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在台湾地区,HCV 基因型 1 患者接受 Elbasvir/Grazoprevir 治疗的疗效和安全性。

The efficacy and safety of elbasvir/grazoprevir treatment in HCV genotype 1 patients in Taiwan.

机构信息

Department of Pharmacy, Chang Gung Memorial Hospital, Taoyuan, Taiwan.

Department of Long Term Care, Hsin Sheng College of Medical Care and Management, Taoyuan, Taiwan.

出版信息

J Med Virol. 2020 Feb;92(2):219-226. doi: 10.1002/jmv.25605. Epub 2019 Oct 22.

Abstract

BACKGROUND

Elbasvir/grazoprevir (EBR/GZR) is a new generation, fixed-dose, combination antiviral drug used in chronic hepatitis C virus (HCV) genotype (GT) 1 or 4 infection. Our study evaluates the clinical efficacy and safety of EBR/GZR after its launch in Taiwan.

METHODS

This is a retrospective observational study. Patients who had received EBR/GZR for chronic HCV GT 1 between June 2017 and April 2018 were recruited. Patients' age, sex, HCV GT, changes in HCV RNA level before and after treatment, sustained virologic response 12 weeks (SVR12) after the cessation of drug administration, side effects, and interaction effects were used to evaluate the clinical efficacy and safety.

RESULTS

A total of 149 patients were recruited. Of them, 145 (97.3%) had HCV GT 1b, and the rest had HCV GT 1a; most of the EBR/GZR-related side effects in this study were mild. Three participants were discontinued because their alanine transaminase levels were elevated to over 10 times the upper limit of normal. The therapeutic effect analyses revealed a rapid virologic response rate of 95.3% and an SVR12 rate of 98%. Subgroup analyses performed using SVR12 as the outcome variable revealed three demographic factors HCV GT 1, hepatocellular carcinoma medical history, and noncirrhosis plus HCV RNA level.

CONCLUSIONS

This study confirmed that EBR/GZR is safe and effective for treating patients with HCV GT 1 and exhibited excellent overall clinical efficacy in Taiwan. The therapeutic effects are unrelated to factors such as sex, HCV RNA level before treatment, and history of liver cirrhosis.

摘要

背景

Elbasvir/grazoprevir(EBR/GZR)是一种新型、固定剂量的联合抗病毒药物,用于治疗慢性丙型肝炎病毒(HCV)基因型(GT)1 或 4 感染。本研究评估了 EBR/GZR 在台湾上市后的临床疗效和安全性。

方法

这是一项回顾性观察性研究。招募了 2017 年 6 月至 2018 年 4 月期间接受 EBR/GZR 治疗慢性 HCV GT1 的患者。使用患者的年龄、性别、HCV GT、治疗前后 HCV RNA 水平的变化、停药后 12 周持续病毒学应答(SVR12)、不良反应以及相互作用效应来评估临床疗效和安全性。

结果

共招募了 149 名患者。其中 145 名(97.3%)患者的 HCV GT 为 1b,其余患者的 HCV GT 为 1a;本研究中大多数 EBR/GZR 相关的不良反应为轻度。有 3 名患者因丙氨酸氨基转移酶水平升高超过正常值上限的 10 倍而停药。疗效分析显示快速病毒学应答率为 95.3%,SVR12 率为 98%。以 SVR12 为结局变量进行的亚组分析显示了 3 个人口统计学因素:HCV GT 1、肝癌病史和非肝硬化合并 HCV RNA 水平。

结论

本研究证实 EBR/GZR 治疗 HCV GT1 患者安全有效,在台湾具有优异的总体临床疗效。治疗效果与性别、治疗前 HCV RNA 水平和肝硬化病史等因素无关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9efe/6916308/c18782292faa/JMV-92-219-g001.jpg

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