Efficacy and Safety of Sofosbuvir-Based Direct Acting Antivirals for Hepatitis C in Septuagenarians and Octogenarians

Snyder, Heather; Ali, Bilal; González, Humberto C.; Nair, Satheesh

doi:10.1016/j.jceh.2017.03.009

Cited by 9 publications

(8 citation statements)

References 11 publications

(11 reference statements)

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“…Moreover, both the SVR rate and rate of discontinuation secondary to AEs were nearly equal in elderly (≥ 75 years) and younger (< 75 years) patients. Although real-world cohort studies demonstrating the effectiveness of several SOF-containing regimens in elderly patients have been published worldwide[ 14 - 16 ], to the best of our knowledge, this is the first real-world study focusing on a high SVR rate and low discontinuation rate due to AEs in Japanese HCV genotype 1 patients aged ≥ 75 years following SOF/LDV therapy.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of sofosbuvir and ledipasvir in Japanese patients aged 75 years or over with hepatitis C genotype 1

Ozono

Nagata

Hasuike

et al. 2017

WJH

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AIMTo evaluate the efficacy and safety of a regimen containing sofosbuvir (SOF) and ledipasvir (LDV) in Japanese patients aged ≥ 75 years with hepatitis C genotype 1.METHODSThis multicenter, retrospective study consisted of 246 Japanese patients with HCV genotype 1 at nine centers in Miyazaki prefecture in Japan. Demographic, clinical, virological, and adverse effects (AE)-related data obtained during and after SOF/LDV therapy were collected from medical records. These patients were divided into two groups, younger (aged < 75 years) and elderly (aged ≥ 75 years). Virological data and AEs were analyzed by age group.RESULTSThe sustained virological response (SVR) rates at 12 wk after treatment were 99.2%, 99.4%, and 98.7% in the overall population and in patients aged < 75 and ≥ 75 years, respectively. Common AEs during therapy were headache, pruritus, constipation, and insomnia. These occurred in fewer than 10% of patients, and their incidence was not significantly different between the younger and elderly groups. Two patients discontinued treatment, one due to a skin eruption and the other due to cerebral bleeding.CONCLUSIONCompared with younger patients, elderly patients had a similar virological response and tolerance to SOF/LDV therapy.

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Section: Discussionmentioning

confidence: 99%

Efficacy and safety of sofosbuvir and ledipasvir in Japanese patients aged 75 years or over with hepatitis C genotype 1

Ozono

Nagata

Hasuike

et al. 2017

WJH

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“…There is currently no consistent upper age cutoff for HCV treatment outlined in the literature, but even among studies of older adults, patients aged 75 years and older remain underrepresented 6,8,16,20 . We describe HCV treatment outcomes with DAAs, with and without ribavirin in patients aged over 75 years treated in three Canadian HCV specialty treatment centers.…”

Section: Introductionmentioning

confidence: 99%

“…The advent of direct‐acting antivirals (DAAs) has opened up treatment to previously difficult‐to‐treat groups, including the elderly 7 . Adults aged 65 years and older were underrepresented in the original phase III licensing studies for most DAA regimens, but data are emerging that DAAs are safe and produce equivalent SVR rates in older adults as younger patients 2,10,11,13,15–17 …”

Section: Introductionmentioning

confidence: 99%

Hepatitis C direct‐acting antiviral outcomes in patients 75 years and older

et al. 2020

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Background and AimElderly patients with hepatitis C virus (HCV) infection have worse interferon‐based treatment outcomes than young patients. Direct‐acting antiviral (DAA) regimens have enabled the treatment of previously difficult‐to‐cure populations. There are few studies that specifically assess DAA treatment outcomes in patients over 75 years of age.MethodsDesign: This was a cohort study. Setting: The setting was three Canadian HCV specialty sites. Participants: Patients aged 75 years and older and treated with DAA without interferon were enrolled. Measurements: Patient demographics, liver fibrosis by transient elastography, treatment regimen, and treatment outcome data were collected.ResultsThe mean age of 78 patients in our analysis was 78.6 years (SD 3.5; range: 75–88 years). The most common genotype was 1b (35%). The most frequently utilized regimens included sofosbuvir‐velpatasvir (33%) and ledipasvir‐sofosbuvir (32%). Ribavirin was included for 17% of recipients. Sustained virological response (SVR) was achieved in 94% of patients (69% of those receiving ribavirin and 98% of patients on ribavirin‐free regimens). Ribavirin toxicity contributed to the lower SVR rates in ribavirin‐exposed patients. Ribavirin dosage was decreased in three patients and ultimately discontinued in two of these patients. All treatment was discontinued in another two patients.ConclusionRibavirin‐free DAA therapy is safe and achieves SVR rates in older adults comparable to those described in the general population. RBV inclusion frequently results in complications, often leads to treatment modification or interruption, and does not improve SVR rates in those with advanced age.

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“…On the contrary, a study by Snyder et al [13] 2017, concluded that patients aged 70 years or older with genotype 1 achieved high rates of sustained virologic response with treatment with newer sofosbuvirbased DAAs without any undue adverse events.…”

Section: Discussionmentioning

confidence: 99%

Impact of Insulin Resistance on Therapeutic Response to Oral Treatment of Chronic Hepatitis C Virus Infection

Hassan

Monem

Hasanain

et al. 2020

Journal of Gastroenterology and Hepatology Research

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Efficacy and Safety of Sofosbuvir-Based Direct Acting Antivirals for Hepatitis C in Septuagenarians and Octogenarians

Abstract: Patients aged 70 years or older with genotype 1 achieved high rates of sustained virologic response with treatment with newer sofosbuvir-based DAAs without any undue adverse events.

Cited by 9 publications

References 11 publications

Efficacy and safety of sofosbuvir and ledipasvir in Japanese patients aged 75 years or over with hepatitis C genotype 1

Efficacy and safety of sofosbuvir and ledipasvir in Japanese patients aged 75 years or over with hepatitis C genotype 1

Hepatitis C direct‐acting antiviral outcomes in patients 75 years and older

Impact of Insulin Resistance on Therapeutic Response to Oral Treatment of Chronic Hepatitis C Virus Infection

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