Division of Gastroenterology and Hepatology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan.
Department of Gastroenterology, Miyazaki Medical Center Hospital, Miyazaki, Japan.
BMC Gastroenterol. 2022 Apr 28;22(1):210. doi: 10.1186/s12876-022-02284-z.
It is estimated that approximately 50% of patients with hepatitis C virus (HCV) infection in Japan are currently over 75 years old. However, patients aged ≥ 75 years are typically underrepresented in clinical trials of direct-acting antivirals. This study aimed to evaluate the efficacy and safety of glecaprevir and pibrentasvir (G/P) treatment in Japanese patients with HCV infection aged ≥ 75 years.
This multicenter, retrospective study included 271 Japanese patients with HCV infection from 12 centers in Miyazaki Prefecture, Japan. Demographic, clinical, virological, and adverse events (AEs) data obtained during and after G/P treatment were collected from medical records. The patients were divided into two groups: younger (n = 199, aged < 75 years) and older (n = 72, aged ≥ 75 years). Virological data and AEs were analyzed according to the age group.
In intention-to-treat (ITT) and per-protocol analyses, the overall sustained virological response 12 (SVR12) rates were 93% and 98.8%, respectively. Two patients in the older group and 14 patients in the younger group dropped out before SVR12 assessment. Although patients in the older group tended to have liver cirrhosis, 95.8% in the older group and 92% in the younger group achieved SVR12 in the ITT analysis (P = 0.404). In total, 48 (17.7%) patients experienced treatment-related AEs. Common AEs during treatment included pruritus, headache, and fatigue. The AEs were not significantly different between the two groups.
Compared with younger patients, older patients showed similar virological response and tolerance to G/P treatment.
据估计,日本约有 50%的丙型肝炎病毒(HCV)感染患者目前年龄超过 75 岁。然而,在直接作用抗病毒药物的临床试验中,年龄≥75 岁的患者通常代表性不足。本研究旨在评估 glecaprevir 和 pibrentasvir(G/P)治疗日本≥75 岁 HCV 感染患者的疗效和安全性。
这是一项多中心、回顾性研究,纳入了来自日本宫崎县 12 个中心的 271 例日本 HCV 感染患者。从病历中收集了 G/P 治疗期间和之后获得的人口统计学、临床、病毒学和不良事件(AE)数据。将患者分为两组:年轻组(n=199,年龄<75 岁)和老年组(n=72,年龄≥75 岁)。根据年龄组分析病毒学数据和 AE。
在意向治疗(ITT)和符合方案分析中,总的持续病毒学应答 12(SVR12)率分别为 93%和 98.8%。老年组中有 2 例和年轻组中有 14 例在 SVR12 评估前退出。尽管老年组患者倾向于患有肝硬化,但在 ITT 分析中,老年组和年轻组分别有 95.8%和 92%的患者达到 SVR12(P=0.404)。共有 48(17.7%)例患者发生与治疗相关的 AE。治疗期间常见的 AE 包括瘙痒、头痛和疲劳。两组之间的 AE 无显著差异。
与年轻患者相比,老年患者对 G/P 治疗的病毒学反应和耐受性相似。