File Download

There are no files associated with this item.

  Links for fulltext
     (May Require Subscription)
Supplementary

Article: Real-world treatment outcome with protease inhibitor direct-acting antiviral in advanced hepatitis C cirrhosis: a REAL-C study

TitleReal-world treatment outcome with protease inhibitor direct-acting antiviral in advanced hepatitis C cirrhosis: a REAL-C study
Authors
KeywordsCirrhosis
Direct-acting antiviral
Effectiveness
Hepatitis C virus
Outcome
Protease inhibitor
Real world
Tolerability
Treatment
Issue Date5-Jun-2023
PublisherSpringer
Citation
Hepatology International, 2023 How to Cite?
AbstractIntroductionCurrent guidelines discourage the use of direct-acting antiviral (DAA) containing protease-inhibitor (PI) in advanced HCV cirrhosis. We aimed to compare the real-world tolerability of PI vs. non-PI DAA regimens in this population.MethodsWe identified advanced cirrhosis patients treated with DAA from the REAL-C registry. The primary outcome was significant worsening or improvement in CPT or MELD scores following DAA treatment.ResultsFrom the REAL-C registry of 15,837 patients, we included 1077 advanced HCV cirrhosis patients from 27 sites. 42% received PI-based DAA. Compared to non-PI group, the PI group was older, had higher MELD and higher percentage with kidney disease. Inverse probability of treatment weighting (IPTW; matching on age, sex, history of clinical decompensation, MELD, platelet, albumin, Asia site, Asian ethnicity, hypertension, hemoglobin, genotype, liver cancer, ribavirin) was used to balance the two groups. In the IPTW-matched cohorts, the PI and non-PI groups had similar SVR12 (92.9% vs. 90.7%, p = 0.30), similar percentages of significant worsening in CTP or MELD scores at posttreatment week 12 and 24 (23.9% vs. 13.1%, p = 0.07 and 16.5% vs. 14.6%, p = 0.77), and similar frequency of new HCC, decompensating event, and death by posttreatment week 24. In multivariable analysis, PI-based DAA was not associated with significant worsening (adjusted odds ratio = 0.82, 95% CI 0.38-1.77).ConclusionTolerability and treatment outcomes were not significantly different in advanced HCV cirrhosis treated with PI-based (vs. non-PI) DAA up to CTP-B or MELD score of 15. Safety of PI-based DAA in those with CTP-C or MELD beyond 15 awaits further data.
Persistent Identifierhttp://hdl.handle.net/10722/331036
ISSN
2023 Impact Factor: 5.9
2023 SCImago Journal Rankings: 1.813
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorWong, YJ-
dc.contributor.authorTran, S-
dc.contributor.authorHuang, CF-
dc.contributor.authorHsu, YC-
dc.contributor.authorPreda, C-
dc.contributor.authorToyoda, H-
dc.contributor.authorLiu, J-
dc.contributor.authorJun, DW-
dc.contributor.authorLandis, C-
dc.contributor.authorHuang, DQ-
dc.contributor.authorGila, A-
dc.contributor.authorNegoita, L-
dc.contributor.authorYasuda, S-
dc.contributor.authorTseng, CH-
dc.contributor.authorTsai, PC-
dc.contributor.authorUojima, H-
dc.contributor.authorNozaki, A-
dc.contributor.authorChuma, M-
dc.contributor.authorAtsukawa, M-
dc.contributor.authorIshigami, M-
dc.contributor.authorItokawa, N-
dc.contributor.authorIio, E-
dc.contributor.authorLam, CPM-
dc.contributor.authorWatanabe, T-
dc.contributor.authorAsai, A-
dc.contributor.authorYokohama, K-
dc.contributor.authorAbe, H-
dc.contributor.authorEnomoto, M-
dc.contributor.authorKawada, N-
dc.contributor.authorTamori, A-
dc.contributor.authorLee, DH-
dc.contributor.authorJun, MJ-
dc.contributor.authorDo, S-
dc.contributor.authorVo, DKH-
dc.contributor.authorLiu, L-
dc.contributor.authorLi, JY-
dc.contributor.authorJi, FP-
dc.contributor.authorWang, WJ-
dc.contributor.authorLi, Y-
dc.contributor.authorWang, XZ-
dc.contributor.authorGuo, F-
dc.contributor.authorXu, Q-
dc.contributor.authorJing, L-
dc.contributor.authorYe, Q-
dc.contributor.authorPan, HY-
dc.contributor.authorZhang, JJ-
dc.contributor.authorWen, X-
