Pioglitazone in chronic hepatitis C not responding to pegylated interferon-alpha and ribavirin

J Hepatol. 2008 Aug;49(2):295-8. doi: 10.1016/j.jhep.2008.03.033. Epub 2008 May 22.


Background/aims: Insulin resistance reduces the response to interferon alfa-based therapy of chronic hepatitis C patients. It has been speculated that improvement of insulin sensitivity might increase the chances of responding to treatment of such individuals.

Methods: We started a multicenter clinical trial of retreatment of chronic hepatitis C patients, who had failed to respond to the pegylated interferon alfa/ribavirin combination, with a triple therapy consisting in these same antivirals plus an insulin-sensitizer (pioglitazone) (The INSPIRED-HCV study).

Results: None of the first five patients fulfilling the inclusion criteria and included in the trial achieved a satisfactory virological response after 12 weeks of retreatment, despite the fact that in at least three of them the insulin resistance score improved. As a result, the study was terminated.

Conclusions: Different schedules are warranted to improve insulin sensitivity prior to attempting retreatment of chronic hepatitis C patients with insulin resistance.

Publication types

  • Case Reports
  • Clinical Trial
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antiviral Agents / administration & dosage*
  • Drug Resistance, Viral
  • Drug Therapy, Combination
  • Female
  • Hepatitis C, Chronic / drug therapy*
  • Hepatitis C, Chronic / metabolism
  • Humans
  • Hypoglycemic Agents / administration & dosage*
  • Insulin Resistance
  • Interferon alpha-2
  • Interferon-alpha / administration & dosage*
  • Male
  • Middle Aged
  • Pioglitazone
  • Polyethylene Glycols / administration & dosage*
  • Recombinant Proteins
  • Ribavirin / administration & dosage*
  • Thiazolidinediones / administration & dosage*


  • Antiviral Agents
  • Hypoglycemic Agents
  • Interferon alpha-2
  • Interferon-alpha
  • Recombinant Proteins
  • Thiazolidinediones
  • Polyethylene Glycols
  • Ribavirin
  • peginterferon alfa-2a
  • Pioglitazone