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土耳其真实世界数据:索磷布韦/达卡他韦联合或不联合利巴韦林治疗慢性丙型肝炎是否真的有效?

Real-World Data from Turkey: Is Sofosbuvir/Ledipasvir With or Without Ribavirin Treatment for Chronic Hepatitis C Really Effective?

机构信息

Department of Infectious Disease and Clinical Microbiology, Afyon Saglik Bilimleri University Medical Faculty, Afyonkarahisar, Turkey.

Department of Infectious Disease and Clinical Microbiology, Erciyes University Medical Faculty, Kayseri, Turkey.

出版信息

Turk J Gastroenterol. 2021 Feb;32(2):155-163. doi: 10.5152/tjg.2020.19569.

Abstract

BACKGROUND

In this study, we aimed to investigate the efficacy and safety of sofosbuvir-based therapies in the treatment of chronic hepatitis C in real-world clinical practice.

METHODS

Data from patients with chronic hepatitis C treated with SOF/LDV ± RBV or SOF/RBV in 31 centers across Turkey between April 1, 2017, and August 31, 2018, were recorded in a nationwide database among infectious disease specialists. Demographics, clinical, and virological outcomes were analyzed.

RESULTS

A total of 552 patients were included in the study. The mean age of the patients was 51.28 ± 14.2, and 293 (55.8%) were female. The majority had HCV genotype 1b infection (65%), 75.04% of the patients underwent treatment, and non-cirrhosis was present at baseline in 381 patients (72.6%). SOF/LDV ± RBV treatment was given to 477 patients and 48 patients received SOF/RBV according to HCV genotype. The total SVR12 rate was 99% in all patients. Five patients experienced disease relapse during the study and all of them were genotype 2. In patients infected with HCV GT2, SVR12 was 77.3%. SVR was 100% in all patients infected with other HCV genotypes. All treatments were well tolerated by patients without causing severe adverse events. Side effects and side effects-associated treatment discontinuation rates were 28.2% and 0.4%, respectively. Weakness (13.7%) was the common side effect.

CONCLUSION

The present real-world data of 525 patients with HCV genotypes 1, 1a, 1b, 3, 4, and 5 who underwent SOF/LDV ± RBV treatment in Turkey demonstrated a high efficacy and safety profile. HCV GT2 patients should be treated with more efficacious treatment.

摘要

背景

在这项研究中,我们旨在研究在真实临床实践中基于索非布韦的治疗方案在慢性丙型肝炎治疗中的疗效和安全性。

方法

2017 年 4 月 1 日至 2018 年 8 月 31 日期间,土耳其 31 个中心的传染病专家在一个全国性数据库中记录了接受 SOF/LDV ± RBV 或 SOF/RBV 治疗的慢性丙型肝炎患者的数据。分析了人口统计学、临床和病毒学结局。

结果

共有 552 名患者纳入研究。患者的平均年龄为 51.28 ± 14.2 岁,293 名(55.8%)为女性。大多数患者感染 HCV 基因型 1b(65%),75.04%的患者接受了治疗,381 名(72.6%)患者基线时无肝硬化。477 名患者接受 SOF/LDV ± RBV 治疗,根据 HCV 基因型,48 名患者接受 SOF/RBV 治疗。所有患者的总 SVR12 率为 99%。研究期间,5 名患者出现疾病复发,均为基因型 2。HCV GT2 感染患者的 SVR12 为 77.3%。所有其他 HCV 基因型感染患者的 SVR 均为 100%。所有治疗均被患者耐受良好,未引起严重不良事件。不良反应和因不良反应而停药的发生率分别为 28.2%和 0.4%。乏力(13.7%)是常见的不良反应。

结论

本研究为土耳其 525 例接受 SOF/LDV ± RBV 治疗的 HCV 基因型 1、1a、1b、3、4 和 5 患者的真实世界数据,显示了高疗效和安全性。HCV GT2 患者应接受更有效的治疗。

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EASL Recommendations on Treatment of Hepatitis C 2018.2018年欧洲肝脏研究学会丙型肝炎治疗推荐意见
J Hepatol. 2018 Aug;69(2):461-511. doi: 10.1016/j.jhep.2018.03.026. Epub 2018 Apr 9.

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