Sofosbuvir‐based regimens in clinical practice achieve <scp>SVR</scp> rates closer to clinical trials: results from <scp>ERCHIVES</scp>

Butt, Adeel A.; Yan, Peng; Shaikh, Obaid S.; Chung, Raymond T.; Sherman, Kenneth E.

doi:10.1111/liv.13036

Cited by 36 publications

(45 citation statements)

References 20 publications

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“…To date, there is very few data on the impact of GA on virological response to new DAA. Preliminary results suggest that the presence of diabetes does not appear to be predictive of treatment failure in G1 patients[46,47]. Further studies are needed to confirm these data and to evaluate the impact of DM on SVR in patients without poor prognostic factors.…”

Section: Discussionmentioning

confidence: 99%

Diabetes mellitus, insulin resistance and hepatitis C virus infection: A contemporary review

Desbois¹,

Cacoub²

2017

WJG

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AIMTo summarise the literature data on hepatitis C virus (HCV)-infected patients concerning the prevalence of glucose abnormalities and associated risk.METHODSWe conducted a PubMed search and selected all studies found with the key words "HCV" or "hepatitis C virus" and "diabetes" or "insulin resistance". We included only comparative studies written in English or in French, published from January 2000 to April 2015. We collected the literature data on HCV-infected patients concerning the prevalence of glucose abnormalities [diabetes mellitus (DM) and insulin resistance (IR)] and associated risk [i.e., severe liver fibrosis, response to antivirals, and the occurrence of hepatocellular carcinoma (HCC)].RESULTSHCV infection is significantly associated with DM/IR compared with healthy volunteers and patients with hepatitis B virus infection. Glucose abnormalities were associated with advanced liver fibrosis, lack of sustained virologic response to interferon alfa-based treatment and with a higher risk of HCC development. As new antiviral therapies may offer a cure for HCV infection, such data should be taken into account, from a therapeutic and preventive point of view, for liver and non-liver consequences of HCV disease. The efficacy of antidiabetic treatment in improving the response to antiviral treatment and in decreasing the risk of HCC has been reported by some studies but not by others. Thus, the effects of glucose abnormalities correction in reducing liver events need further studies.CONCLUSIONGlucose abnormalities are strongly associated with HCV infection and show a negative impact on the main liver related outcomes.

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Section: Discussionmentioning

confidence: 99%

Diabetes mellitus, insulin resistance and hepatitis C virus infection: A contemporary review

Desbois¹,

Cacoub²

2017

WJG

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“…In a study in Taiwan, 16.5% of study participants seropositive for HCV had CKD [1], while a US study found the unadjusted prevalence of HCV infection in patients receiving hemodialysis to be 14.4% [14]. Similarly, a recent study of HCV patients reported 14.4% had stage 3–5 CKD [34]. Patients with more advanced CKD have higher rates of HCV infection, with one study reporting a prevalence of 8.5% in those with stage 1 CKD and 14.5% in those with stages 4–5 [4].…”

Section: Discussionmentioning

confidence: 99%

Disease Burden, Early Discontinuation, and Healthcare Costs in Hepatitis C Patients with and without Chronic Kidney Disease Treated with Interferon-Free Direct-Acting Antiviral Regimens

