Interferon-free treatments in patients with hepatitis C genotype 1-4 infections in a real-world setting

Ramos, Huascar; Linares, Pedro; Badía, Ester; Martín, I. Concepción; Gómez, Judith; Almohalla, C.; Jorquera, Francisco; Calvo, Sara; García, I.; Conde, P.; Álvarez, B Magalys De la Caridad; Karpman, G.; Lorenzo, Sara Di; Gozalo, V.; Vasquez, Monica M.; Joao, Diana; Benito, Marina de; Ruiz, Lourdes; Jiménez, Felipe Piñol; Sáez-Royuela, F; Hepatología, Asociación Castellano y Leonesa de

doi:10.4292/wjgpt.v8.i2.137

Cited by 19 publications

(13 citation statements)

References 29 publications

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“…1 ). Overall, SVR rates for SOF/DCV ± RBV and SOF/SIM ± RBV during 12 weeks ranged from 83 to 98% [ 16 , 17 ] and from 75 to 96% [ 18 – 29 ], respectively. SVR rates were lower in presence of cirrhosis compared to non-cirrhotic patients (87% vs 98% with SOF/DCV [ 17 ] and 81% vs 91% with SOF/SIM [ 26 ].…”

Section: Resultsmentioning

confidence: 99%

Micro-costing analysis of guideline-based treatment by direct-acting agents: the real-life case of hepatitis C management in Brazil

et al. 2017

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BackgroundEradication of hepatitis C virus (HCV) using direct-acting agents (DAA) has been associated with a financial burden to health authorities worldwide. We aimed to evaluate the guideline-based treatment costs by DAAs from the perspective of the Brazilian Ministry of Health (BMoH).MethodsThe activity based costing method was used to estimate the cost for monitoring/treatment of genotype-1 (GT1) HCV patients by the following strategies: peg-interferon (PEG-IFN)/ribavirin (RBV) for 48 weeks, PEG-IFN/RBV plus boceprevir (BOC) or telaprevir (TEL) for 48 weeks, and sofosbuvir (SOF) plus daclastavir (DCV) or simeprevir (SIM) for 12 weeks. Costs were reported in United States Dollars without (US$) and with adjustment for purchasing power parity (PPP$). Drug costs were collected at the National Database of Health Prices and an overview of the literature was performed to assess effectiveness of SOF/DCV and SOF/SIM regimens in real-world cohorts.ResultsTreatment costs of GT1-HCV patients were PPP$ 43,176.28 (US$ 24,020.16) for PEG-IFN/RBV, PPP$ 71,196.03 (US$ 39,578.23) for PEG-IFN/RBV/BOC and PPP$ 86,250.33 (US$ 47,946.92) for PEG-IFN/RBV/TEL. Treatment by all-oral interferon-free regimens were the less expensive approach: PPP$ 19,761.72 (US$ 10,985.90) for SOF/DCV and PPP$ 21,590.91 (US$ 12,002.75) for SOF/SIM. The overview reported HCV eradication in up to 98% for SOF/DCV and 96% for SOF/SIM.ConclusionStrategies with all oral interferon-free might lead to lower costs for management of GT1-HCV patients compared to IFN-based regimens in Brazil. This occurred mainly because of high discounts over international DAA prices due to negotiation between BMoH and pharmaceutical industries.Electronic supplementary materialThe online version of this article (10.1186/s12876-017-0676-8) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Micro-costing analysis of guideline-based treatment by direct-acting agents: the real-life case of hepatitis C management in Brazil

et al. 2017

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“…However, when stratified by eras, the higher waitlist mortality was noted only in the pre‐DAA era and not in the post‐DAA era. This observation is likely attributable to the advent of DAA therapies and corresponds to the relationship between increased success of SVR with DAA therapy and the correlation between SVR and improved mortality for chronic HCV patients …”

Section: Discussionmentioning

confidence: 99%

“…Although protease inhibitors such as boceprevir and telaprevir improved overall SVR rates, use of these medications was limited due to drug‐drug interactions and direct drug toxicity . Sofosbuvir, a second‐generation DAA, targets NS5B and was approved by the FDA in December 2013, and initial clinical trials showed 90% of treatment naïve patients achieved SVR when combined with interferon and ribavirin among patients with genotype 1, and 93%‐100% over genotypes 1‐4 when sofosbuvir was combined with protease inhibitors …”

Section: Introductionmentioning

confidence: 99%

“…3 Sofosbuvir, a second-generation DAA, targets NS5B and was approved by the FDA in December 2013, and initial clinical trials showed 90% of treatment naïve patients achieved SVR when combined with interferon and ribavirin among patients with genotype 1, 4 and 93%-100% over genotypes 1-4 when sofosbuvir was combined with protease inhibitors. 5 Achieving SVR is associated with decreased HCV-related liver failure, HCC, mortality and need for LT and has been demonstrated with both interferon therapy and DAAs. 6,7 Studies have also shown that SVR can also lead to regression of fibrosis.…”

