Patel Parth, Malik Kunal, Krishnamurthy Karthik
Department of Medicine, Division of Dermatology, Albert Einstein College of Medicine, Bronx, NY, USA.
College of Medicine, SUNY Downstate Medical Center, Brooklyn, NY, USA.
J Cutan Med Surg. 2016 Jan;20(1):58-66. doi: 10.1177/1203475415595775. Epub 2015 Jul 10.
Direct-acting antivirals (DAAs) are known to present with additional dermatological events over pegylated-interferon/ribavirin (Peg-IFN/RBV).
A systematic review and meta-analysis was conducted to assess the incidence/risk of cutaneous adverse events (AEs) for simeprevir, sofosbuvir, ABT450/r-ombitasvir, dasabuvir, ledipasvir, daclatasvir, and asunaprevir.
The databases searched included PubMed, Clinicaltrials.gov, and Clinicaloptions.com. Data on telaprevir and boceprevir were obtained from a previous study.
The incidences of cutaneous AEs were 34.3% (95% CI 18.4%-54.8%) for the old DAAs + Peg-IFN/RBV, 22.0% (95% CI 17.9%-26.8%) for the new DAAs + Peg-IFN/RBV, 9.8% (95% CI 8.6%-11.2%) for the DAAs + RBV, and 3.8% (95% CI 2.4%-6.1%) for DAAs only. Simeprevir + Peg-IFN/RBV was associated with an increased relative risk over Peg-IFN/RBV; RR = 1.319 (95% CI 1.026-1.697).
Dermatological events are still an important issue for many of the new DAAs. Appropriate monitoring, management, and patient education are needed to minimize AEs and achieve HCV cure.
已知直接作用抗病毒药物(DAA)比聚乙二醇干扰素/利巴韦林(Peg-IFN/RBV)会出现更多皮肤相关事件。
进行一项系统评价和荟萃分析,以评估simeprevir、索磷布韦、ABT450/r-奥比他韦、达沙布韦、来迪帕司韦、达拉他韦和阿舒瑞韦发生皮肤不良事件(AE)的发生率/风险。
检索的数据库包括PubMed、Clinicaltrials.gov和Clinicaloptions.com。替拉瑞韦和博赛泼维的数据来自之前的一项研究。
旧的DAA + Peg-IFN/RBV皮肤AE的发生率为34.3%(95%CI 18.4%-54.8%),新的DAA + Peg-IFN/RBV为22.0%(95%CI 17.9%-26.8%),DAA + RBV为9.8%(95%CI 8.6%-11.2%),仅DAA为3.8%(95%CI 2.4%-6.1%)。与Peg-IFN/RBV相比,simeprevir + Peg-IFN/RBV的相对风险增加;RR = 1.319(95%CI 1.026-1.697)。
皮肤相关事件对许多新的DAA来说仍然是一个重要问题。需要进行适当的监测、管理和患者教育,以尽量减少AE并实现丙型肝炎病毒的治愈。