Use of Dronabinol for Treatment of Common Side Effects of Chronic Hepatitis
C Therapy

Common side effects of treatment with ribavirin (RBV) plus pegylated
interferon (PEG IFN) for chronic hepatitis C (CHC), such as anorexia, weight
loss, and nausea +/- vomiting, are difficult to manage and have been major
causes of dose reduction or discontinuation of treatment.
Dronabinol is an orally-active, synthetic cannabinoid which is approved for
treatment of anorexia and weight loss in AIDS patients and for nausea and
vomiting in patients on cancer chemotherapy.

In the current study, researchers evaluated the use of dronabinol for
treatment of these side effects in patients receiving RBV/PEG IFN for CHC.

By retrospective chart review of a cohort of patients with CHC undergoing
treatment with RBV/PEG IFN, 12 patients were identified who were treated
with dronabinol for the designated medication side effects.

The age range of these patients was 39 to 61 years. 4/12 (33%) were females.
9/12 (75%) were co-infected with HIV. 4/12 (33%) had known prior history of
intravenous drug use (IVDU). An additional 2/12 (17%) were known to be
active users of marijuana at the time of prescription of dronabinol.

Results

Of the 12 patients treated with dronabinol, the charts of 11 could be
evaluated for the patient's response to therapy.

In 1 of the 11 (a CHC mono-infected patient with prior history of IVDU)
dronabinol therapy was associated with significant CNS side effects,
prompting its early discontinuation.

10/11 (91%) reported no side effects associated with dronabinol therapy.

In 4/10 (40%) dronabinol provided effective therapy of medication side
effects.

This group included the remaining two patients with CHC mono-infection and
the remaining two patients with prior history of IVDU. It also included the
three oldest patients in the series (ages 50, 59, and 61).

In 6/10 (60%) dronabinol did not provide effective therapy of medication
side effects. This group included the two active users of marijuana.

Conclusions

In a cohort of patients with CHC, dronabinol was well-tolerated by greater
than 90% of the patients.

In 40% of these patients dronabinol was an effective treatment of major side
effects of RBV/PEG IFN therapy.

Further investigation by randomized controlled trial, including delineation
of possible treatment-responsive subgroups, would appear to be warranted,"
conclude the authors.

05/26/04

Reference
S A Levitan and others. Use of Dronabinol for Treatment of Common Side
Effects of Chronic Hepatitis C Therapy. Abstract 1237 (poster). Digestive
Disease Week. May 15-20, 2004. New Orleans, LA

http://www.hivandhepatitis.com/2004icr/ddw2004/docs/0526/052804_c.html

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