Outcomes after sofosbuvir-containing regimens for hepatitis C virus in patients with decompensated cirrhosis: a real-world study

Ji, Fanpu; Wang, Wenjun; Dang, Shuangsuo; Wang, Shengbang; Li, Burong; Bai, Dan; Zhao, Wenxue; Deng, Hong; Tian, Changyin; Li, Zongfang

doi:10.1186/s13027-017-0158-1

Cited by 14 publications

(12 citation statements)

References 41 publications

(55 reference statements)

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“…In this study, we demonstrated for the first time that patients with previous placement of TIPS can achieve optimal rates of SVR24 (92.5%) and a significant decrease in MELD and MELD-Na score from T0 to W24. In particular, both SVR rate and the improvement of liver function in patients with prior placement of TIPS treated with DAA are coherent with previous studies in patients with advanced cirrhosis without TIPS [6,20]. It should be noted that in patients with TIPS the decline of MELD was somehow slower than in patients without TIPS.…”

Section: Discussionsupporting

confidence: 87%

Transjugular Intrahepatic Portosystemic Shunt does not affect the efficacy and safety of direct-acting antivirals in patients with advanced cirrhosis: A real-life, case-control study

Gitto

Vizzutti

Schepis

et al. 2019

Digestive and Liver Disease

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Background: Transjugular Intrahepatic Portosystemic Shunt (TIPS) is a well-established treatment for complications of portal hypertension. Aims: To analyze the impact of TIPS on virologic response and safety profile in patients treated with direct-acting antivirals (DAAs). Methods: We analyzed data from HCV-positive cirrhotic patients treated with DAAs. Twenty-one patients with previous TIPS placement were compared with 42 matched subjects without TIPS. Logistic regression was used to identify predictors of hepatic function worsening and adverse events. Results: No differences were found between the two groups in particular regarding sustained virologic response (92.5 and 97.6% in TIPS vs no-TIPS, p = 0.559). Model for End-stage Liver Disease (MELD) of both TIPS and no-TIPS groups declined from baseline to week 24 of follow-up (from 12.5 ± 3.5 to 10.8 ± 3.4 and from 11.1 ± 3.5 to 10.3 ± 3.4, p = 0.044 and 0.025). There were no differences in adverse event rates. At univariate analysis, age was associated with MELD increase from baseline to week 24 (OR 1.111, 95% CI 1.019-1.211, p = 0.017), and patients with higher baseline MELD developed serious adverse events more frequently (OR 0.815, 95% CI 0.658-1.010, p = 0.062). Patients with or without TIPS did not show differences in transplant-free survival. Conclusion: TIPS placement does not affect virologic response and clinical outcome of patients receiving DAAs.

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Section: Discussionsupporting

confidence: 87%

Transjugular Intrahepatic Portosystemic Shunt does not affect the efficacy and safety of direct-acting antivirals in patients with advanced cirrhosis: A real-life, case-control study

Gitto

Vizzutti

Schepis

et al. 2019

Digestive and Liver Disease

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“…This is supported by a recent study from Egypt involving 2400 patients with HCV-related cirrhosis, where sofosbuvir and ribavirin therapy lead to SVR in only 71.2%, with more than 5% of patients discontinuing therapy due to adverse effects 21. In a Chinese study, patients with HCV-related decompensated cirrhosis achieved 90% SVR;23 however, this likely relates to the small number of patients (n=30).…”

Section: Discussionmentioning

confidence: 77%

<p>Efficacy of direct-acting antiviral therapy for hepatitis C viral infection. Real-life experience in Bahrain</p>

Abdulla¹,

Ali²,

Nass³

et al. 2019

HMER

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Purpose: The introduction of direct-acting antivirals (DAAs) has revolutionized the treatment of chronic hepatitis C viral (HCV) infection. This study aims to establish real-world treatment efficacy of Sofosbuvir-based (SOF-B) and Ombitasvir/Paritaprevir/Ritonavir-based (OPR-B) regimens. Patients and methods: This prospective, non-randomized observational real-life study was conducted in Salmaniya Medical Complex, Bahrain, and included consecutive patients with chronic HCV infection (genotypes 1–4) who were treated with direct-acting antivirals. Sustained virologic response to therapy was assessed at week 12 post end of treatment (SVR12). Results: Of the 167 patients included, 60.5% (n=101) were treated with SOF-B and 39.5% (n=66) with OPR-B regimens for 12 weeks (n=148; 88.6%) or 24 weeks (n=19; 11.4%). SVR12 was achieved in 156 (93.4%) patients, 4 patients failed to achieve SVR despite completion of treatment, and 7 patients discontinued treatment due to non-compliance and were included in the analysis on an intention-to-treat basis. There was no difference between SOF-B and OPR-B regimens (95/101; 94.1%) and (61/66; 92.4%), respectively ( p =0.68). However, SVR12 rates were significantly higher in patients without liver cirrhosis (103/104; 99.0%) compared to patients with cirrhosis (53/63; 84.1%; p <0.001), and in patients who received 12-week-regimen (141/148; 95.3%) compared to those who received 24-week regimen (15/19; 78.9%; p <0.024). However, logistic regression analysis identified cirrhosis at baseline to be the only independent predictor of non-SVR12 (OR: 16.1, 95% confidence interval 1.96–131.91, p =0.01). Apart from Hb, INR, and ALP, all other laboratory parameter improved following treatment ( p <0.05). Conclusion: Both SOF-B and OPR-B regimens achieved high SVR12 rates in this real-life cohort of patients with chronic HCV infection, similar to what is reported in other real-world studies. Cirrhosis was the only independent predictor of poor response.

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“…25 Recent medical literature suggests that ribavirin-unrelated anaemia is uncommon in HCVinfected patients who undergo treatment with DAAs. 26,27 The management of anaemia in our study required blood transfusions in seven patients. Therefore, we suggest a careful monitoring of Hb levels during antiviral therapy with DAAs.…”

Section: Discussionmentioning

confidence: 99%

‘Real-life’ experience with direct-acting antiviral agents for hepatitis C virus in end-stage renal disease

García-Agudo¹,

Aoufi-Rabih²,

Salgueira-Lazo

et al. 2018

Int J Artif Organs

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All-oral, interferon-free therapy with direct-acting antiviral agents for chronic hepatitis C virus in advanced chronic kidney disease was effective and well tolerated in a 'real-life' clinical setting. Careful monitoring of haemoglobin and serum creatinine during therapy with direct-acting antiviral agents is suggested. Studies are under way to address whether sustained viral response translates into better survival in this population.

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Outcomes after sofosbuvir-containing regimens for hepatitis C virus in patients with decompensated cirrhosis: a real-world study

Cited by 14 publications

References 41 publications

Transjugular Intrahepatic Portosystemic Shunt does not affect the efficacy and safety of direct-acting antivirals in patients with advanced cirrhosis: A real-life, case-control study

Transjugular Intrahepatic Portosystemic Shunt does not affect the efficacy and safety of direct-acting antivirals in patients with advanced cirrhosis: A real-life, case-control study

<p>Efficacy of direct-acting antiviral therapy for hepatitis C viral infection. Real-life experience in Bahrain</p>

‘Real-life’ experience with direct-acting antiviral agents for hepatitis C virus in end-stage renal disease

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