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老年人使用达卡他韦和阿舒瑞韦联合治疗的疗效与安全性

Efficacy and safety of dual therapy with daclatasvir and asunaprevir in elderly patients.

作者信息

Tarao Kazuo, Tanaka Katsuaki, Nozaki Akito, Sato Akira, Ishii Toshiya, Komatsu Hirokazu, Ikeda Takaaki, Komatsu Tatsuji, Matsushima Shozo, Oshige Kenji

机构信息

Kazuo Tarao, Tarao's Gastroenterological Clinic, Yokohama 241-0821, Japan.

出版信息

World J Hepatol. 2017 Apr 18;9(11):544-550. doi: 10.4254/wjh.v9.i11.544.

Abstract

AIM

To survey the efficacy and safety of dual therapy with daclatasvir and asunaprevir in the elderly hepatitis C virus (HCV) patients multicentricity.

METHODS

Interferon-ineligible/intolerant patients and non-responders to previous pegylated-interferon/ribavirin therapy with chronic HCV genotype 1b infection were enrolled. Child B, C cirrhotic patients were excluded. Patients received oral direct acting antiviral treatment consisting of 60 mg daclatasvir once daily plus 200 mg asunaprevir twice daily for 24 wk. We divided the patients into two groups of 56 elderly patients (≥ 75 years-old) and 141 non-elderly patients (< 75 years old) and compared the efficacy and safety.

RESULTS

Ninety-one point one percent of elderly patients and 90.1% of non-elderly patients achieved sustained virological response at 24 wk (SVR). In the former, 1.8% experienced viral breakthrough, as compared with 3.5% in the latter (not significant). Adverse events occurred in 55.4% of the former and 56.0% of the latter. In the former, 7 cases (12.5%) were discontinued due to adverse events, and in the latter 9 cases were discontinued (6.4%, not significant).

CONCLUSION

Dual therapy with daclatasvir and asunaprevir achieved the same high rates of SVR in HCV elderly patients without more adverse events than in the non-elderly patients.

摘要

目的

多中心调查在老年丙型肝炎病毒(HCV)患者中使用达卡他韦和阿舒瑞韦联合治疗的疗效和安全性。

方法

纳入对干扰素不适用/不耐受的患者以及既往聚乙二醇化干扰素/利巴韦林治疗无应答的慢性HCV 1b型感染患者。排除Child B、C级肝硬化患者。患者接受口服直接抗病毒治疗,方案为每日一次60mg达卡他韦加每日两次200mg阿舒瑞韦,疗程24周。我们将患者分为两组,56例老年患者(≥75岁)和141例非老年患者(<75岁),比较疗效和安全性。

结果

91.1%的老年患者和90.1%的非老年患者在24周时达到持续病毒学应答(SVR)。前者1.8%发生病毒突破,后者为3.5%(无显著差异)。前者55.4%发生不良事件,后者为56.0%。前者7例(12.5%)因不良事件停药,后者9例停药(6.4%,无显著差异)。

结论

在HCV老年患者中,达卡他韦和阿舒瑞韦联合治疗达到了与非老年患者相同的高SVR率,且不良事件不比非老年患者多。

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