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8 周 glecaprevir/pibrentasvir 在初治代偿性肝硬化 HCV 患者中的疗效和安全性:来自台湾全国 HCV 注册登记的真实世界经验。

Effectiveness and safety of 8-week glecaprevir/pibrentasvir in HCV treatment-naïve patients with compensated cirrhosis: real-world experience from Taiwan nationwide HCV registry.

机构信息

Division of Hepatogastroenterology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan.

College of Medicine, Chang Gung University, Taoyuan, Taiwan.

出版信息

Hepatol Int. 2023 Jun;17(3):550-561. doi: 10.1007/s12072-023-10506-z. Epub 2023 Mar 27.

Abstract

BACKGROUND

Large-scale real-world data of the 8-week glecaprevir/pibrentasvir (GLE/PIB) therapy for treatment-naïve patients of chronic hepatitis C virus (HCV) infection with compensated cirrhosis is scarce.

METHODS

The TASL HCV Registry (TACR) is an ongoing nationwide registry program that aims to set up a database and biobank of patients with chronic HCV infection in Taiwan. In this study, data were analyzed as of 31 October 2021 for treatment-naïve HCV patients with compensated cirrhosis receiving 8-week GLE/PIB therapy. Effectiveness reported as sustained virologic response at off-therapy week 12 (SVR12) and safety profiles were assessed. Patient characteristics potentially related to SVR12 were also evaluated.

RESULTS

Of the 301 patients enrolled, 275 had available SVR12 data. The SVR12 rate was 98.2% (270/275) in the modified intention-to-treat (mITT) population and 89.7% (270/301) in the ITT population. For those mITT patients with genotype 3, FibroScan > 20 kPa, platelet < 150,000/µl, and FibroScan > 20 kPa and platelet < 150,000/µl, the SVR12 rates were 100% (6/6), 100% (12/12), 98.0% (144/147), 100% (7/7), respectively. Overall, 24.9% (75/301) patients experienced adverse events (AEs). The most frequent AEs (> 5%) included fatigue (9.0%) and pruritus (7.0%). Seven (2.3%) patients experienced serious AEs and two (0.7%) resulted in permanent drug discontinuation. None of them were considered as GLE/PIB-related.

CONCLUSIONS

In this large-scale real-world Taiwanese cohort, 8-week GLE/PIB therapy was efficacious and well tolerated for treatment-naïve compensated cirrhosis patients. SVR12 rates were similarly high as in the clinical trials, including those with characteristics of advanced liver disease.

摘要

背景

大规模真实世界数据显示,初治代偿性肝硬化慢性丙型肝炎病毒(HCV)感染患者接受 8 周 glecaprevir/pibrentasvir(GLE/PIB)治疗的疗效有限。

方法

TASL HCV 登记处(TACR)是一个正在进行的全国性登记计划,旨在建立一个数据库和生物库,收集台湾慢性 HCV 感染患者的数据。本研究分析了截至 2021 年 10 月 31 日接受 8 周 GLE/PIB 治疗的初治代偿性肝硬化 HCV 患者的数据。评估了治疗结束后 12 周的持续病毒学应答(SVR12)疗效和安全性。还评估了与 SVR12 相关的患者特征。

结果

301 名患者中,275 名有可用的 SVR12 数据。在改良意向治疗(mITT)人群中,SVR12 率为 98.2%(270/275),在 ITT 人群中为 89.7%(270/301)。对于 mITT 基因型 3 患者,FibroScan>20kPa、血小板<150,000/μl、FibroScan>20kPa 和血小板<150,000/μl,SVR12 率分别为 100%(6/6)、100%(12/12)、98.0%(144/147)、100%(7/7)。总体而言,24.9%(75/301)的患者发生不良事件(AE)。最常见的 AE(>5%)包括疲劳(9.0%)和瘙痒(7.0%)。7 例(2.3%)患者发生严重不良事件,2 例(0.7%)患者永久停药。均与 GLE/PIB 无关。

结论

在这项大规模的真实世界台湾队列研究中,8 周 GLE/PIB 治疗对初治代偿性肝硬化患者有效且耐受性良好。SVR12 率与临床试验相似,包括那些具有晚期肝病特征的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e68e/10042416/d2d605b7aea6/12072_2023_10506_Fig1_HTML.jpg

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