Association Between Baseline Creatinine Clearance and Treatment Failure in Patients With Hepatitis C Virus Treated With Ledipasvir and Sofosbuvir.

Autor: Jansen JW; Department of Research, VA Saint Louis Health Care System, St. Louis, Missouri.; Department of Pharmacy, SCL St. Vincent Healthcare, Billings, Montana., Linneman TW; Department of Pharmacy, VA Saint Louis Health Care System, St. Louis, Missouri., Powderly GM; Department of Pharmacy, VA Saint Louis Health Care System, St. Louis, Missouri., Moenster RP; Department of Pharmacy, VA Saint Louis Health Care System, St. Louis, Missouri.; Department of Pharmacy Practice, Saint Louis College of Pharmacy, St. Louis, Missouri., Nayak L; Department of Gastroenterology, Southeastern Louisiana Veterans Healthcare System, New Orleans, Louisiana.
Jazyk: angličtina
Zdroj: Open forum infectious diseases [Open Forum Infect Dis] 2019 Feb 19; Vol. 6 (3), pp. ofz087. Date of Electronic Publication: 2019 Feb 19 (Print Publication: 2019).
DOI: 10.1093/ofid/ofz087
Abstrakt: Background: Hepatitis C remains a major cause of liver disease globally and is responsible for approximately 500 000 deaths annually. Newer direct-acting antivirals achieve cure rates at or above 90% with excellent tolerability for most patients. The literature focusing on identification of predictors of efficacy and safety with specific hepatitis C therapies has been inconclusive and often conflicting.
Methods: A retrospective, single-center, case-control analysis of all veteran patients aged ≥18 through ≤89 years who completed a treatment course of 8, 12, or 24 weeks with ledipasvir and sofosbuvir (LDV/SOF) combination therapy for hepatitis C infection was conducted. Patients who were identified and met inclusion criteria were assigned to either the case group (SVR12 failure; hepatitis C viral load detectable at least 11 weeks after therapy completion) or the control group (SVR12 success; hepatitis C viral load undetectable at least 11 weeks after therapy completion).
Results: Twenty-nine SVR12 failures and 411 SVR12 successes were included in the analysis. The overall failure rate was consistent with the current literature, at 6.6% (29/440). Bivariate analysis identified only baseline creatinine clearance >80 mL min-1 (Cockcroft-Gault) as a possible predictor of SVR12 failure ( P = .026). In the multivariate analysis, pretreatment creatinine clearance >80 mL min-1 remained independently associated with SVR12 failure (odds ratio, 2.95; 95% confidence interval, 1.17-7.46; P = .023).
Conclusions: In hepatitis C patients treated with LDV/SOF, a pretreatment creatinine clearance of >80 mL min-1 was associated with SVR12 failure.
Databáze: MEDLINE
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