dc.contributor.authorWang, Q-
dc.contributor.authorRen, H-
dc.contributor.authorCai, DC-
dc.contributor.authorShang, J-
dc.contributor.authorLiu, JP-
dc.contributor.authorLu, CZ-
dc.contributor.authorZang, WQ-
dc.contributor.authorLi, J-
dc.contributor.authorNiu, JQ-
dc.contributor.authorZhang, MY-
dc.contributor.authorWu, C-
dc.contributor.authorHuang, R-
dc.contributor.authorMaeda, M-
dc.contributor.authorNakanishi, A-
dc.contributor.authorYeh, ML-
dc.contributor.authorChuang, WL-
dc.contributor.authorHuang, JF-
dc.contributor.authorDai, CY-
dc.contributor.authorIshikawa, T-
dc.contributor.authorTakaguchi, K-
dc.contributor.authorSenoh, T-
dc.contributor.authorTrinh, HN-
dc.contributor.authorTakahashi, H-
dc.contributor.authorEguchi, Y-
dc.contributor.authorQuek, SXZ-
dc.contributor.authorHaga, H-
dc.contributor.authorOgawa, E-
dc.contributor.authorWong, G-
dc.contributor.authorButi, M-
dc.contributor.authorFukunishi, S-
dc.contributor.authorUeno, Y-
dc.contributor.authorYuen, MF-
dc.contributor.authorTanaka, Y-
dc.contributor.authorLim, SG-
dc.contributor.authorCheung, R-
dc.contributor.authorYu, ML-
dc.contributor.authorNguyen, MH-
dc.date.accessioned2023-09-21T06:52:14Z-
dc.date.available2023-09-21T06:52:14Z-
dc.date.issued2023-06-05-
dc.identifier.citationHepatology International, 2023-
dc.identifier.issn1936-0533-
dc.identifier.urihttp://hdl.handle.net/10722/331036-
dc.description.abstractIntroductionCurrent guidelines discourage the use of direct-acting antiviral (DAA) containing protease-inhibitor (PI) in advanced HCV cirrhosis. We aimed to compare the real-world tolerability of PI vs. non-PI DAA regimens in this population.MethodsWe identified advanced cirrhosis patients treated with DAA from the REAL-C registry. The primary outcome was significant worsening or improvement in CPT or MELD scores following DAA treatment.ResultsFrom the REAL-C registry of 15,837 patients, we included 1077 advanced HCV cirrhosis patients from 27 sites. 42% received PI-based DAA. Compared to non-PI group, the PI group was older, had higher MELD and higher percentage with kidney disease. Inverse probability of treatment weighting (IPTW; matching on age, sex, history of clinical decompensation, MELD, platelet, albumin, Asia site, Asian ethnicity, hypertension, hemoglobin, genotype, liver cancer, ribavirin) was used to balance the two groups. In the IPTW-matched cohorts, the PI and non-PI groups had similar SVR12 (92.9% vs. 90.7%, p = 0.30), similar percentages of significant worsening in CTP or MELD scores at posttreatment week 12 and 24 (23.9% vs. 13.1%, p = 0.07 and 16.5% vs. 14.6%, p = 0.77), and similar frequency of new HCC, decompensating event, and death by posttreatment week 24. In multivariable analysis, PI-based DAA was not associated with significant worsening (adjusted odds ratio = 0.82, 95% CI 0.38-1.77).ConclusionTolerability and treatment outcomes were not significantly different in advanced HCV cirrhosis treated with PI-based (vs. non-PI) DAA up to CTP-B or MELD score of 15. Safety of PI-based DAA in those with CTP-C or MELD beyond 15 awaits further data.-
dc.languageeng-
dc.publisherSpringer-
dc.relation.ispartofHepatology International-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectCirrhosis-
dc.subjectDirect-acting antiviral-
dc.subjectEffectiveness-
dc.subjectHepatitis C virus-
dc.subjectOutcome-
dc.subjectProtease inhibitor-
dc.subjectReal world-
dc.subjectTolerability-
dc.subjectTreatment-
dc.titleReal-world treatment outcome with protease inhibitor direct-acting antiviral in advanced hepatitis C cirrhosis: a REAL-C study-
dc.typeArticle-
dc.identifier.doi10.1007/s12072-023-10547-4-
dc.identifier.pmid37273170-
dc.identifier.scopuseid_2-s2.0-85160909232-
dc.identifier.eissn1936-0541-
dc.identifier.isiWOS:001000895200003-
dc.publisher.placeNEW YORK-
dc.identifier.issnl1936-0533-

Export via OAI-PMH Interface in XML Formats


OR


Export to Other Non-XML Formats