Predicting Discontinuation of Pegylated Interferon as a Result of Lack of Efficacy in United States Veterans With Chronic Hepatitis C on Dual Therapy

Nelson, Richard E.; Hoop, Robert; Korner, Eli J.; DuVall, Scott L.; Hayden, Candace; Knippenberg, Kristin; Morgan, Timothy R.; Pandya, Prashant; Han, Jian; LaFleur, Joanne

doi:10.1177/1060028014531724

Cited by 2 publications

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“…To confirm that we identified true chronic HCV infected patients, we excluded patients who did not have either (a) a second diagnosis for HCV on a different date within 395 days of the first (to ensure capture of yearly follow-ups with a one month variance), or (b) a confirmatory lab result within 6 months before or 395 days after the date of the first diagnosis. Laboratory values that were considered “confirmatory” included HCV genotype with any valid value (1–7), positive HCV antibody, positive qualitative HCV RNA, or quantitative HCV RNA with any numerical value [ 20 , 21 ].…”

Section: Methodsmentioning

confidence: 99%

Correlates of Initiation of Treatment for Chronic Hepatitis C Infection in United States Veterans, 2004–2009

et al. 2015

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We describe the rates and predictors of initiation of treatment for chronic hepatitis C (HCV) infection in a large cohort of HCV positive Veterans seen in U.S. Department of Veterans Affairs (VA) facilities between January 1, 2004 and December 31, 2009. In addition, we identify the relationship between homelessness among these Veterans and treatment initiation. Univariate and multivariable Cox Proportional Hazards regression models with time-varying covariates were used to identify predictors of initiation of treatment with pegylated interferon alpha plus ribavirin. Of the 101,444 HCV treatment-naïve Veterans during the study period, rates of initiation of treatment among homeless and non-homeless Veterans with HCV were low and clinically similar (6.2% vs. 7.4%, p<0.0001). For all U.S. Veterans, being diagnosed with genotype 2 or 3, black or other/unknown race, having Medicare or other insurance increased the risk of treatment. Veterans with age ≥50 years, drug abuse, diabetes, and hemoglobin < 10 g/dL showed lower rates of treatment. Initiation of treatment for HCV in homeless Veterans is low; similar factors predicted initiation of treatment. Additionally, exposure to treatment with medications for diabetes predicted lower rates of treatment. As newer therapies become available for HCV, these results may inform further studies and guide strategies to increase treatment rates in all U.S. Veterans and those who experience homelessness.

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Section: Methodsmentioning

confidence: 99%

Correlates of Initiation of Treatment for Chronic Hepatitis C Infection in United States Veterans, 2004–2009

et al. 2015

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“…These 37 reports presented data on 51 HCV-carecontinuum outcomes of testing (n=16, Table 1), [43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58] linkage to care (n=12, Table 2), [44][45][46]49,51,52,54,[57][58][59][60][61] and treatment (n=23, Table 3). 44,45,51,[61][62][63][64][65][66][67][68][69][70][71][72][73][74][75][76][77][78][79]…”

Section: Resultsmentioning

confidence: 99%

Application of an adapted PRECIS-2 instrument to assess efficacy- and effectiveness-study designs in a systematic review of intervention studies of the hepatitis C virus-care continuum among people who use drugs

Jordan¹,

Perlman²,

Smith³

et al. 2018

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Introduction: Systematic reviews and meta-analyses examining intervention studies may need to categorize studies by the degree to which they reflect efficacy or effectiveness study-design elements when reporting systematic reviews and meta-analysis results. Materials and methods: We identified reports presenting data from intervention studies eligible for evaluation with an adapted PRECIS-II instrument as part of a larger systematic review of the hepatitis C virus (HCV)-care continuum among people who used drugs. We applied the instrument to score reports examining any of the HCV-care-continuum steps of testing, linkage to care, and treatment on an efficacy-effectiveness spectrum. Composite scores are presented in tabular format and in stacked dot plots. Results: The adapted PRECIS-II instrument was applied to 37 unique reports that presented data on 51 HCV-care-continuum outcomes of testing (n=16), linkage to care (n=12), and treatment (n=23). Totals of 28, six, and three reports had been produced on one, two, or all three outcomes, respectively. Ten and eight studies described themselves as having efficacy or effectiveness designs, respectively; 33 did not specify. PRECIS-II composite scores for reports produced on testing, linkage to care, and treatment ranged widely: 1.22-5. Composite scores for reports examining HCV treatment indicated study designs that tended toward effectiveness (3.35), but those examining testing (3.85) or linkage (3.8) had more effectiveness-study designs (P=0.003, P=0.013, respectively). Conclusion: Reviewed reports varied widely in their use of efficacy/effectiveness-study designs, suggesting that systematic reviews and meta-analyses need to consider heterogeneity in efficacy/effectiveness study design in analyses. Most reports tended modestly toward having effectiveness designs, and treatment studies contained the most elements of efficacy-study designs. When assessing large numbers of reports with the PRECIS-II instrument, stacked dot plots may aid visually in depicting the range of scores. This review suggests that studies of the effectiveness of HCV treatment of people who use drugs at a population level is a research gap.

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Predicting Discontinuation of Pegylated Interferon as a Result of Lack of Efficacy in United States Veterans With Chronic Hepatitis C on Dual Therapy

Abstract: We identified risk factors for discontinuation caused by LOE. Future work should focus on determining whether these characteristics are also predictive of triple-therapy LOE discontinuations.

Cited by 2 publications

References 67 publications

Correlates of Initiation of Treatment for Chronic Hepatitis C Infection in United States Veterans, 2004–2009

Correlates of Initiation of Treatment for Chronic Hepatitis C Infection in United States Veterans, 2004–2009

Application of an adapted PRECIS-2 instrument to assess efficacy- and effectiveness-study designs in a systematic review of intervention studies of the hepatitis C virus-care continuum among people who use drugs

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