Section: Introductionmentioning

confidence: 99%

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Improved liver transplant waitlist mortality and lower risk of disease progression among chronic hepatitis C patients awaiting liver transplantation after the introduction of direct‐acting antiviral therapies in the United States

Young

Liu

Bhuket

et al. 2018

Journal of Viral Hepatitis

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Summary Direct‐acting antiviral (DAA) therapies for chronic hepatitis C virus (HCV) infection achieve high cure rates, reducing HCV‐related disease progression to cirrhosis and hepatocellular carcinoma. We aim to evaluate the impact of DAAs on US liver transplant (LT) waitlist outcomes. We retrospectively evaluated US adults (age ≥18) with and without chronic HCV listed for LT before and after the widespread use of sofosbuvir, allowing a 6‐month period after approval (Era 1: 1/1/2002‐5/31/2014 vs Era 2: 6/1/2014‐12/31/2016) using the United Network for Organ Sharing registry. Overall, LT waitlist survival and likelihood of receiving LT were evaluated with multivariate Cox regression models. From 2002 to 2016, 158 045 patients were listed for LT. While the number of patients listed for HCV has been decreasing since 2012, the proportion of HCV patients with concurrent HCC is increasing by 3.33% per year (R2: 0.99, P < 0.001 by simple linear regression). While there was no difference in likelihood of LT between HCV and non‐HCV patients, those listed in Era 2 had lower likelihood of LT (HR: 0.91, P < 0.001), more pronounced in the HCV cohort (HR: 0.83, P < 0.001) compared to the non‐HCV cohort (HR: 0.93, P < 0.001). Compared to non‐HCV patients, higher waitlist mortality was seen in HCV patients in Era 1 (HR: 1.08, P < 0.001) but not in Era 2 (HR: 1.02, P = 0.75). Since the introduction of DAAs for HCV treatment, number of patients with HCV listed for LT has declined. In the post‐DAA era, HCV patients on the LT waitlist had improved waitlist mortality.

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“…Lower liver stiffness (assessed during treatment at week 4, and after treatment at week 12) was associated with the achievement of sustained virological response in a large observational study (that included 462 patients treated with interferonfree regimen for chronic hepatitis C with viral genotype 1-4) [53].…”

Section: The Liver Stiffness After Treatmentmentioning

confidence: 99%

Liver stiffness in chronic hepatitis C virus infection

Mihăilă

2019

Romanian Journal of Internal Medicine

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Introduction. The severity of liver fibrosis can be assessed noninvasively today by liver stiffness measurements. Vibration-controlled transient elastography, shear wave elastography or magnetic resonance elastography are techniques increasingly used for this purpose. Methods. This article presents the recent advances in the use of new techniques for liver fibrosis assessment in chronic hepatitis C: the correlation between liver stiffness values and liver fibrosis estimated by liver biopsies, the prognosis role of liver stiffness values, their usefulness in monitoring the treatment response, in assessing the severity of portal hypertension and in estimating the presence of esophageal varices. Scientific articles from January 2017 to January 2018 were searched in PubMed and PubMed Central databases, using the terms “liver stiffness” and “hepatitis C”. Results. The median liver stiffness values measured with different techniques are not identical, so that FibroScan thresholds cannot be used on any other elastographic machine. The higher the liver’s stiffness measurement, the higher the liver-related events in patients with chronic hepatitis C. A liver stiffness measurement over 17 kPa could be an independent predictor for the presence of esophageal varices as well as a spleen with a longitudinal span ≥ 15 cm for patients with a value of liver stiffness < 17 kPa. A progressive and persistent decrease in liver stiffness is dependent on sustained virological response achievement. The lack of liver stiffness decrease has been associated with relapsers and a low value of liver stiffness at baseline. Conclusion. Liver stiffness provides clues about the severity and evolution of liver disease.

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Interferon-free treatments in patients with hepatitis C genotype 1-4 infections in a real-world setting

Cited by 19 publications

References 29 publications

Micro-costing analysis of guideline-based treatment by direct-acting agents: the real-life case of hepatitis C management in Brazil

Micro-costing analysis of guideline-based treatment by direct-acting agents: the real-life case of hepatitis C management in Brazil

Improved liver transplant waitlist mortality and lower risk of disease progression among chronic hepatitis C patients awaiting liver transplantation after the introduction of direct‐acting antiviral therapies in the United States

Liver stiffness in chronic hepatitis C virus infection

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