English hepatitis C registry data show high response rates to directly acting anti-virals, even if treatment is not completed

Autor: David Mutimer, Yevedzo Ntuli, Ahmed M. El-Sharkawy, William Gelson, Kosh Agarwal, Ceri Townley, Daniel M. Forton, Kathryn Drysdale, Graham R. Foster, Faizel Mahomed, Jonathan P. Bestwick
Rok vydání: 2020
Předmět:
Cyclopropanes
Male
Sustained Virologic Response
Sofosbuvir
chemistry.chemical_compound
0302 clinical medicine
Medicine
Anilides
Pharmacology (medical)
Registries
030212 general & internal medicine
Young adult
Aged
80 and over
Sulfonamides
Imidazoles
Gastroenterology
Valine
Anti virals
Hepatitis C
Middle Aged
Drug Combinations
England
Grazoprevir
Female
030211 gastroenterology & hepatology
Registry data
Uridine Monophosphate
medicine.drug
Adult
Ledipasvir
medicine.medical_specialty
Elbasvir
Macrocyclic Compounds
Adolescent
Proline
Lactams
Macrocyclic
Antiviral Agents
Young Adult
03 medical and health sciences
Quinoxalines
Internal medicine
Ribavirin
Humans
Aged
Benzofurans
Fluorenes
Hepatology
business.industry
medicine.disease
digestive system diseases
chemistry
Benzimidazoles
Carbamates
business
Zdroj: Alimentary Pharmacology & Therapeutics. 52:168-181
ISSN: 0269-2813
DOI: 10.1111/apt.15780
Popis: Background In England, choice of hepatitis C therapy is determined by national contracts that change with time, facilitating comparisons between different regimens. England has a diverse population with hepatitis C including large proportions of uncommon viral genotypes. Aim To evaluate efficacy of directly acting anti-viral treatments for hepatitis C in England using real-world data from the national treatment registry. Methods Sustained virological response (SVR) rates 12 weeks after treatment completion for patients treated between 2014 and August 2018 who attended for SVR tests were analysed in univariate subgroups using Chi-squared tests. Multivariate models were constructed with clinically relevant variables to determine predictors of SVR and evaluate the impact of treatment regimens. Results SVR data were available on 14,603 treated patients. The overall SVR rate was 95.59% [95% CI 95.25%-95.91%]. Multivariable regression modelling in patients with genotype 1 infection showed that the odds of SVR with elbasvir/grazoprevir were higher than for those treated with sofosbuvir/ledipasvir (OR 1.891, 95% CI 1.072-3.336, P = 0.028). For genotype 3, we found no significant difference between any of the treatment regimens. Patients who completed at least one third of the planned treatment duration achieved SVR rates in excess of 80%. Conclusions All of the currently licensed hepatitis C direct-acting anti-viral regimens had similar efficacy (>95%) in an unselected population. Noncompletion of planned treatment duration still resulted in over 80% SVR rates provided that more than one third of treatment was completed.
Databáze: OpenAIRE
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