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德国单一中心研究索磷布韦/维帕他韦和来迪派韦/索磷布韦治疗丙型肝炎的真实世界疗效和安全性。

Real-world effectiveness and safety of sofosbuvir/velpatasvir and ledipasvir/sofosbuvir hepatitis C treatment in a single centre in Germany.

机构信息

Asklepios Klinik St. Georg Haus L, IFI Institut für Interdisziplinäre Medizin, Hamburg, Germany.

Amaris Consulting, London, United Kingdom.

出版信息

PLoS One. 2019 Apr 4;14(4):e0214795. doi: 10.1371/journal.pone.0214795. eCollection 2019.

Abstract

BACKGROUND

Newer direct-acting antiviral therapies are increasingly becoming the therapy of choice in patients with hepatitis C virus (HCV) infection. Here, we report the safety and effectiveness of sofosbuvir/velpatasvir (SOF/VEL) and ledipasvir/sofosbuvir (LDV/SOF) in real-world cohorts in Germany.

METHODS

Patients initiated on SOF/VEL 12 weeks or LDV/SOF 8, 12 or 24 weeks regimens in a single German centre were included in this study. Data on treatment outcomes and adverse events (AE) were analysed in patients with available sustained virologic response 12 weeks after cessation of treatment (SVR12) information overall and by subgroups.

RESULTS

This study included 115 patients who received SOF/VEL from July-2016 to July-2017, and 249 patients who received LDV/SOF from November-2014 to September-2015. Overall, SVR12 was achieved in 99% of patients on SOF/VEL ± ribavirin 12 weeks independent of HCV genotype, treatment history, or cirrhosis status, and in 96% of patients treated with LDV/SOF 8 weeks or LDV/SOF ± ribavirin 12 or 24 weeks. In genotype 1 treatment-naïve, non-cirrhotic patients, ≥99% achieved SVR12 across SOF/VEL and LDV/SOF regimens. Likewise, 100% of genotype 3-cirrhotic patients on SOF/VEL ± ribavirin regimens achieved SVR12. Grade 3/4 AE were reported in 13 (5.2%) patients on LDV/SOF and in 1 (<1%) patient on SOF/VEL.

CONCLUSION

Overall, SOF/VEL and LDV/SOF achieved high SVR rates in a broad patient population. We showed the effectiveness of SOF/VEL as a pan-genotypic regimen, and regardless of treatment history or cirrhosis status. Use of such therapies improves outcomes and contributes towards the global efforts to eradicate HCV.

摘要

背景

新型直接作用抗病毒药物在丙型肝炎病毒(HCV)感染患者中越来越成为治疗选择。在此,我们报告了在德国真实队列中使用索磷布韦/维帕他韦(SOF/VEL)和达卡他韦/索磷布韦(LDV/SOF)的安全性和有效性。

方法

在单一德国中心,纳入了接受 SOF/VEL 12 周或 LDV/SOF 8、12 或 24 周治疗方案的患者。对所有患者和亚组患者治疗结局和不良反应(AE)进行了分析。

结果

这项研究包括了 115 名在 2016 年 7 月至 2017 年 7 月期间接受 SOF/VEL 治疗的患者,以及 249 名在 2014 年 11 月至 2015 年 9 月期间接受 LDV/SOF 治疗的患者。SOF/VEL 联合利巴韦林 12 周治疗的患者总体上和按 HCV 基因型、治疗史或肝硬化状态分层的患者中,99%实现了 SVR12;LDV/SOF 8 周或 LDV/SOF 联合利巴韦林 12 或 24 周治疗的患者中,96%实现了 SVR12。在基因型 1 初治非肝硬化患者中,SOF/VEL 和 LDV/SOF 方案的 SVR12 率均≥99%。同样,SOF/VEL 联合利巴韦林方案的基因型 3 肝硬化患者 100%实现了 SVR12。LDV/SOF 组有 13 例(5.2%)患者和 SOF/VEL 组有 1 例(<1%)患者报告了 3/4 级 AE。

结论

SOF/VEL 和 LDV/SOF 在广泛的患者人群中实现了高 SVR 率。我们证明了 SOF/VEL 作为一种泛基因型方案的有效性,并且与治疗史或肝硬化状态无关。这些治疗方法的应用改善了治疗结局,并为全球消除 HCV 的努力做出了贡献。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2044/6448908/fa784f50e278/pone.0214795.g001.jpg

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