et al. 2017

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BackgroundHepatitis C virus (HCV) is a risk factor for chronic kidney disease (CKD) and end-stage renal disease (ESRD). Direct-acting antiviral agents (DAAs) have improved HCV management in CKD patients, however real-world clinical practice data are limited.ObjectiveThis study examined the prevalence of CKD among HCV patients receiving oral DAAs in a real-world setting. Comorbidities, early discontinuation rates, and healthcare costs were compared between patients with and without CKD.MethodsPatients with HCV who were treated with oral DAAs between November 2013 and June 2015, and who were enrolled in a US health plan, were identified. Early discontinuation was calculated based on observed versus expected treatment duration, and expected treatment duration was based on genotype, initial treatment regimen, baseline cirrhosis, and prior treatments. Healthcare costs were calculated during the baseline, treatment, and post-treatment periods.ResultsThis study included 3438 patients receiving oral DAAs, of whom 6.9% had a CKD diagnosis. CKD patients were more often male (70.8 vs. 62.9%, p = 0.02) and older (mean age 62.0 vs. 58.8 years, p < 0.001) than non-CKD patients, and had a higher prevalence of most comorbidities. Among early discontinuers, CKD patients were more likely to experience anemia (19.4 vs. 7.7%, p = 0.028).ConclusionsFew patients with CKD receive DAA treatment for HCV infections. HCV patients with CKD had significantly more comorbidities and higher baseline healthcare costs than patients without CKD. Compared with non-CKD patients, CKD patients were equally likely to discontinue DAA treatment early but had higher rates of anemia. This study highlights the need for more renal-friendly HCV therapies.

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“…However, over 90% of the patients in this study were male, a large proportion had advanced liver disease by FIB-4, and the regimens did not include SOF/LDV that may make these findings less generalizable [23]. In contrast, another study from the VA population of over four thousand patients with genotypes 1–4 that included SOF/LDV regimens along with the other regimens reported by Backus et al, showed higher response rates of over 90% among those treatment naïve or experienced patients who had received SOF/LDV [24]. …”

Section: Discussionmentioning

confidence: 99%

Sofosbuvir-Containing Regimens for Chronic Hepatitis C Are Successful in the Safety-Net Population: A Real-World Experience

2016

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Background Vulnerable populations are disproportionately affected by hepatitis C virus infection (HCV), and experience high rates of health disparity. There is no data on real world experience with highly efficacious direct acting anti-HCV (DAA) treatment in this population. Aims We aimed to evaluate the real world experience with sofosbuvir-based regimens among a vulnerable HCV-infected population. Methods HCV treatment response was assessed among 204 patients who completed 12–24 weeks of sofosbuvir (SOF)-based regimens (in combination with pegylated interferon and ribavirin, simeprevir, ledipasvir, or daclatasvir) at the San Francisco safety-net healthcare system liver specialty clinic between January 2014 and December 2015. Virologic response during therapy was assessed at weeks 4, 8, end of therapy, and 12 weeks treatment discontinuation (SVR 12). Results Patient characteristics were median age 58 years, 60% male, 42% Caucasian (21% black, 19% Hispanic), 72% had genotype 1 (23% genotype 2 or 3), and the median baseline log10 HCV viral load was 6.1 IU/ml and alanine transaminase 63 U/L. Cirrhosis was present in 36% (of whom 40% were decompensated) and 18% were HCV treatment experienced. Overall, SVR 12 was achieved in 97% (99% genotype 1, 100% genotype 2, 84% genotype 3). Five of six (83%) of patients who relapsed had decompensated cirrhosis and 67% were also non-adherent to therapy. On treatment virologic response did not impact SVR. Conclusions High rates of sustained virologic response can be achieved in safety-net HCV-infected patients. Access to DAA-based regimens is critical to addressing HCV-related health disparity in this at risk population.

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Sofosbuvir‐based regimens in clinical practice achieve SVR rates closer to clinical trials: results from ERCHIVES

Abstract: Sofosbuvir-based regimens in clinical practice are associated with SVR rates comparable to those seen in clinical trials and low rates of grade 3/4 haematological adverse events.

Cited by 36 publications

References 20 publications

Diabetes mellitus, insulin resistance and hepatitis C virus infection: A contemporary review

Diabetes mellitus, insulin resistance and hepatitis C virus infection: A contemporary review

Disease Burden, Early Discontinuation, and Healthcare Costs in Hepatitis C Patients with and without Chronic Kidney Disease Treated with Interferon-Free Direct-Acting Antiviral Regimens

Sofosbuvir-Containing Regimens for Chronic Hepatitis C Are Successful in the Safety-Net Population: A Real-World Experience

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