Direct antiviral drugs in the treatment of hepatitis C-infected rheumatoid arthritis Egyptian cohort: safety and clinical impact.
| Autor: | Lashen SA; Department of Internal Medicine, Hepatology and Gastroenterology Division., Metawea MI; Department of Internal Medicine, Hepatology and Gastroenterology Division., Shaaban A; Department of Internal Medicine, Rheumatology and Immunology Division, University of Alexandria, Alexandria, Egypt. |
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| Jazyk: | angličtina |
| Zdroj: | European journal of gastroenterology & hepatology [Eur J Gastroenterol Hepatol] 2021 Dec 01; Vol. 33 (1S Suppl 1), pp. e239-e246. |
| DOI: | 10.1097/MEG.0000000000002015 |
| Abstrakt: | Background and Aim: Data about the safety and efficacy of direct-acting antivirals (DAAs) in the treatment of hepatitis C virus (HCV) patients with concomitant rheumatoid arthritis (RA) are scarce. We assessed the impact and safety of DAAs treatment of hepatitis C on rheumatoid arthritis disease activity. Patients and Methods: Prospectively, we enrolled 65 patients with RA and HCV. A clinico-laboratory evaluation was done at baseline, including liver assessment and RA disease activity score-28 (DAS28). At 12 weeks of post-DAAs treatment, sustained virologic response (SVR12) and DAS28 were reevaluated. Results: The SVR12 was achieved in 59 (90.8%) patients. RA control was achieved in 47 (79.9%) patients. The post SVR12 DAS28 score was significantly lower than the baseline (3.32 ± 0.93 vs. 4.37 ± 0.90; P < 0.001). There was a significant decline in the mean values of serum anticyclic citrullinated peptide, rheumatoid factor, erythrocyte sedimentation rate and C-reactive protein after achieving an SVR12 (30.47 ± 12.37 vs. 57.61 ± 15.91 U/ml; 29.78 ± 19.58 vs. 55.14 ± 16.89 IU/ml; 17.13 ± 10.84 vs. 29.68 ± 14.32 mm/h and 5.76 ± 1.57 vs. 11.44 ± 4.13 mg/l, respectively; P < 0.05). RA activity and antirheumatic drugs were stepped-down [12 (20.3%) and 35 (59.3%) patients showed good and moderate RA response, respectively]. The baseline viral load, absence of cirrhosis and SVR12 were the only predictors of disease control (P < 0.05). No drug-related adverse events or drug-related discontinuation. Conclusions: Unlike interferon, HCV elimination by DAAs significantly improves RA activity and treatment outcome with high safety and efficacy. (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.) |
| Databáze: | MEDLINE |
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