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索非布韦联合利巴韦林用于印度初治的慢性丙型肝炎病毒1型或3型感染患者

Sofosbuvir plus ribavirin in treatment-naïve patients with chronic hepatitis C virus genotype 1 or 3 infection in India.

作者信息

Shah S R, Chowdhury A, Mehta R, Kapoor D, Duseja A, Koshy A, Shukla A, Sood A, Madan K, Sud R, Nijhawan S, Pawan R, Prasad M, Kersey K, Jiang D, Svarovskaia E, Doehle B, Kanwar B, Subramanian M, Acharya S K, Sarin S

机构信息

Global Hospitals, Mumbai, Maharashtra, India.

Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India.

出版信息

J Viral Hepat. 2017 May;24(5):371-379. doi: 10.1111/jvh.12654. Epub 2016 Dec 9.

Abstract

Until 2014, pegylated interferon plus ribavirin was the recommended standard of care for the treatment of chronic hepatitis C virus (HCV) infection in India. This open-label phase 3b study, conducted across 14 sites in India between 31 March 2014 and 30 November 2015, evaluated the efficacy and safety of sofosbuvir plus ribavirin therapy among treatment-naïve patients with chronic genotype 1 or 3 HCV infection. A total of 117 patients with genotype 1 or 3 HCV infection were randomized 1:1 to receive sofosbuvir 400 mg and weight-based ribavirin (1000 or 1200 mg) daily for 16 or 24 weeks. Among those with genotype 1 infection, the primary efficacy endpoint of sustained virologic response at 12 weeks post-treatment (SVR12) was reported in 90% (95% confidence intervals [CI], 73-98) and 96% (95% CI, 82-100) of patients following 16 and 24 weeks of treatment, respectively. For patients with genotype 3 infection, SVR12 rates were 100% (95% CI, 88-100) and 93% (95% CI, 78-99) after 16 and 24 weeks of therapy, respectively. Adverse events, most of which were mild or moderate in severity, occurred in 69% and 57% of patients receiving 16 and 24 weeks of treatment, respectively. The most common treatment-emergent adverse events were asthenia, headache and cough. Only one patient in the 24-week group discontinued treatment with sofosbuvir during this study. Overall, sofosbuvir plus ribavirin therapy achieved SVR12 rates ≥90% and was well tolerated among treatment-naïve patients with chronic genotype 1 or 3 HCV infection in India.

摘要

在2014年之前,聚乙二醇化干扰素联合利巴韦林是印度慢性丙型肝炎病毒(HCV)感染治疗的推荐标准治疗方案。这项开放标签的3b期研究于2014年3月31日至2015年11月30日在印度的14个地点进行,评估了索磷布韦联合利巴韦林疗法在初治的慢性基因1型或3型HCV感染患者中的疗效和安全性。共有117例基因1型或3型HCV感染患者按1:1随机分组,接受每日400毫克索磷布韦和基于体重的利巴韦林(1000或1200毫克)治疗16或24周。在基因1型感染患者中,治疗16周和24周后,分别有90%(95%置信区间[CI],73 - 98)和96%(95%CI,82 - 100)的患者达到治疗后12周持续病毒学应答(SVR12)这一主要疗效终点。对于基因3型感染患者,治疗16周和24周后的SVR12率分别为100%(95%CI,88 - 100)和93%(95%CI,78 - 99)。不良事件大多为轻度或中度,接受16周和24周治疗的患者中分别有69%和57%发生。最常见的治疗中出现的不良事件为乏力、头痛和咳嗽。在本研究中,24周治疗组只有1例患者停止索磷布韦治疗。总体而言,索磷布韦联合利巴韦林疗法在印度初治的慢性基因1型或3型HCV感染患者中实现了≥90%的SVR12率,且耐受性良好。

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