Multiple Factors Predict Physical Performance in People with Chronic Liver Disease

Loria, Anthony; Doyle, Katherine; Weinstein, Ali A.; Winter, Patrice; Escheik, Carey; Price, Jillian Kallman; Wang, Lei; Birerdinc, Aybike; Baranova, Ancha; Gerber, Lynn H.; Younossi, Zobair M.

doi:10.1097/phm.0000000000000050

Cited by 20 publications

(26 citation statements)

References 44 publications

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“…Chronic hepatitis C continues to be the most common cause of cirrhosis and its complications (e.g., hepatocellular carcinoma) in the United States and the Western world. It is associated with substantially greater mortality and resource utilization, and there is extensive evidence that the hepatitis C virus (HCV) affects not only clinical outcomes such as liver‐related mortality, but also patient‐reported outcomes (PROs) such as health‐related quality of life (HRQL) . This is of utmost importance in the baby boomers, born between 1945 and 1965, and data from the U.S. Centers for Disease Control and Prevention (CDC) suggest that these baby boomers have the highest prevalence of HCV in the United States .…”

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confidence: 99%

“…One argument against treating older adults with chronic hepatitis C with pegylated IFN and ribavirin (RBV) was low efficacy and severe side effects, resulting in poor treatment tolerability of this regimen . Although IFN‐based anti‐HCV treatment has numerous side effects in all people regardless of age, the negative effect of IFN on HRQL was even more substantial in older adults, leading to the recommendation against treatment by most clinicians …”

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confidence: 99%

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Patient‐Reported Outcomes of Elderly Adults with Chronic Hepatitis C Treated with Interferon‐ and Ribavirin‐Free Regimens

Younossi

Stepanova

Nader

et al. 2016

J American Geriatrics Society

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The purpose of the study was to assess the effect of different treatment regimens for chronic hepatitis C on patient-reported outcomes (PROs) of individuals aged 65 and older with chronic hepatitis C. PRO data from eight multinational multicenter Phase 2 and 3 clinical trials were included. Of 3,120 participants in these clinical trials, 229 were aged 65 and older (67.8 ± 3.2, 57% male, 75% treatment-naïve, 22% cirrhotic), and 90 of those received ledipasvir plus sofosbuvir (LDV + SOF), 119 received SOF plus ribavirin (SOF + RBV), and 20 received pegylated IFN, SOF, and RBV (IFN + SOF + RBV). Participants aged 65 and older had slightly more pretreatment PRO impairment in their physical functioning than younger individuals (-3.1% on a normalized 0-100% PRO scale, P < .001). Despite this, these participants experienced significant PRO improvement during treatment with IFN-free RBV-free regimens (up to +8.0%, P < .001), similar to improvements in younger participants. In contrast, participants aged 65 and older experienced substantial decline in PROs while receiving IFN- or RBV-containing regimens (up to -18.9% in IFN + SOF + RBV, -10.4% in IFN-free SOF+RBV, P < .001), and some were greater than in the younger group. Nevertheless, after achieving sustained viral clearance at Posttreatment Week 12, PROs in participants aged 65 and older improved regardless of the regimen (up to +10.4%, P < .001). In multivariate analysis of the cohort aged 65 and older, the use of IFN and RBV was consistently associated with PRO impairment during treatment. The use of an IFN- and RBV-free anti-HCV regimen in older adults with hepatitis C results in significant improvement of PROs.

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confidence: 99%

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confidence: 99%

Patient‐Reported Outcomes of Elderly Adults with Chronic Hepatitis C Treated with Interferon‐ and Ribavirin‐Free Regimens

Younossi

Stepanova

Nader

et al. 2016

J American Geriatrics Society

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“…Impairment in HRQOL in patients with chronic HCV infection is mainly driven by fatigue, insomnia, anxiety, and depression which are prevalent comorbid conditions, and may also affect adherence to antiviral treatment [152]. It is well known that in patients treated with peg-IFN and ribavirin show a decrease in both physical and mental component summary scores at the end of treatment (all p < 0.05), which reverts at the end of follow-up [153].…”

Section: Quality Of Life In Hcv+ Patients and Role Of Curementioning

confidence: 98%

Current and future challenges in HCV: insights from an Italian experts panel

et al. 2017

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“…Therefore, through the use of PRO instruments, clinical investigators have been able to establish that patients with HCV infection experience tremendous impairment in their health related quality of life (HRQOL) and well-being, especially in the domains of physical functioning, mental health, and work productivity as a result of the virus itself [64][65][66][67][68][69][70][71][72][73][75][76][77][78][79][80]. Additionally, multivariate analyses have determined that disease severity (presence of advanced liver disease), and psychiatric co-morbidities, especially depression, are important drivers of PRO impairment [67,75,76,78].…”

Section: Patient Reported Outcomes Related To Hcv Infectionmentioning

confidence: 99%

“…Additionally, multivariate analyses have determined that disease severity (presence of advanced liver disease), and psychiatric co-morbidities, especially depression, are important drivers of PRO impairment [67,75,76,78]. It is important to recognize that, in a similar fashion that the clinical outcomes are considered the surrogate markers of survival, and PROs are important surrogate markers of patient experience [81].…”

Section: Patient Reported Outcomes Related To Hcv Infectionmentioning

confidence: 99%

Hepatitis C infection: A multi-faceted systemic disease with clinical, patient reported and economic consequences

Younossi

Birerdinc

Henry

2016

Journal of Hepatology

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Hepatitis C virus infection (HCV) affects approximately 170-200 million individuals globally. HCV is one of the primary causes of hepatocellular carcinoma (HCC) and cirrhosis and has been identified as the leading indication for liver transplantation in most Western countries. Because HCV is a systemic disease with hepatic, extrahepatic, economic and patient reported consequences, it is important for healthcare practitioners to understand the comprehensive and multi-faceted picture of this disease. In this context, it is important to fully appreciate the impact of HCV on the individual patient and the society. With the recent advent of the new generation of direct antiviral agents, the long standing goal of eradicating HCV in most infected patients has been accomplished. Therefore, now more than ever, it is critical to assess the total benefits of sustained virological response in a comprehensive manner. This should not be limited to the clinical benefits of HCV cure, but also to account for the improvement of patient reported health and economic outcomes of HCV cure. It is only through this comprehensive approach to HCV and its treatment that we will understand the full impact of this disease and the tremendous gains that have been achieved with the new antiviral regimens.

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Multiple Factors Predict Physical Performance in People with Chronic Liver Disease

Cited by 20 publications

References 44 publications

Patient‐Reported Outcomes of Elderly Adults with Chronic Hepatitis C Treated with Interferon‐ and Ribavirin‐Free Regimens

Patient‐Reported Outcomes of Elderly Adults with Chronic Hepatitis C Treated with Interferon‐ and Ribavirin‐Free Regimens

Current and future challenges in HCV: insights from an Italian experts panel

Hepatitis C infection: A multi-faceted systemic disease with clinical, patient reported and economic consequences

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