Hepatitis C therapy with grazoprevir/elbasvir and glecaprevir/pibrentasvir in patients with advanced chronic kidney disease: data from the German Hepatitis C-Registry (DHC-R)
| Autor: | Christine John, Claus Niederau, Renate Heyne, Albrecht Stoehr, Hartwig Klinker, Gerlinde Teuber, Johannes Wiegand, U Naumann, Yvonne Serfert, Thomas Berg, Stefan Zeuzem, German Hepatitis C-Registry, K. Stein |
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| Rok vydání: | 2020 |
| Předmět: |
Cyclopropanes
medicine.medical_specialty Elbasvir Aminoisobutyric Acids Pyrrolidines Genotype Proline Sustained Virologic Response Lactams Macrocyclic Renal function Hepacivirus Antiviral Agents Gastroenterology chemistry.chemical_compound Leucine Quinoxalines Internal medicine Ribavirin medicine Humans Prospective Studies Registries Renal Insufficiency Chronic Benzofurans Hepatitis Sulfonamides Hepatology business.industry Imidazoles Hepatitis C Glecaprevir Hepatitis C Chronic medicine.disease Amides Pibrentasvir chemistry Grazoprevir Benzimidazoles Drug Therapy Combination Carbamates business |
| Zdroj: | European Journal of Gastroenterology & Hepatology. 34:76-83 |
| ISSN: | 0954-691X |
| Popis: | Grazoprevir/elbasvir and glecaprevir/pibrentasvir (G/P) are the two preferred treatment options for patients with chronic hepatitis C virus (HCV) infection and a glomerular filtration rate (GFR)30 mL/min. Both therapies have been separately analyzed in different real-life cohorts; however, a direct comparison has not been performed so far. We, therefore, analyzed safety and effectiveness of both regimens in a concerted real-life population.The Germany Hepatitis C-Registry is a prospective national real-world registry. The analysis is based on 2773 patients with documented GFR at baseline treated with grazoprevir/elbasvir (N = 1041), grazoprevir/elbasvir + ribavirin (N = 53) and glecaprevir/pibrentasvir (N = 1679).A total of 93 patients with GFR30 mL/min were treated with grazoprevir/elbasvir (N = 56), grazoprevir/elbasvir + ribavirin (N = 4), and glecaprevir/pibrentasvir (N = 33). They suffered significantly more frequent from diabetes mellitus, hypertension, and coronary heart disease than individuals with GFR30 mL/min and showed the following baseline characteristics: 20.4, 55.9, 3.2, 12.9, and 5.3% were infected with HCV-genotypes 1a, 1b, 2, 3, and 4; 12.9% suffered from liver cirrhosis; 80.1% were treatment-naïve. Baseline characteristics except distribution of HCV-genotype 1b (n = 43/52 treated with grazoprevir/elbasvir) and sustained virologic response rates (SVR12) did not differ significantly between glecaprevir/pibrentasvir (SVR12: 100%) and grazoprevir/elbasvir (SVR12: 97.9%).Fatigue, headache, abdominal discomfort, and arthralgia were the most frequently reported adverse events without a statistical difference between grazoprevir/elbasvir and glecaprevir/pibrentasvir.In patients with chronic hepatitis C and a baseline GFR ≤30 mL/min grazoprevir/elbasvir and glecaprevir/pibrentasvir show an equally favorable safety profile and antiviral efficacy and can both be recommended for real-life use. |
| Databáze: | OpenAIRE |
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