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A QUASI-EXPERIMENTAL STUDY TO COMPARE METFORMIN AND PIOGLITAZONE WITH STANDARD INTERFERON AND RIBAVIRIN IN ACHIEVING SUSTAINED VIROLOGICAL RESPONSE IN CHRONIC HEPATITIS-C PATIENTS

Dr. Anam Iftikhar, Dr. Abid Hussain, Dr. Muhammad Atif Aziz

Objective: To compare metformin and pioglitazone with standard interferon and ribavirin in achieving sustained virological response in chronic hepatitis C patients. Methods: This quasi-experimental, comparative, interventional study was conducted at Benazir Bhutto hospital and Holy Family hospital, Rawalpindi, Pakistan, from June, 2018 to May, 2019 and comprised chronic hepatitis C patients who had insulin resistance. The patients were divided evenly in three groups. Group A had patients treated with interferon 3 million units, three times in a week and ribavirin 400mg three times in a day. In addition to interferon and ribavirin, group B was treated with metformin, and group C received pioglitazone. Polymerase chain reaction was done at the completion of 24 and 48 weeks to assess the end treatment and sustained virological response, respectively. SPSS 20 was used for data analysis. Results: Of the 138 patients, there were 46(33.3%) in each group. The mean age of the patients in group A was 36.83±9.65 years, in group B was 37.72±10.00 years and in group C it was 38.07±8.85 years. Overall, there were 70(50.72%) males and 68(49.28%) females. At the end of 24 weeks, polymerase chain reaction exhibited that in group A, the score was <100 in 28(60.9%) and >100 in 18(39.1%) patients. In group-B, it was <100 in 39(84.8%) and >100 in 7(15.2%) patients. In group-C, it was <100 in 31(67.4%) and >100 in 15(32.6%) patients. The sustained virological response was considerably higher in group B (p=0.003). Conclusion: Sustained virological response with standard therapy with metformin gave high-end response as compared to other groups. Keywords: Metformin, Pioglitazone, Hepatitis C, Interferon, Insulin resistance.

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