Safety, efficacy and cost of two direct-acting antiviral regimens: A comparative study in chronic hepatitis C Egyptian patients.

Autor: Ibrahim Mohammed Ebid AH; Department of Pharmacy Practice, Faculty of Pharmacy, Helwan University, Cairo, Egypt., Ashraf Ahmed O; Department of Internal Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt., Hassan Agwa S; Department of Clinical & Chemical Pathology at MASRI, Faculty of Medicine, Ain Shams University, Cairo, Egypt., Mohamed Abdel-Motaleb S; Department of Pharmacy Practice, Faculty of Pharmacy, Helwan University, Cairo, Egypt., Mohamed Elsawy A; Department of Pharmacy Practice, Faculty of Pharmacy, Helwan University, Cairo, Egypt., Hagag RS; Department of Pharmacy Practice, Faculty of Pharmacy, Egyptian Russian University, Badr City, Egypt.
Jazyk: angličtina
Zdroj: Journal of clinical pharmacy and therapeutics [J Clin Pharm Ther] 2020 Jun; Vol. 45 (3), pp. 539-546. Date of Electronic Publication: 2019 Dec 31.
DOI: 10.1111/jcpt.13104
Abstrakt: What Is Known and Objective: Direct-acting antivirals (DAAs) have become the most widely used treatment of chronic hepatitis C infection. Comparative studies on DAAs regimens approved by the Egyptian Ministry of Health for easy-to-treat genotype 4 (G4) Egyptian patients are still deficient. In this prospective study, we compared the efficacy and cost of two DAA regimens that are used in the treatment of Egyptian chronic hepatitis C virus (HCV) G4. The cost-saving regimen is determined.
Methods: Eligible patients were randomized into 2 groups. Group 1 (Gp 1) received sofosbuvir plus daclatasvir, and group 2 (Gp 2) received ombitasvir, paritaprevir and ritonavir plus ribavirin (RBV) for 12 weeks. Data were collected and evaluated at baseline and at weeks 4, 8 and 12. Sustained virologic response 12 weeks after the end of treatment (SVR 12 ) was evaluated. Cost-minimization analysis (CMA) was performed.
Results and Discussion: Eligibility was achieved in 107 patients, Gp1 included 57 patients, and Gp 2 included 50 patients. Two patients dropped out from Gp 2 due to non-compliance. All patients in the two groups showed negative HCV blood levels at the end of treatment. At the 24th week, 3 relapsers (5.2%) were detected in Gp1 and 2 relapsers (4.1%) were detected in Gp 2. SVR 12 was 54/57 (94.7%) and 46/48 (95.8%) for Gp 1 and Gp 2, respectively. After the 12th week of treatment, a significant decrease in aspartate aminotransferase (AST), alanine aminotransferase (ALT) and haemoglobin levels were observed in both groups. Albumin levels declined in Gp 2 only. CMA showed higher cost in Gp 2 than Gp 1, although similar efficacy and safety.
What Is New and Conclusion: The two DAA regimens showed high SVR 12 and safety in Egyptian HCV G4 patients. Sofosbuvir plus daclatasvir is the cost-saving regimen.
(© 2019 John Wiley & Sons Ltd.)
Databáze: MEDLINE
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