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接受艾尔巴韦/格拉瑞韦治疗的丙型肝炎病毒感染患者的自我报告结局

Patient-reported outcomes in individuals with hepatitis C virus infection treated with elbasvir/grazoprevir.

作者信息

Ng Xinyi, Nwankwo Chizoba, Arduino Jean Marie, Corman Shelby, Lasch Kathryn Eilene, Lustrino Jacqueline Mary, Patel Sushma, Platt Heather Loryn, Qiu Jingjun, Sperl Jan

机构信息

Pharmerit International, LP, Bethesda, MD, USA,

Merck & Co. Inc., Kenilworth, NJ, USA.

出版信息

Patient Prefer Adherence. 2018 Dec 11;12:2631-2638. doi: 10.2147/PPA.S172732. eCollection 2018.

Abstract

PURPOSE

People chronically infected with hepatitis C virus (HCV) have diminished patient-reported outcomes (PROs). This study aimed to compare the impact of elbasvir/grazoprevir (EBR/GZR) treatment versus sofosbuvir with pegylated interferon and ribavirin (SOF/PR) on changes in PROs: 1) during the treatment period and 2) at posttreatment follow-up.

PATIENTS AND METHODS

PRO data collected during the Phase III C-EDGE Head-2-Head (H2H) open-label study was analyzed. In this trial, patients infected with HCV were randomized 1:1 to receive either EBR/GZR or SOF/PR for 12 weeks. Patients self-administered the Short Form-36 version 2 (SF-36v2) Health Survey Acute (1-week recall) Form and the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) Scale at baseline, during treatment, and posttreatment. Between-group differences in mean change of PRO scores from baseline were estimated during the treatment period and also at the posttreatment follow-up. Effect sizes were calculated to evaluate if the detected change in mean PRO scores is clinically meaningful between groups.

RESULTS

There were 255 patients (99.2% White, 54.1% female, 74.9% treatment naïve) included in the analysis. During the treatment period, significant declines in SF-36v2 scores were observed across all domains for the SOF/PR group. Compared to the SOF/PR group, the EBR/GZR group reported more improvement in scores across all SF-36v2 domain scores at the end of the treatment period. At treatment week 12, the between-group differences for 6 out of the 8 domain scores for these patients reflected at least moderate effects (effect sizes >0.5). No significant between-group differences in change in SF-36v2 scores from baseline were detected posttreatment. The decline in SF-36v2 scores observed during the treatment period for the SOF/PR group returned to near baseline scores or above posttreatment. Treatment with EBR/GZR did not impact fatigue scores, but treatment with SOF/PR led to increased fatigue scores during treatment which resolved by posttreatment follow-up week 12.

CONCLUSION

This study demonstrated that HCV treatment with EBR/GZR resulted in a significantly better PRO profile as compared to SOF/PR. PROs are an important consideration as worsening PROs experienced during treatment may negatively influence adherence and ultimately contribute to an unfavorable clinical outcome.

CLINICALTRIALSGOV IDENTIFIER

NCT02358044.

摘要

目的

丙型肝炎病毒(HCV)慢性感染患者的患者报告结局(PRO)有所下降。本研究旨在比较艾尔巴韦/格拉瑞韦(EBR/GZR)治疗与索磷布韦联合聚乙二醇干扰素及利巴韦林(SOF/PR)治疗对PRO变化的影响:1)治疗期间;2)治疗后随访时。

患者与方法

分析了在III期C-EDGE头对头(H2H)开放标签研究中收集的PRO数据。在该试验中,HCV感染患者按1:1随机分组,接受EBR/GZR或SOF/PR治疗12周。患者在基线、治疗期间和治疗后自行填写简短36项健康调查简表第2版(SF-36v2)急性(1周回忆)表和慢性病治疗功能评估-疲劳(FACIT-疲劳)量表。在治疗期间以及治疗后随访时,估计两组PRO评分相对于基线的平均变化差异。计算效应量以评估两组间PRO评分均值的检测变化在临床上是否有意义。

结果

分析纳入了255例患者(99.2%为白人,54.1%为女性,74.9%为初治患者)。在治疗期间,SOF/PR组所有领域的SF-36v2评分均显著下降。与SOF/PR组相比,EBR/GZR组在治疗期末所有SF-36v2领域评分的改善更为明显。在治疗第12周时,这些患者8个领域评分中的6个领域评分的组间差异反映出至少为中度效应(效应量>0.5)。治疗后未检测到两组间SF-36v2评分相对于基线的变化有显著差异。SOF/PR组在治疗期间观察到的SF-36v2评分下降在治疗后恢复到接近基线评分或高于基线评分。EBR/GZR治疗未影响疲劳评分,但SOF/PR治疗导致治疗期间疲劳评分增加,在治疗后随访第12周时恢复正常。

结论

本研究表明,与SOF/PR相比,EBR/GZR治疗HCV可显著改善PRO。PRO是一个重要的考虑因素,因为治疗期间PRO恶化可能对依从性产生负面影响,并最终导致不良临床结局。

临床试验注册号

NCT02358044。

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