English hepatitis C registry data show high response rates to directly acting anti-virals, even if treatment is not completed.
Adolescent
Adult
Aged
Aged, 80 and over
Anilides
/ therapeutic use
Antiviral Agents
/ therapeutic use
Benzimidazoles
/ therapeutic use
Benzofurans
/ therapeutic use
Carbamates
/ therapeutic use
Cyclopropanes
Drug Combinations
England
Female
Fluorenes
/ therapeutic use
Hepatitis C
/ drug therapy
Humans
Imidazoles
/ therapeutic use
Lactams, Macrocyclic
Macrocyclic Compounds
/ therapeutic use
Male
Middle Aged
Proline
/ analogs & derivatives
Quinoxalines
/ therapeutic use
Registries
Ribavirin
/ therapeutic use
Sofosbuvir
Sulfonamides
Sustained Virologic Response
Uridine Monophosphate
/ analogs & derivatives
Valine
Young Adult
Journal
Alimentary pharmacology & therapeutics
ISSN: 1365-2036
Titre abrégé: Aliment Pharmacol Ther
Pays: England
ID NLM: 8707234
Informations de publication
Date de publication:
07 2020
07 2020
Historique:
received:
04
10
2019
revised:
31
10
2019
accepted:
17
04
2020
pubmed:
23
5
2020
medline:
23
10
2020
entrez:
23
5
2020
Statut:
ppublish
Résumé
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. To evaluate efficacy of directly acting anti-viral treatments for hepatitis C in England using real-world data from the national treatment registry. 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. 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%. 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.
Sections du résumé
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.
Substances chimiques
Anilides
0
Antiviral Agents
0
Benzimidazoles
0
Benzofurans
0
Carbamates
0
Cyclopropanes
0
Drug Combinations
0
Fluorenes
0
Imidazoles
0
Lactams, Macrocyclic
0
Macrocyclic Compounds
0
Quinoxalines
0
Sulfonamides
0
elbasvir-grazoprevir drug combination
0
ledipasvir, sofosbuvir drug combination
0
ombitasvir
2302768XJ8
Ribavirin
49717AWG6K
Proline
9DLQ4CIU6V
Uridine Monophosphate
E2OU15WN0N
Valine
HG18B9YRS7
paritaprevir
OU2YM37K86
Sofosbuvir
WJ6CA3ZU8B
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
168-181Informations de copyright
© 2020 The Authors. Alimentary Pharmacology & Therapeutics published by John Wiley & Sons Ltd.
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