Ng Xinyi, Nwankwo Chizoba, Arduino Jean Marie, Corman Shelby, Lasch Kathryn Eilene, Lustrino Jacqueline Mary, Patel Sushma, Platt Heather Loryn, Qiu Jingjun, Sperl Jan
Pharmerit International, LP, Bethesda, MD, USA,
Merck & Co. Inc., Kenilworth, NJ, USA.
Patient Prefer Adherence. 2018 Dec 11;12:2631-2638. doi: 10.2147/PPA.S172732. eCollection 2018.
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.
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.
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.
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.
NCT02358044.
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。
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。
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。
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。
NCT02358044。