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接受新型直接抗病毒药物治疗的慢性丙型肝炎患者的皮肤不良事件:一项系统评价和荟萃分析。

Cutaneous Adverse Events in Chronic Hepatitis C Patients Treated With New Direct-Acting Antivirals: A Systematic Review and Meta-Analysis.

作者信息

Patel Parth, Malik Kunal, Krishnamurthy Karthik

机构信息

Department of Medicine, Division of Dermatology, Albert Einstein College of Medicine, Bronx, NY, USA.

College of Medicine, SUNY Downstate Medical Center, Brooklyn, NY, USA.

出版信息

J Cutan Med Surg. 2016 Jan;20(1):58-66. doi: 10.1177/1203475415595775. Epub 2015 Jul 10.

Abstract

BACKGROUND

Direct-acting antivirals (DAAs) are known to present with additional dermatological events over pegylated-interferon/ribavirin (Peg-IFN/RBV).

OBJECTIVE

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.

METHODS

The databases searched included PubMed, Clinicaltrials.gov, and Clinicaloptions.com. Data on telaprevir and boceprevir were obtained from a previous study.

RESULTS

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).

CONCLUSION

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.

摘要

背景

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。

目的

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。

方法

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。

结果

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)。

结论

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。

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