Efficacy and Safety of Sofosbuvir Plus Daclatasvir for Treatment of HCV-Associated Cryoglobulinemia Vasculitis

Saadoun, David; Pol, Stanislas; Ferfar, Yasmina; Alric, Laurent; Hézode, Christophe; Ahmed, Si Nafa Si; Martin, Luc de Saint; Comarmond, Cloé; Bouyer, Anne Sophie; Musset, Lucile; Poynard, Thierry; Resche-Rigon, Matthieu; Cacoub, Patrice

doi:10.1053/j.gastro.2017.03.006

Cited by 141 publications

(138 citation statements)

References 20 publications

Supporting

Mentioning

122

Contrasting

Unclassified

Order By: Relevance

“…Several centers have published their experience with novel DAA therapies in HCV‐MCS, including agents such as sofosbuvir, simeprevir, daclatasvir, ledipasvir, asunaprevir, dasabuvir, pariteprevir, and ombitasvir (Table ). Studies demonstrate that DAA regimens achieve SVR in 95% (297 out of 313) of patients with HCV‐MCS, which is similar to cure rates in the general population with HCV . There are currently no reports of HCV‐MCS treated with more recently approved DAAs, such as sofosbuvir/velpatasvir/voxilaprevir, elbasvir/grazoprevir, glecaprevir/pibrentasvir, or sofosbuvir/velpatasvir, but there is no reason to think that these agents would be less effective in HCV‐MCS.…”

Section: Direct‐acting Antiviral Treatment In Mixed Cryoglobulinemia mentioning

confidence: 95%

“…Symptoms such as myalgia, arthralgia, purpura, and skin ulcers were the most likely to respond with typical response rates of 75%–100% and often a rapid improvement in skin manifestations. Peripheral neuropathy and renal manifestations had lower rates of complete resolution (ranging from 30% to 70%) …”

Section: Direct‐acting Antiviral Treatment In Mixed Cryoglobulinemia mentioning

confidence: 99%

See 1 more Smart Citation

Treatment of hepatitis C virus infection in patients with mixed cryoglobulinemic syndrome and cryoglobulinemic glomerulonephritis

Rutledge

Chung

Sise

2018

Hemodialysis International

View full text Add to dashboard Cite

Cryoglobulinemia is a common extrahepatic manifestation of infection with hepatitis C virus (HCV). When signs and symptoms of systemic vasculitis or glomerulonephritis occur in the presence of circulating cryoglobulins, this syndrome is called "mixed cryoglobulinemia syndrome" (MCS). Historically, interferon-based therapies in HCV have been associated with lower rates of viral cure in patients with MCS than in the general HCV-infected population. The advent of direct-acting antiviral therapies have revolutionized the treatment of HCV, dramatically increasing rates of cure. Early studies of first-generation protease inhibitors (telaprevir and boceprevir) in combination with interferon and ribavirin demonstrated HCV cure rates of 67% and complete clinical response rates of vasculitis symptoms in 60% of patients with MCS; however, regimens were poorly tolerated by patients, 22% discontinued treatment early. More recently, all-oral, interferon-free regimens have become available and combination therapies are now being approved for patients with and without renal impairment. Patients with HCV-MCS achieved sustained virologic response in 297 out of 313 patients (95%) treated with direct-acting antiviral therapy, and 85% had a complete or partial clinical response of MCS symptoms. Current direct-acting antiviral therapies are well tolerated in patients with HCV-MCS and only 1.6% discontinued treatment early. Patients with cryoglobulinemic glomerulonephritis also had an excellent cure rate (94%). The majority improved; 17/52 (33%) experienced full remission and 15/52 (29%) experienced partial remission. There were no reports of worsening kidney function in patients treated with direct-acting antiviral therapies. Less than 5% of patients with HCV-MCS treated with IFN-free direct-acting antiviral therapy required immunosuppression. However, patients with severe vasculitis appear to still require concomitant immunosuppression.

show abstract

Section: Direct‐acting Antiviral Treatment In Mixed Cryoglobulinemia mentioning

confidence: 95%

Section: Direct‐acting Antiviral Treatment In Mixed Cryoglobulinemia mentioning

confidence: 99%

Treatment of hepatitis C virus infection in patients with mixed cryoglobulinemic syndrome and cryoglobulinemic glomerulonephritis

Rutledge

Chung

Sise

2018

Hemodialysis International

View full text Add to dashboard Cite

show abstract

“…With the caveat that follow-up time for DAA-treated patients is still limited, evidence is accumulating that SVR may be associated with fibrosis regression (25), improvement in portal pressures (26, 27), improvement in extrahepatic manifestations of HCV (28, 29), and reduced risk of mortality (30, 31). However, enthusiasm for DAAs was tempered after a series of publications reported potentially higher than expected rates of HCC following DAA treatment.…”

Section: Daa Treatment and De Novo Hccmentioning

confidence: 99%

The Impact of Direct-acting Antiviral Therapy for Hepatitis C on Hepatocellular Carcinoma Risk

Ioannou

2018

Curr Hepatology Rep

View full text Add to dashboard Cite

Purpose of review Direct-acting antiviral agents (DAAs) eradicate hepatitis C virus (HCV) infection in the majority of patients. We critically evaluated the impact of DAAs on hepatocellular carcinoma (HCC) risk, a major complication of HCV infection. Recent findings Large cohort studies show that patients who achieve sustained virologic response (SVR) with DAAs have a significantly lower risk of developing de novo HCC than patients who fail treatment or remain untreated. Furthermore, reduction in HCC risk is similar whether SVR is achieved with DAAs or interferon (IFN). However, DAA-induced SVR does not eliminate HCC risk entirely. Therefore, patients with pre-existing cirrhosis require ongoing surveillance even after SVR is achieved. Early, descriptive, uncontrolled reports suggested that DAAs may increase the risk of recurrent HCC. While studying HCC recurrence presents major methodologic challenges, larger studies containing appropriate comparison control groups largely refuted these concerns. Summary Recent studies provide evidence that DAA-induced SVR reduces HCC risk.

show abstract

“…We were reluctant to use these agents in our patient because of a history of squamous cell carcinoma of the glottis. This case shows that it is now possible to treat the acute form of this glomerulonephritis successfully, at least in the short term, with the newer anti‐viral agents alone . The long‐term outcome remains unclear given the persisting cryoglobulinaemia and microscopic haematuria.…”

mentioning

confidence: 97%

Successful treatment of HCV‐related glomerulonephritis with sofosbuvir and daclatasvir

et al. 2018

View full text Add to dashboard Cite

Efficacy and Safety of Sofosbuvir Plus Daclatasvir for Treatment of HCV-Associated Cryoglobulinemia Vasculitis

Cited by 141 publications

References 20 publications

Treatment of hepatitis C virus infection in patients with mixed cryoglobulinemic syndrome and cryoglobulinemic glomerulonephritis

Treatment of hepatitis C virus infection in patients with mixed cryoglobulinemic syndrome and cryoglobulinemic glomerulonephritis

The Impact of Direct-acting Antiviral Therapy for Hepatitis C on Hepatocellular Carcinoma Risk

Successful treatment of HCV‐related glomerulonephritis with sofosbuvir and daclatasvir

Contact Info

Product

Resources

About