Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy.
Veterans Health Administration, Office of Academic Affiliations, UC Davis, School of Medicine, Sacramento, CA, USA.
Adv Ther. 2021 Mar;38(3):1397-1403. doi: 10.1007/s12325-021-01636-7. Epub 2021 Feb 16.
The availability of pangenotypic direct-acting antivirals for treatment of hepatitis C (HCV) has provided an opportunity to simplify patient pathways. Recent clinical practice guidelines have recognised the need for simplification to ensure that elimination of HCV as a public health concern remains a priority. Despite the move towards simplified treatment algorithms, there remains some complexity in the recommendations for the management of genotype 3 patients with compensated cirrhosis. In an era where additional clinical trial data are not anticipated, clinical guidance should consider experience gained in real-world settings. Although more experience is required for some pangenotypic therapeutic options, on the basis of published real-world data, there is already sufficient evidence to consider a simplified approach for genotype 3 patients with compensated cirrhosis. The coronavirus disease 2019 (COVID-19) pandemic has highlighted the need to minimise the need for complex patient pathways and clinical practice guidelines need to continue to evolve in order to ensure that patient outcomes remain optimised.
泛基因型直接作用抗病毒药物的出现为丙型肝炎(HCV)的治疗提供了简化患者治疗途径的机会。最近的临床实践指南认识到需要简化治疗方案,以确保消除 HCV 作为公共卫生问题仍然是一个优先事项。尽管朝着简化治疗算法的方向发展,但对于代偿性肝硬化基因型 3 患者的管理建议仍然存在一些复杂性。在不太可能出现额外临床试验数据的时代,临床指导应该考虑在现实环境中获得的经验。尽管某些泛基因型治疗方案需要更多的经验,但根据已发表的真实世界数据,已经有足够的证据考虑对代偿性肝硬化基因型 3 患者采用简化治疗方法。2019 年冠状病毒病(COVID-19)大流行凸显了减少复杂患者治疗途径的必要性,临床实践指南需要不断发展,以确保患者的治疗结果保持最佳。