Department of Internal Medicine, Brain Korea 21 Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea.
Department of Internal Medicine, Konkuk University Hospital, Seoul, Korea.
Gut Liver. 2020 May 15;14(3):368-376. doi: 10.5009/gnl18100.
BACKGROUND/AIMS: Chronic hepatitis C virus (HCV) infections put patients at risk of serious liver disease and adversely affects patient quality of life (QoL). MOSAIC (International Multicenter Prospective Observational Study to Evaluate the Epidemiology, Humanistic and Economic Outcomes of Treatment for Chronic Hepatitis C Virus) was a prospective, non-interventional, international, multicenter study that aimed to describe the epidemiology of the infection, the impact of the infection on health-related QoL (HRQoL) and daily activities, and healthcare resource use related to HCV and treatment. Here, we present the results on HRQoL and daily activity impairment in consecutively enrolled South Korean patients treated with interferon (IFN)-containing regimens prospectively followed for up to 48 weeks.
General HRQoL, HCV-specific HRQoL, perceived health state, and work/general activity impairments were measured using the EuroQoL 5-dimension 5-level (EQ-5D-5L), HCV patient-reported outcomes (HCV-PRO), EQ-5D Visual Analog Scale, and Work Productivity and Activity Impairment questionnaires, respectively.
Thirty-three of the 100 enrolled patients initiated IFN-based treatment, with an intended duration of 24 weeks for 20 patients and 48 weeks for 12 patients; this information was missing for one patient. Fourteen patients (42.4%) prematurely withdrew. After treatment initiation, IFN-treated patients showed a trend towards deterioration of both general (baseline: 0.87±0.103, week 4: 0.77±0.153) and HCV-specific (baseline: 76.2±19.5, week 4: 68.2±22.3) HRQoL. The scores recovered somewhat towards the end of treatment (EOT) (0.84±0.146 for EQ-5D-5L and 70.8±21.9 for HCV-PRO). The perceived health state and work/general activity impairment displayed similar temporal patterns.
Initiating IFN-based treatment prompted some deterioration in general and HCV-related HRQoL, accompanied by impaired daily activities and most work productivity measures; however, the HRQoL and productivity scores improved towards the EOT. HRQoL impairment upon treatment initiation likely contributed to treatment discontinuation.
背景/目的:慢性丙型肝炎病毒(HCV)感染使患者面临严重肝脏疾病的风险,并对患者的生活质量(QoL)产生不利影响。MOSAIC(评估慢性丙型肝炎病毒治疗的流行病学、人文和经济结局的国际多中心前瞻性观察研究)是一项前瞻性、非干预性、国际性、多中心研究,旨在描述感染的流行病学,感染对健康相关生活质量(HRQoL)和日常活动的影响,以及与 HCV 和治疗相关的医疗资源使用。在这里,我们介绍了连续纳入的接受干扰素(IFN)为基础的治疗的韩国患者的 HRQoL 和日常活动障碍的结果,这些患者前瞻性地随访了长达 48 周。
使用 EuroQoL 五维 5 级量表(EQ-5D-5L)、丙型肝炎患者报告结局(HCV-PRO)、EQ-5D 视觉模拟量表和工作生产力和活动障碍问卷,分别测量一般 HRQoL、HCV 特异性 HRQoL、感知健康状况和工作/一般活动障碍。
100 名纳入患者中有 33 名开始接受 IFN 为基础的治疗,20 名患者的预期治疗时间为 24 周,12 名患者的预期治疗时间为 48 周;一名患者的信息缺失。14 名患者(42.4%)提前退出。治疗开始后,IFN 治疗组患者的一般(基线:0.87±0.103,第 4 周:0.77±0.153)和 HCV 特异性(基线:76.2±19.5,第 4 周:68.2±22.3)HRQoL 均呈下降趋势。在治疗结束时(EOT),评分有所恢复(EQ-5D-5L 为 0.84±0.146,HCV-PRO 为 70.8±21.9)。感知健康状况和工作/一般活动障碍呈现出相似的时间模式。
开始 IFN 为基础的治疗会导致一般和 HCV 相关的 HRQoL 恶化,同时伴有日常活动和大多数工作生产力测量的障碍;然而,HRQoL 和生产力评分在 EOT 时有所改善。治疗开始时的 HRQoL 损害可能导致治疗中断。