and G-CSF prescription were age of practitioner less than 45 years (EPO: OR = 1.96, P = 0.03; G-CSF: OR = 2.27, P = 0.004), practice in university hospital (EPO: OR = 5.89, P < 0.0001; G-CSF: OR = 2.39, P = 0.003), and the high number of CHC treated/year (EPO: OR = 6.18, P < 0.0001; G-CSF: OR = 2.58, P = 0.002). Conclusion : Our survey reveals an important rate of EPO and G-CSF prescriptions but with considerable disparity in the schedule of injections, the molecules used, and above all the indications. The suitable role of EPO and G-CSF as complements to HCV therapy urgently needs to be clarified.

Keywords

Adult, Male, 610, MESH: Drug Administration Schedule, Hematopoietic Cell Growth Factors, MESH: Multivariate Analysis, Drug Administration Schedule, MESH: Health Surveys, Granulocyte Colony-Stimulating Factor, MESH: Chemotherapy, Humans, MESH: Erythropoietin, Chronic, Practice Patterns, Physicians', MESH: Physician's Practice Patterns, MESH: Hematopoietic Cell Growth Factors, Erythropoietin, Adjuvant, Retrospective Studies, MESH: Age Factors, MESH: Hepatitis C, MESH: Humans, MESH: Middle Aged, Age Factors, MESH: Adult, MESH: Retrospective Studies, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Hepatitis C, Chronic, Middle Aged, Health Surveys, MESH: Male, [SDV.MHEP.HEG] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, MESH: France, Chemotherapy, Adjuvant, Multivariate Analysis, MESH: Granulocyte Colony-Stimulating Factor, Female, France, MESH: Female

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
29
Average
Top 10%
Top 10%
bronze